Abdominal obesity, ethnicity and gastro-oesophageal reflux symptoms

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Abstract
Objective: To evaluate the associations between abdominal obesity and gastro-oesophageal reflux disease (GORD), and their interactions with ethnicity and gender. Design: A cross-sectional study. Participants completed detailed symptom questionnaires and underwent a standardised examination, including anthropometric measurements. Setting: A large integrated healthcare system. Patients: 80 110 members of the Kaiser Permanente multiphasic health check-up cohort. Main outcome measures: Gastro-oesophageal reflux-type symptoms. Results: Recent reflux-type symptoms were present in 11% of the population. The multivariate OR for symptoms with an abdominal diameter (adjusted for body mass index (BMI)) of ⩾26 vs Conclusions: There was a consistent association between abdominal diameter (independent of BMI) and reflux-type symptoms in the white population, but no consistent associations in the black population or Asians. The BMI association was also strongest among the white population. These findings, combined with the increased prevalence of abdominal obesity in male subjects, suggest that an increased obesity may disproportionately increase GORD-type symptoms in the white population and in male subjects.