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Disease Outcomes

Extreme childhood obesity is associated with increased risk for gastroesophageal reflux disease in a large population-based study

, , , , &
Pages e257-263 | Received 09 Nov 2009, Published online: 09 Jul 2010
 

Abstract

Objective. Gastroesophageal reflux disease (GERD) may link the obesity epidemic to an array of adverse health outcomes including chronic esophageal inflammation and, consequentially, to pathophysiological changes of the esophagus. Although obesity and GERD are associated in adults, data in children are scarce and inconclusive. The aim of this study is to investigate whether, similar to adults, obesity is associated with GERD in youth. Methods. For this population-based, cross-sectional study, measured weight and height and diagnosis of GERD were extracted from electronic medical records of 690 321 patients, aged 2–19 years, who were enrolled in an integrated prepaid health plan between 2007 and 2008. Weight class (normal weight, overweight, moderate and extreme obesity) was assigned based on body mass index-for-age. Results. Overall, GERD was diagnosed in 1.5% of boys and 1.8% of girls (P<0.001). Moderately and extremely obese children, aged 6–11 years, were more likely to have a diagnosis of GERD compared with normal weight (OR 1.16, 95% CI: 1.02–1.32 and 1.32, 95% CI: 1.13–1.56, respectively). Children aged 12–19 years showed similar associations (OR 1.16, 95% CI: 1.07–1.25 and 1.40, 95% CI: 1.28–1.52, respectively). These associations remained with adjustment for sex and race/ethnicity. By contrast, obesity was not related to increased odds for GERD in children aged 2–5 years of age. Conclusions. The association between childhood obesity and GERD may have important implications for their future risk of GERD-associated diseases, such as esophageal adenocarcinoma.

Acknowledgements

This research was supported by Kaiser Permanente Direct Community Benefit Funds. The authors gratefully thank Britta Amundsen and Cecilia Crisantes for their technical support.

List of abbreviations and acronyms

GERD: Gastroesophageal reflux syndrome; BMI: Body mass index; KPSC: Kaiser Permanente Southern California; OR: Odds ratio; CI: Confidence interval.

Declaration of interest: The authors report no conflicts of interest. The authors alone are responsible for the content and writing of the paper.

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