Epidemiology Of Gastroesophageal Reflux Disease In Chinese Population: A Systematic Review

Objective To investigate the epidemiology of gastroesophageal reflux disease (GERD)in Chinese population.Methods A comprehensive literature search through CBM, CNKI, VIP, PubMedpublished before December2013was performed in order to identify relevant studiesreporting the prevalence of GERD in Chinese population. Study quality was assessed usingAHRQ or NOS score. Prevalence of GERD in Chinese population was conducted bycritically distinguishing between the definitions of GERD. Data on risk factors potentiallyassociated with GERD were evaluated by meta-analysis or qualitative analysis. Inmeta-analysis, a fixed-effect model or random-effect model was performed with the oddsratio (OR) and95%confidence interval (CI). Subgroup analysis and sensitivity analysiswere performed to explore the possible causes of heterogeneity. Funnel plots were producedand Begg’s test and Egger’s test were conducted to examine publication bias.Results Twenty-four studies were included in this systematic review. Prevalenceestimates were2.5-6.2%in five studies that reported the prevalence of at least weekly refluxsymptoms. Prevalence estimates were2.8-8.4%in three studies using the Montrealdefinition. Prevalence estimates were2.7-10%in twelve studies using the reflux diagnosticquestionnaire (RDQ). Prevalence estimates were5.77-8.68%in four studies using thesymptomatic gastroesophageal reflux (SGER) questionnaire. Meta-analysis outcomesshowed that obesity, alcohol consumption, living in rural areas, greasy food, overeating,sweet food, coffee and constipation were associated with GERD. The pooled OR values and 95%CI were as follows: obesity1.75(1.51,2.04), alcohol1.10(1.01,1.20), rural areas1.39(1.23,1.56), greasy food1.41(1.15,1.71), overeating1.92(1.64,2.25), sweet food1.43(1.15,1.79), coffee1.25(1.04,1.50) and constipation1.82(1.44,2.31). Gender, smoking,working, spicy food and tea were not found to be associated with GERD. The pooled ORvalues and95%CI were as follows: male1.13(0.99,1.29), smoking1.10(0.86,1.42),mental work0.92(0.68,1.23), spicy food1.10(0.97,1.26), tea1.17(0.96,1.44). Qualitativeanalysis outcomes showed that older age, family history of gastrointestinal disease, poormental state, work burden, hiatal hernia and bile reflux were associated with GERD.Publication bias was observed in some of the above risk factors.Conclusion Epidemiological studies of GERD in China varied in design. Prevalenceestimates varied slightly, all below10%. Obesity, older age, living in rural areas, unhealthyliving and dieting habits, family history of gastrointestinal disease, poor mental state andwork burden were risk factors of GERD.