Incidence of gastroesophageal reflux disease in Uygur and Han Chinese adults in Urumqi

Abstract

Aim: To investigate the incidence of gastroesophageal reflux disease (GERD) and its related risk factors in Uygur and Han Chinese adult in Urumqi, China.

Methods: A population-based cross-sectional survey was undertaken in a total of 972 Uygur (684 male and 288 female) aged from 24 to 61 and 1023 Han Chinese (752 male and 271 female) aged from 23 to 63 years. All participants were recruited from the residents who visited hospital for health examination from November 2011 to May 2012. Each participant signed an informed consent and completed a GERD questionnaire (Gerd Q) and a lifestyle-food frequency questionnaire survey. Participants whose Gerd Q score was ≥ 8 and met one of the following requirements would be enrolled into this research: (1) being diagnosed with erosive esophagitis (EE) or Barrett's esophagus (BE) by endoscopy; (2) negative manifestation under endoscopy (non-erosive reflux disease, NERD) with abnormal acid reflux revealed by 24-h esophageal pH monitoring; and (3) suffering from typical heartburn and regurgitation with positive result of proton pump inhibitor test.

Results: According to Gerd Q scoring criteria, 340 cases of Uygur and 286 cases of Han Chinese were defined as GERD. GERD incidence in Uygur was significantly higher than in Han Chinese (35% vs 28%, χ(2) = 11.09, P < 0.005), Gerd Q score in Uygur was higher than in Han Chinese (7.85 ± 3.1 vs 7.15 ± 2.9, P < 0.005), and Gerd Q total score in Uygur male was higher than in female (8.15 ± 2.8 vs 6.85 ± 2.5, P < 0.005). According to normalized methods, 304 (31%) cases of Uygur were diagnosed with GERD, including 89 cases of EE, 185 cases of NERD and 30 cases of BE; 256 (25%) cases of Han Chinese were diagnosed with GERD, including 90 cases of EE, 140 cases of NERD and 26 cases of BE. GERD incidence in Uygur was significantly higher than in Han Chinese (31% vs 25%, χ(2) = 9.34, P < 0.005) while the incidences were higher in males of both groups than in females (26% vs 5% in Uygur, χ(2) = 35.95, P < 0.005, and 19.8% vs 5.2% in Han, χ(2) = 5.48, P < 0.025). GERD incidence in Uygur male was higher than in Han Chinese male (26% vs 19.8%, χ(2) = 16.51, P < 0.005), and incidence of NERD in Uygur was higher than in Han Chinese (χ(2) = 10.06, P < 0.005). Occupation (r = 0.623), gender (r = 0.839), smoking (r = 0.322), strong tea (r = 0.658), alcohol drinking (r = 0.696), meat-based diet (mainly meat) (r = 0.676) and body mass index (BMI) (r = 0.567) were linearly correlated with GERD in Uygur (r = 0.833, P = 0.000); while gender (r = 0.957), age (r = 0.016), occupation (r = 0.482), strong tea (r = 1.124), alcohol drinking (r = 0.558), meat diet (r = 0.591) and BMI (r = 0.246) were linearly correlated with GERD in Han Chinese (r = 0.786, P = 0.01). There was no significant difference between Gerd Q scoring and three normalized methods for the diagnosis of GERD.

Conclusion: GERD is highly prevalent in adult in Urumqi, especially in Uygur. Male, civil servant, smoking, strong tea, alcohol drinking, meat diet and BMI are risk factors correlated to GERD.

Keywords: Gastroesophageal reflux disease; Han; Incidence; Risk factors; Urumqi; Uygur.

Figure 1

Relationship between occupation (civil servant), smoking, strong tea, alcohol drinking as well as body mass index and gastroesophageal reflux disease in Uygur and Han Chinese adults. A: For gastroesophageal reflux disease (GERD) males, civil servant ratio (OR = 1.49, 95%CI 1.44-1.54), strong tea ratio (OR = 5.36, 95%CI 5.29-5.41), alcohol drinking ratio (OR = 2.33, 95%CI 2.13-2.53); B: Body mass index (BMI) value (26.5 ± 3.1 vs 22.7 ± 3.0 for GERD males vs normal males, P < 0.005 and 26.5 ± 3.1 vs 23.8 ± 3.8 for GERD males vs GERD females, P < 0.01) were higher than those in normal males and in GERD females, respectively; while for GERD females, civil servant ratio (OR = 2.77, 95%CI 2.56-2.98), alcohol drinking ratio (OR = 6.81, 95%CI 5.62-8) and BMI value (23.8 ± 3.8 vs 21.4 ± 2.9, P < 0.05) were higher than those in normal females; C: For GERD males, civil servant ratio (OR = 1.64, 95%CI 1.59-1.7), strong tea ratio (OR = 2.3, 95%CI 2.23-2.36), alcohol drinking ratio (OR = 3.3, 95%CI 3.19-3.41), mainly meat ratio (OR = 2.35, 95%CI 2.28-2.42); D: BMI value (25.8 ± 3.5 vs 22.3 ± 2.7 for GERD males vs normal males, P < 0.005 and 25.8 ± 3.5 vs 23.8 ± 3.0 for GERD males vs GERD females, P < 0.01) were higher than those in normal males and in GERD females, respectively; while for GERD females, civil servant ratio (OR = 2.05, 95%CI 1.86-2.24), alcohol drinking ratio (OR = 4.44, 95%CI 3.61-5.27), mainly meat ratio (OR = 2.58, 95%CI 2.19-2.97) and BMI value (22.9 ± 3.8 vs 20.4 ± 2.9, P < 0.01) were higher than those in normal females. ^aP < 0.05 vs male of the same ethnic group; ^cP < 0.05 vs female of the same ethnic group.

Figure 2

The risk factors linearly correlated with gastroesophageal reflux disease in both Uygur (A) and Han Chinese (B).