Altay ÇELEBİ, GÖKTUĞ ŞİRİN, Uğur KORKMAZ, Öğütmen Deniz KOÇ, Ömer ŞENTÜRK, SADETTİN HÜLAGÜ

Özofagusun 24 saatlik pH-metre izlemine hastanın vücut kitle indeksinin etkisi var mı?

Giriş ve Amaç: Gastroözefageal reflü hastalığı ve obezite önemli sağlık problemlerindendir. Obezite ve gastroözofageal reflü hastalığı arasındaki ilişki konusunda yapılan çalışma sonuçları çelişkilidir. Özofagusun 24 saatlik pH-izlemi gastroözofageal reflü hastalığı tanısında kullanılan yüksek spesifiteye sahip en objektif tanı yöntemidir. Bu çalışmamızı, gastroözofageal reflü hastalığı nedeniyle pH-metre yapılan hastalarımızda vücut kitle indeksi ile pH-metre verileri arasında bir ilişki olup olmadığını araştırmak için retrospektif olarak planladık. Gereç ve Yöntem: Özofagusun 24 saatlik pH-metre izleminin yapıldığı 207 hasta değerlendirildi. Hastaların demografik verileri ve pH-metre kayıtları incelendi. Vücut kitle indeksi ile 24 saatlik özofageal pH ölçüm parametreleri arasında korelasyon analizi yapıldı. Ardından hastalar Dünya Sağlık Örgütü’nün vücut kitle indeksi kategorilerine göre gruplara ayrıldı ve pH-izlem parametreleri açısından gruplar arasında fark olup olmadığı araştırıldı. Bulgular: Hastaların 93 tanesi erkek (%45), 114 tanesi kadındı (%55) ve yaş ortalamaları 42 ± 12 yıldı (18-74 yaş arasında). Vücut kitle indeksi < 25 olan hasta grubu ile ≥25 olan hasta grubu karşı- laştırıldığında özofageal pH ölçüm parametrelerinden reflü sayısı, uzun reflü sayısı, pH < 4 zaman yüzdesi ve total DeMeester skoru vücut kitle indeksi ≥25 olan grupta istatiksiksel olarak anlamlı derecede fazla bulundu. Sonuç: Asit reflü sayısı, uzun asit reflü sayısı, pH < 4 fraksiyone zaman ve total pH-metre skoru normal kilolu hasta grubunda fazla kilolu ve obez hastalardan anlamlı olarak düşük bulundu

Anahtar Kelimeler:

VKİ, pH-metre, GÖRH

Does body mass index have any impact on 24-hour esophageal pH monitoring results?

Background and Aims: Gastroesophageal reflux disease and obesity are increasingly important health problems. The literature on the relationship between gastroesophageal reflux disease and obesity is conflicting. The most objective method of defining gastroesophageal reflux disease is 24-hour esophageal pH monitoring, which has a high specificity. We planned this retrospective study to investigate if there is a relationship between body mass index (BMI) and pH monitoring data in patients with gastroesophageal reflux disease. Materials and Methods: Data of 207 patients who underwent 24-hour esophageal pH monitoring were analyzed. The demographic characteristics and pH monitoring records were evaluated. The correlation between body mass index and 24-hour esophageal pH monitoring parameters was investigated. The World Health Organization categories of body mass index were used to group the patients. The esophageal 24-hour pH monitoring parameters were compared between body mass index groups. Results: Of the 207 patients, 93 were male (45%), 114 were female (55%) and the mean age was 42 ± 12 (range: 18-74 years). Patients with body mass index

Keywords:

