1156 Influence of Body Mass Index on Gastroesophageal Reflux Disease in Patients With Sleep-Related Breathing Disorders

Abstract

patients aged 1-17 years between 2000 and 2005; patients with a recorded diagnosis of gastroesophageal reflux disease (GERD) during the study period (n = 1809) and a cohort of patients without GERD (n = 5000). Non-GERD patients were frequency matched to GERD patients by age, sex and calendar year. Among GERD patients, 2 sub-cohorts of patients were identified according to whether they had been prescribed a PPI within 1 year of GERD diagnosis; there were 487 GERD PPI users and 1322 GERD PPI non-users. All patients (GERD and non-GERD) were followed-up for up to 1 year from the start date (date of first prescription for GERD PPI users, date of GERD diagnosis for GERD PPI non-users and a random date for non-GERD patients). A total of 118 patients with a recorded diagnosis of fracture were identified; their medical records were reviewed manually to ascertain incident cases. There were a total of 45 fracture cases among GERD patients; 11 among PPI users and 34 among PPI non-users. Adjusted incidence rate ratios (IRRs) for fracture risk associated with exposure to PPIs were calculated. We also conducted a nested case-control analysis, using all 118 cases of fracture identified in both GERD and non-GERD cohorts. All remaining patients without fracture at the end of follow-up in both cohorts served as controls (n = 6656). The index date was the date of diagnosis for fracture cases and a random date for controls. Data on PPI use were obtained and odds ratios (ORs) for fracture risk associated with PPI use were calculated by multivariate adjusted logistic regression models. Results. Among GERD patients, there was no association between fracture risk and current (IRR: 0.68; 95% CI: 0.24-1.94) or recent/past use (IRR: 0.90; 95% CI: 0.40-2.05) of PPIs compared with non-use of PPIs. Similarly, among all patients (with or without GERD), neither current (OR: 0.71; 95% CI: 0.25-2.04) nor recent/past use (OR: 0.95; 95% CI: 0.41-2.18) of PPIs was associated with an increased risk of fracture compared with non-use of PPIs. However, these estimates were based on only four currently exposed cases and seven recently/past exposed cases. Conclusion. The results of our study do not support an association between PPI use and risk of fracture in children and adolescents with or without a diagnosis of GERD. However, it should be noted that only a small number of cases were exposed to a PPI.