Increased risk of concurrent gastroesophageal reflux disease among patients with Sjogren's syndrome: A nationwide population-based study

Background: Little data is available on the risk of gastroesophageal reflux disease in patients diagnosed with Sjogren's syndrome. Methods: We identified 4650 Sjogren's syndrome patients between 2000 and 2011 from the National Health Insurance Research Database. Each Sjogren's syndrome patient was matched to 4 controls based on age, sex, and index year, and all subjects were followed up from the index date to December 31, 2011. Cox proportional hazards regression model was used to estimate the risk of gastroesophageal reflux disease. Results: The risk of gastroesophageal reflux disease for Sjogren's syndrome patients was 2.41-fold greater than that for the comparison cohort after adjusting for age, sex, and comorbidities. In age stratified analyses, the youngest Sjogren's syndrome cohort (age: 20-44 years old) had the highest risk (HR=3.02; 95% CI=2.48-3.69) and the lowest risk at age >= 65 years (HR=1.95; 95% CI=1.61-2.36). Regardless of in subjects with and without comorbidity, Sjogren's syndrome patients had a higher risk than the controls. Sjogren's syndrome subjects with ischemic heart disease, hyperlipidemia and renal disease had the highest risk for gastroesophageal reflux disease compared with the comparison cohort without those diseases (HR=7.67; 95% CI=5.32-11.1). Conclusion: Patients with Sjogren's syndrome have a significantly greater risk of developing subsequent gastroesophageal reflux disease than the general population. (C) 2016 European Federation of Internal Medicine. Published by Elsevier B.V. All rights reserved.