Body mass index, pH-monitoring, gastroesophageal reflux disease,

PDF

___

Locke GR, Talley NJ, Fett SL, et al. Prevalence and clinical spectrum of gastroesophageal reflux: A population-based study in olmsted county, Minnesota. Gastroenterology 1997;112:1448-56.
Bor S, Mandiracioglu A, Kitapcioglu G, et al. Gastroesophageal reflux in a low-income region in Turkey. Am J Gastroenterol 2005; 100:744-54.
Flegal KM, Carroll MD, Ogden CL, et al. Prevalence and trends in obesity among US adults, 1999–2000. JAMA 2002;288:1723–27.
Ogden CL, Carroll MD, Curtin LR, et al. Prevalence of overweight and obesity in the United States, 1999–2004. JAMA 2006;295: 1549–55.
Corley DA, Kubo A. Body mass index and gastroesophageal reflux disease: a systematic review and meta-analysis. Am J Gastroenterol 2006;108:2619–28.
El-Serag HB, Graham DY, Satia JA, et al. Obesity is an independent risk factor for GERD symptoms and erosive esophagitis. Am J Gastroenterol 2005;100: 1243–50.
Edelstein ZR, Farrow DC, Bronner MP, et al. Central adiposity and risk of Barrett’s esophagus. Gastroenterology 2007; 133: 403–11.
Lagergren J, Bergstrom R, Nyren O. Association between body mass and adenocarcinoma of the esophagus and gastric cardia. Ann Intern Med 1999; 130: 883–90.
Hampel H, Abraham NS, El-Serag HB. Meta-analysis: obesity and the risk for gastroesophageal reflux disease and its complications. Ann Intern Med 2005; 143: 199–211.
Nam SY, Choi IJ, Nam BH, et al. Obesity and weight gain as risk factors for erosive oesophagitis in men. Aliment Pharm Ther 2009; 29:1042-52
Dent J, El-Serag HB, Wallander MA, et al. Epidemiology of gastrooesophageal reflux disease: a systematic review. Gut 2005; 54: 710–7.
Murray L, Johnston B, Lane A, et al. Relationship between body mass and gastrooesophageal reflux symptoms: the Bristol Helicobacter Project. Int J Epidemiol 2003; 32:645–50.
Lagergren J, Bergstrom R, Nyren O. No relation between body mass and gastro- esophageal reflux symptoms in a Swedish population based study. Gut 2000;47:26–9.
Abnet CC, Freedman ND, Hollenbeck AR, et al. A prospective study of BMI and risk of oesophageal and gastric adenocarcinoma. Eur J Cancer 2008;44:465–71.
El-Serag HB, Tran T, Richardson P,et al. Anthropometric correlates of intragastric pressure. Scand J Gastroenterol 2006; 41:887–91
Pandolfino JE, El-Serag HB, Zhang Q, et al. Obesity: a challenge to esophagogastric junction integrity. Gastroenterology 2006; 130:639–49.
Holloway RH, Hongo M, Berger K, et al. Gastric distention: a mechanism for postprandial gastroesophageal reflux. Gastroenterology 1985;89:779–84.
Wu JC, Mui LM, Cheung CM, et al. Obesity is associated with increased transient lower esophageal sphincter relaxation. Gastroenterology 2007; 132:883–9.
Herbella FA, Sweet MP, Tedesco P, et al. Gastroesophageal reflux disease and obesity: pathophysiology and implications for treatment. J Gastrointest Surg 2007; 11:286–90.
Ayazi S, Hagen JA, Chan LS, et al. Obesity and gastroesophageal reflux: quantifying the association between body mass index, esophageal acid exposure, and lower esophageal sphincter status in a large series of patients with reflux symptoms. J Gastrointest Surg 2009;13: 1440-7.
Kramer CK, von Mühlen D, Gross JL, et al. Study of abdominal obesity and coronary artery calcium progression in older adults. J Clin Endocrinol Metab. 2009 Oct 21. [Epub ahead of print].
Irace C, Scavelli F, Carallo C, et al. Body mass index, metabolic syndrome and carotid atherosclerosis. Coron Artery Dis. 2009; 20:94-9.
Orlando RC. Esophageal epithelial resistance. J Clin Gastroenterol. 1986; 8 Suppl 1:12-6.
Iwakiri K, Kobayashi M, Kotoyori M, et al. Relationship between postprandial esophageal acid exposure and meal volume and fat content. Dig Dis Sci 1996;41:926–930.
Colombo P, Mangano M, Bianchi PA, et al. Effect of calories and fat on postprandial gastro-oesophageal reflux. Scand J Gastroenterol 2002;37:3–5.