Obesity and Risk of Peptic Ulcer Disease: A Large-Scale Health Check-Up Cohort Study.

Jeung Hui Pyo,Jee Eun Kim,Heejin Yoo,Yang Won Min,Jae J Kim,Tae Jun Kim,Hyuk Lee,Kyunga Kim,Yoon Ho Choi,Poong Lyul Rhee,Jun Haeng Lee,Byung Hoon Min

doi:10.3390/nu11061288

Jeung Hui Pyo, Jee Eun Kim + Show 10 more

Open Access

https://doi.org/10.3390/nu11061288

Copy DOI

Journal: Nutrients	Publication Date: Jun 6, 2019
Citations: 10	License type: CC BY 4.0

Affiliation: Samsung Medical Center, Sungkyunkwan University

Abstract

The association between obesity and peptic ulcer disease (PUD) is inconclusive. To evaluate the association of obesity and metabolically healthy obesity (MHO) with PUD risk, we performed a retrospective cohort study of 32,472 subjects without PUD at baseline who underwent repeated health examinations. Participants were stratified by body mass index (BMI) and metabolically healthy state. Hazard ratios (HRs) and 95% confidence intervals (CIs) were calculated using Cox proportional hazard modelling. During the follow-up period, 1940 PUD cases occurred. PUD, particularly gastric ulcer (GU), had significantly higher cumulative incidence in obese subjects compared to non-obese subjects (p value < 0.001). The HR for developing GU was 1.32 (95% CI, 1.16–1.49; p value <0.001); after adjusting for confounding factors (lifestyle, metabolic, and Helicobacter pylori status), the association was no more significant (p value = 0.789). For duodenal ulcer (DU), cumulative incidence between obese and non-obese groups was not significantly different (p value = 0.464). The risk of developing DU in the obese group was not significantly different from the non-obese group (HR 0.95; 95% CI, 0.83–1.09; p value = 0.469) and consistently showed no association after adjusting for metabolic parameters (p value = 0.199). Furthermore, MHO subjects had no increase in GU or DU risks. In this large cohort study, PUD risk was not associated with obesity or MHO.

Highlights

Despite the decreasing incidence of peptic ulcer disease (PUD) and its complications due to the discovery of potent acid suppressants and eradication of Helicobacter pylori infection, PUD remains one of the most commonly encountered gastrointestinal diseases with a significant impact on the healthcare system [1,2].The prevalence of idiopathic ulcer, ulcers not caused by Helicobacter pylori infection or nonsteroidal anti-inflammatory drugs (NSAIDs) or aspirin, is increasing [3] and past studies proposed possible risk factors [4,5]
We found that PUD, gastric ulcer (GU), had significantly higher cumulative incidence in obese subjects compared to non-obese subjects
There was a significant association between the risk of developing GU and obesity, but when adjusted for possible confounding factors, the association was no more significant

Summary

Introduction

Despite the decreasing incidence of peptic ulcer disease (PUD) and its complications due to the discovery of potent acid suppressants and eradication of Helicobacter pylori infection, PUD remains one of the most commonly encountered gastrointestinal diseases with a significant impact on the healthcare system [1,2].The prevalence of idiopathic ulcer, ulcers not caused by Helicobacter pylori infection or nonsteroidal anti-inflammatory drugs (NSAIDs) or aspirin, is increasing [3] and past studies proposed possible risk factors [4,5]. Despite the decreasing incidence of peptic ulcer disease (PUD) and its complications due to the discovery of potent acid suppressants and eradication of Helicobacter pylori infection, PUD remains one of the most commonly encountered gastrointestinal diseases with a significant impact on the healthcare system [1,2]. Obesity has been reported as a risk factor of PUD in many studies [4,5,6,7,8], yet conflicting results have been reported in several studies [9]. It is unclear whether PUD is independently associated. No study has evaluated the role of MHO as a determinant of PUD

Methods

Results

Conclusion