Gastroesophageal reflux and obesity are both increasing in prevalence. However the evidence for an association between these 2 conditions is sparse.
It has been proposed that this relationship differs between the sexes.
In this study, researchers from Norway and Sweden assessed the relationship between body mass and gastroesophageal reflux symptoms. They also examined how this relation is influenced by female sex hormones.
|Reduction in BMI was associated with decreased risk of reflux symptoms.|
|Journal of the American Medical Association|
The team performed a population-based, cross-sectional, case-control study.
From 65,363 adult survey participants, 3113 reported severe heartburn or regurgitation during the last 12 months. The researchers defined these individuals as cases, while 39,872 participants without reflux symptoms were controls.
The research team identified a dose-response association between increasing body mass index (BMI) and reflux symptoms in both sexes. They found that this association was stronger in women.
They determined that the risk of reflux was increased among severely obese (BMI > 35) men (OR, 3.3) and women (OR, 6.3), when compared with subjects with a BMI < 25.
The researchers also found that the association between BMI and reflux symptoms was stronger in premenopausal women, compared with postmenopausal women. However, the use of postmenopausal hormone therapy increased the strength of the association.
Reduction in BMI was associated with decreased risk of reflux symptoms.
Dr Magnus Nilsson's team concluded, "There is a significant association between body mass and symptoms of gastroesophageal reflux".
"The association is stronger among women, especially premenopausally, and use of hormone therapy strengthens the association, suggesting that estrogens may play an important role in the etiology of reflux disease".