Sex differences in risk factors for future onset of reflux esophagitis

概要

Background: Reflux esophagitis (RE) is known to be more prevalent in males, and previous studies have suggested sex differences in its risk factors. However, little is known about sex differences in the time-course of risk factors before RE onset. Thus, we conducted a retrospective longitudinal study using health checkup records of 10 years from nine institutes in Japan.

Methods: From the health checkup records, we selected RE cases whose records existed before RE onset and age- and sex-matched controls who had no history of RE. The dataset was divided into male and female sub-datasets, and the time-courses of risk factors for RE were compared between the case and control groups for males and females.

Results: From initial data of 230,056 individuals, 1,558 male RE cases, 3,116 male controls, 508 female RE cases, and 1,016 female controls were finally selected. We identified abdominal circumference (AC), diastolic blood pressure, alanine transaminase (ALT), and current smoking in males and body mass index (BMI) in females as sex-specific risk factors. We also found that AC and ALT in males and BMI in females were significantly different between the RE case and control groups during the five years before RE onset.

Conclusions: Our results suggest that visceral fat-type obesity and fatty liver in males and higher BMI in females are more frequently observed in RE cases several years before RE onset, and that proactive intervention to lifestyle, including dietary and exercise habits, can help prevent RE in both males and females.

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