Systematic assessment of environmental factors for gastroesophageal reflux disease: An umbrella review of systematic reviews and meta-analyses

Cheng, Yuan; Kou, Fushun; Liu, Jiali; Dai, Yi; Li, Xiaohong; Li, Junxiang

doi:10.1016/j.dld.2020.11.022

Cited by 13 publications

(14 citation statements)

References 55 publications

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“…Estimates were obtained from the inverse variance weighted method with random-effects with the except for estimate for caffeine consumption that was obtained from the inverse variance weighted method with fixed-effects. obesity were associated with an ascended risk of GERD [3,4,17]. In a meta-analysis of 20 observational studies (mostly case-control and cross-sectional studies) with a total of 18 346 GERD patients, overweight and obesity was associated with a 57% and 115% higher risk of GERD, respectively [3], which is in line with our findings.…”

Section: Discussionsupporting

confidence: 91%

“…Review articles of the association between obesity and GERD have found consistent evidence that overweight and obesity were associated with an ascended risk of GERD [ 3 , 4 , 17 ]. In a meta-analysis of 20 observational studies (mostly case–control and cross-sectional studies) with a total of 18 346 GERD patients, overweight and obesity was associated with a 57% and 115% higher risk of GERD, respectively [ 3 ], which is in line with our findings.…”

Section: Discussionmentioning

confidence: 99%

“…Epidemiological studies have revealed several possible risk factors for GERD, including excess adiposity [3][4][5][6][7], diabetes [8], smoking [6,7,[9][10][11][12], alcohol consumption [11,13], and coffee and caffeine consumption [6,14]. However, evidence on most associations is equivocal with inconsistent findings across studies [15][16][17][18][19]. Additionally, unobserved confounding, misclassification, reverse causality, and other biases may hinder causal inference in these associations in observational studies.…”

Section: Introductionmentioning

confidence: 99%

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Adiposity, diabetes, lifestyle factors and risk of gastroesophageal reflux disease: a Mendelian randomization study

Yuan

Larsson

2022

Eur J Epidemiol

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Adiposity, diabetes, and lifestyle factors are linked to gastroesophageal reflux disease (GERD) in observational studies. We conducted a two-sample Mendelian randomization analysis to determine whether those associations are causal. Independent genetic variants associated with body mass index (BMI), waist circumference (with and without adjustment for BMI), type 2 diabetes, smoking, and alcohol, coffee and caffeine consumption at the genome-wide significance level were selected as instrumental variables. Summary-level data for GERD were available from a genome-wide association meta-analysis of 71,522 GERD cases and 261,079 controls of European descent from the UK Biobank and QSkin Sun and Health studies. The odds ratio (OR) of GERD was 1.49 (95% confidence interval (CI), 1.40–1.60) for one standard deviation (SD) increase in BMI, 1.07 (95% CI, 1.04–1.10) for one-unit increase in log-transformed OR of type 2 diabetes, and 1.41 (95% CI, 1.31–1.52) for one SD increase in prevalence of smoking initiation. There were suggestive associations with GERD for higher genetically predicted waist circumference (OR per one SD increase, 1.14, 95% CI, 1.02–1.26) and caffeine consumption (OR per 80 mg increase, 1.08, 95% CI, 1.02–1.15). Genetically predicted waist circumference adjusted for BMI, alcohol or coffee consumption was not associated GERD. This study suggests causal roles of adiposity, diabetes, and smoking, and a possible role of high caffeine consumption in the development of GERD.

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Section: Discussionsupporting

confidence: 91%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Adiposity, diabetes, lifestyle factors and risk of gastroesophageal reflux disease: a Mendelian randomization study

Yuan

Larsson

2022

Eur J Epidemiol

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“…Several large cohort studies and meta-analyses have demonstrated evidence linking smoking to GORD ( 3 , 43 , 44 ). Currently, it is believed that smoking causes GORD by prolonging the acid gap time, decreasing the secretion of saliva and neutralizing bases ( 45 ) and loosening the lower oesophageal sphincter (LES) ( 46 ).…”

Section: Discussionmentioning

confidence: 99%

Genetic estimation of correlations and causalities between multifaceted modifiable factors and gastro-oesophageal reflux disease

Sun

Cao²,

Cao³

et al. 2022

Front. Nutr.

