Background

It is unknown whether gastroesophageal reflux disease (GERD) is a risk factor or consequence of idiopathic pulmonary fibrosis (IPF). This study aimed to determine whether patients with IPF were more likely to have GERD compared with age- and sex-matched controls who either had 1) interstitial lung disease (ILD) other than IPF or 2) no diagnosed lung disease (population control).

Methods

We used the medical records-linkage system of the Rochester Epidemiology Project (REP) to identify patients with IPF who resided in Olmsted County, Minnesota, from January 1, 1997, through June 30, 2017. IPF cases were each matched with patients from 2 control groups (non-IPF ILD controls and population controls). We used conditional logistic regression to model associations between GERD diagnosis and IPF case status. P values were adjusted for multiple comparisons by using the Bonferroni adjustment (P values < .025 were considered statistically significant).

Results

One hundred thirteen IPF cases were identified and matched to 226 population controls and 226 controls with non-IPF ILD. After multivariable adjustment, the odds of having GERD were 1.78 times higher (95% CI, 1.09–2.91; P = .02) in IPF cases compared with population controls. After multivariable adjustment, the odds of having GERD were 0.46 times lower (95% CI, 0.23–0.94; P = .03) in IPF cases compared with non-IPF ILD controls.

Conclusion

GERD may be an important contributor to the development of lung fibrosis. Thus, it should be investigated and addressed adequately when detected in patients with IPF and patients with non-IPF ILD.

中文翻译：

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特发性肺纤维化和胃食管反流病：一项基于人群的病例对照研究

背景

目前尚不清楚胃食管反流病 (GERD) 是否是特发性肺纤维化 (IPF) 的危险因素或后果。本研究旨在确定与年龄和性别匹配的对照组相比，IPF 患者是否更有可能患有 GERD，这些对照组要么患有 1) 患有 IPF 以外的间质性肺病 (ILD) 或 2) 未诊断出肺部疾病（人群控制）。

方法

我们使用罗切斯特流行病学项目 (REP) 的医疗记录关联系统来识别 1997 年 1 月 1 日至 2017 年 6 月 30 日期间居住在明尼苏达州奥姆斯特德县的 IPF 患者。每个 IPF 病例与来自 2对照组（非 IPF ILD 控制和人口控制）。我们使用条件逻辑回归来模拟 GERD 诊断与 IPF 病例状态之间的关联。使用 Bonferroni 调整对多重比较的P值进行了调整（ P值 < .025 被认为具有统计学意义）。

结果

113 个 IPF 病例被确定并与 226 名人群对照和 226 名非 IPF ILD 对照相匹配。 经过多变量调整后， IPF 病例发生 GERD 的几率是人群对照组的 1.78 倍（95% CI，1.09-2.91；P = .02）。 多变量调整后，与非 IPF ILD 对照组相比，IPF 病例发生 GERD 的几率低 0.46 倍（95% CI，0.23–0.94；P = .03）。

结论

GERD可能是肺纤维化发展的重要因素。因此，当在 IPF 患者和非 IPF ILD 患者中检测到它时，应该对其进行充分调查和解决。