Obesity is associated with higher prevalence of gastroesophageal reflux disease and reflux related complications: A global healthcare database study

BackgroundPrior studies have demonstrated that obesity may be associated with the development of gastroesophageal reflux disease (GERD) and GERD-related complications. However, such association has never been assessed in a global-wide real-world patient population.MethodsThe TriNetX electronic health records network, which involves 92 healthcare organizations in 12 countries, was utilized for this multicenter global health research network study. The cohort with obesity comprised adult patients with body mass index (BMI) of more than 30 kg/m2. We performed 1:1 propensity score matching to decrease confounders effects. The prevalence of GERD and GERD-related complications including erosive esophagitis, Barrett's esophagus (BE), BE with dysplasia, and esophageal adenocarcinoma were assessed.ResultsA total of 2,356,548 patients were included in the obesity and non-obesity groups after propensity score matching. In the group with obesity, patients had a significantly higher prevalence of GERD (30% vs. 24%, OR 1.35, 95% CI 1.34-1.36) compared to the group without obesity. Further analysis showed a higher prevalence of GERD-related complications in the group with obesity with statistical significance: Erosive esophagitis (OR 1.07, 95% CI 1.05-1.08), Barrett's esophagus (1.08, 1.05-1.10), BE with dysplasia (1.11, 1.04-1.18), esophageal cancer (1.32, 1.15-1.51).ConclusionGlobally, obesity was associated with a higher prevalence of GERD and GERD-related complications. Our study found a strong link between obesity and a higher prevalence of GERD, erosive esophagitis, BE, and esophageal cancer. The correlation was particularly strong in women and Caucasian individuals. However, the relationship between obesity and esophageal cancer was stronger in men, warranting further investigation into the male-specific mechanisms.image