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BackgroundGastro-oesophageal reflux disease (GORD) is a common gastrointestinal dysfunction that significantly affects the quality of daily life, and health interventions are challenging to prevent the risk of GORD. In this study, we used Mendelian randomization framework to genetically determine the causal associations between multifaceted modifiable factors and the risk of GORD.Materials and methodsSixty-six exposures with available instrumental variables (IVs) across 6 modifiable pathways were included in the univariable MR analysis (UVMR). Summary-level genome-wide association studies (GWAS) datasets for GORD were retrieved from the Neale Lab (GORDNeale, Ncases = 29975, Ncontrols = 390556) and FinnGen (GORDFinn, Ncases = 13141, Ncontrols = 89695). Using the METAL software, meta-analysis for single nucleotide polymorphisms (SNPs) from GORDNeale and GORDFinn was conducted with an inverse variance weighted (IVW) fixed-effect model. Moreover, we leveraged partition around medoids (PAM) clustering algorithm to cluster genetic correlation subtypes, whose hub exposures were conditioned for multivariable MR (MVMR) analyses. P-values were adjusted with Bonferroni multiple comparisons.ResultsSignificant causal associations were identified between 26 exposures (15 risk exposures and 11 protective exposures) and the risk of GORD. Among them, 13 risk exposures [lifetime smoking, cigarette consumption, insomnia, short sleep, leisure sedentary behavior (TV watching), body mass index (BMI), body fat percentage, whole body fat mass, visceral adipose tissue, waist circumference, hip circumference, major depressive disorder, and anxious feeling], and 10 protective exposures (leisure sedentary behavior (computer use), sitting height, hand grip strength (left and right), birth weight, life satisfaction, positive affect, income, educational attainment, and intelligence) showed novel significant causal associations with the risk of GORD. Moreover, 13 exposures still demonstrated independent associations with the risk of GORD following MVMR analyses conditioned for hub exposures (educational attainment, smoking initiation and BMI). In addition, 12 exposures showed suggestive causal associations with the risk of GORD.ConclusionThis study systematically elucidated the modifiable factors causally associated with the risk of GORD from multifaceted perspectives, which provided implications for prevention and treatment of GORD.

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“…[6][7][8] GERD is a clinically common gastrointestinal disease in Western countries, affecting up to 20% of the Western population, and is associated with a variety of risk factors such as obesity and smoking. 9,10 A meta-analysis reported a global incidence of GERD of 13.98%, with an estimated 1.03 billion people worldwide experiencing GERD. 1 GERD mainly refers to the reflux of stomach and duodenum contents to the esophagus, which, in turn, causes acid reflux, heartburn, and other symptoms.…”

Section: Introductionmentioning

confidence: 99%

Association Between Psychosocial Disorders and Gastroesophageal Reflux Disease: A Systematic Review and Meta-analysis

Wang

Yao

et al. 2022

J Neurogastroenterol Motil

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Background/AimsThe incidence of gastroesophageal reflux disease (GERD) is increasing annually. Studies have suggested that psychosocial disorders may be linked to the development of GERD. However, studies evaluating the association between psychosocial disorders and GERD have been inconsistent. Thus, we conducted a systematic review and meta-analysis of observational studies that evaluated the association between psychosocial disorders and GERD. MethodsWe systematically searched the PubMed, Embase, Cochrane, and Web of Science databases until October 17, 2020. Pooled OR with 95% CI and subgroup analyses were calculated using a random-effects model. Subgroup analyses were performed to identify the sources of heterogeneity. Sensitivity analysis by one-study removal was used to test the robustness of our results. ResultsThis meta-analysis included 1 485 268 participants from 9 studies. Studies using psychosocial disorders as the outcome showed that patients with GERD had a higher incidence of psychosocial disorders compared to that in patients without GERD (OR, 2.57; 95% CI, 1.87-3.54; I 2 = 93.8%; P < 0.001). Studies using GERD as an outcome showed an association between psychosocial disorders and an increased risk of GERD (OR, 2.23; 95% CI,; I 2 = 97.1%; P < 0.001). The results of the subgroup analysis showed that the non-erosive reflux disease group had a higher increased risk of anxiety than erosive reflux disease group (OR, 9.45; 95% CI, 5.54-16.13; I 2 = 12.6%; P = 0.285). ConclusionResults of our meta-analysis showed that psychosocial disorders are associated with GERD; there is an interaction between the two.

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Systematic assessment of environmental factors for gastroesophageal reflux disease: An umbrella review of systematic reviews and meta-analyses

Cited by 13 publications

References 55 publications

Adiposity, diabetes, lifestyle factors and risk of gastroesophageal reflux disease: a Mendelian randomization study

Adiposity, diabetes, lifestyle factors and risk of gastroesophageal reflux disease: a Mendelian randomization study

Genetic estimation of correlations and causalities between multifaceted modifiable factors and gastro-oesophageal reflux disease

Association Between Psychosocial Disorders and Gastroesophageal Reflux Disease: A Systematic Review and Meta-analysis

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