Postmenopausal Hormone Therapy as a Risk Factor for Gastroesophageal Reflux Symptoms Among Female Twins

Nordenstedt, Helena; Zheng, Zongli; Cameron, Andrew; Ye, Weimin; Pedersen, Nancy L.; Lagergren, Jesper

doi:10.1053/j.gastro.2008.01.009

Cited by 48 publications

(57 citation statements)

References 41 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Although the Norwegian study showed a significant synergic interaction between BMI and estrogen therapy in the association with symptomatic GER, one study from the Swedish Twin Register did not. 29 A possible explanation for these discrepancies could be due to the different estrogen formulations and that the Norwegian study studied estrogen use before 1986.…”

Section: Discussionmentioning

confidence: 99%

“…Body mass index (BMI; in kg/m 2 ) was calculated and was categorized as underweight (<21, equivalent to below the 5th percentile of our study participants) and, according to the World Health Organization classification, normal (21 to <25), overweight (25)(26)(27)(28)(29)(30), class 1 obesity (>30-35), class 2 obesity (>35-40), and class 3 obesity (>40, equivalent to above the 95th percentile of our study participants). Waist circumference and waist-to-hip ratio were categorized into 6 categories, based on their distribution percentiles among our study participants with equivalent to <5th (referred to as lowest), 5th-25th (referred to as normal and used as reference), 26th-50th, 51st-75th, 76th-95th, and >95th (referred to as highest) percentiles.…”

Section: Statistical Analysesmentioning

confidence: 99%

“…118 (4.2) 107 (3.9) 369 (7.8) 380 (7.6) Normal (21 to <25) 581 (20.9) 621 (22.8) 1362 (28.6) 1424 (28.3) Overweight ( [25][26][27][28][29][30] 987 ( 294 (10.6) 293 (10.8) 354 (7.4) 381 (7.6) Class 3 obesity (>40) 155 (5.6) 171 (6.3) .28…”

Section: Abbreviations Used In This Papermentioning

confidence: 99%

See 2 more Smart Citations

Effects of Estrogen With and Without Progestin and Obesity on Symptomatic Gastroesophageal Reflux

Zheng

Margolis

Liu³

et al. 2008

Gastroenterology

Self Cite

View full text Add to dashboard Cite

show abstract

Section: Discussionmentioning

confidence: 99%

Section: Statistical Analysesmentioning

confidence: 99%

See 1 more Smart Citation

Effects of Estrogen With and Without Progestin and Obesity on Symptomatic Gastroesophageal Reflux

Zheng

Margolis

Liu³

et al. 2008

Gastroenterology

Self Cite

View full text Add to dashboard Cite

show abstract

“…120 On the other hand, it has been suggested that female sex hormones can increase the risk of gastroesophageal reflux symptoms by relaxing the lower esophageal sphincter via NO. [122][123][124] A populationbased study demonstrated a positive correlation between reflux symptoms and postmenopausal HRT use. 125 The …”

Section: Hormone Replacement Therapymentioning

confidence: 99%

Sex and Gender Differences in Gastroesophageal Reflux Disease

Kim

2016

J Neurogastroenterol Motil

117

View full text Add to dashboard Cite

It is important to understand sex and gender-related differences in gastroesophageal reflux disease (GERD) because gender-related biologic factors might lead to better prevention and therapy. Non-erosive reflux disease (NERD) affects more women than men. GERD symptoms are more frequent in patients with NERD than in those with reflux esophagitis. However, men suffer pathologic diseases such as reflux esophagitis, Barrett's esophagus (BE), and esophageal adenocarcinoma (EAC) more frequently than women. The prevalence of reflux esophagitis is significantly increased with age in women, especially after their 50s. The mean age of EAC incidence in women is higher than in men, suggesting a role of estrogen in delaying the onset of BE and EAC. In a chronic rat reflux esophagitis model, nitric oxide was found to be an aggravating factor of esophageal injury in a male-predominant way. In addition, the expression of esophageal occludin, a tight junction protein that plays an important role in the esophageal defense mechanism, was up-regulated in women. This explains the male predominance of reflux esophagitis and delayed incidence of BE or EAC in women. Moreover, the symptoms such as heartburn, regurgitation, and extra-esophageal symptoms have been more frequently reported by women than by men, suggesting that sex and gender play a role in symptom perception. Differential sensitivity with augmented symptoms in women might have diagnostic and therapeutic influence. Furthermore, recent studies have suggested that hormone replacement therapy has a protective effect against esophageal cancer. However, an anti-inflammatory role of estrogen remains compelling, which means further study is necessary in this area.

show abstract

“…These findings not only confirmed an association between chronic HBV and GERD, but also suggested an enhanced association between HBV and GERD in females. Female sex hormones may increase the risk of GERD symptoms through a relaxing effect on the lower esophageal sphincter [22], whether HBV could strengthen this relaxing effect or aggravate GERD through the actions of sex hormonerelated mechanisms need further examinations. The associations of GERD and HBV infection between different stages of hepatic fibrosis are worthy of attention.…”

Section: Discussionmentioning

confidence: 99%

Increased incidence of gastroesophageal reflux disease in patients with chronic hepatitis B virus infection

et al. 2010

View full text Add to dashboard Cite

Background Although chronic liver disease is associated with gastroesophageal reflux disease (GERD), the impact of chronic hepatitis B virus (HBV) infection on this association remains unclear. We thus aimed to evaluate the relationship between chronic HBV infection and GERD.Methods In this prospective population-based study, 1,001 adult subjects who underwent an upper gastrointestinal endoscopic examination in a health check-up and completed a gastroesophageal reflux questionnaire were consecutively enrolled. Endoscopic findings were classified according to the Los Angeles classification. Hepatitis B surface antigen was used as a marker of HBV infection. Univariate and multivariate approaches were used to evaluate the effects of chronic HBV infection on GERD.Results Chronic HBV infection was associated with heartburn sensation [odds ratio (OR) 1.27, 95% confidence interval 1.01-1.61, P = 0.037], and erosive esophagitis (adjusted OR 1.75, 1.03-2.97, P = 0.037). Although male gender is a risk factor of erosive esophagitis, further analyses stratified by gender and aspartate aminotransferase to platelet ratio index (APRI) showed that chronic HBV infection was associated with erosive esophagitis in female subjects (adjusted OR 2.70, 1.14-6.39, P = 0.024) and those with APRI of more than 0.3 (adjusted OR 3.94, 1.73-8.96, P = 0.001). Moreover, higher serum aspartate aminotransferase (AST) and triglyceride (TG) levels were risk factors of erosive esophagitis in patients with chronic HBV infection. Conclusions Our findings indicate a close association between chronic HBV infection and GERD, especially in female subjects and those with higher APRI levels. Moreover, HBV carriers with higher AST or TG levels have higher incidence of erosive esophagitis. The interactions between chronic HBV infection and GERD need further studies.

show abstract

Postmenopausal Hormone Therapy as a Risk Factor for Gastroesophageal Reflux Symptoms Among Female Twins

Cited by 48 publications

References 41 publications

Effects of Estrogen With and Without Progestin and Obesity on Symptomatic Gastroesophageal Reflux

Effects of Estrogen With and Without Progestin and Obesity on Symptomatic Gastroesophageal Reflux

Sex and Gender Differences in Gastroesophageal Reflux Disease

Increased incidence of gastroesophageal reflux disease in patients with chronic hepatitis B virus infection

Contact Info

Product

Resources

About