Prevalence of common upper gastrointestinal diseases in Chinese adults aged 18-64 years

Hong Yang; Mei Zhang; Hui Li; Zhengjing Huang; Yuanyuan Sun; Wenbo Li; Chun Li; Xuzhen Qin; Yanhong Wang; Xiao Zhang; Zhenping Zhao; Limin Wang; Li Wang; Jiaming Qian

doi:10.1016/j.scib.2024.07.048

Prevalence of common upper gastrointestinal diseases in Chinese adults aged 18-64 years

Sci Bull (Beijing). 2024 Nov 5:S2095-9273(24)00797-7. doi: 10.1016/j.scib.2024.07.048. Online ahead of print.

Authors

Hong Yang¹, Mei Zhang², Hui Li³, Zhengjing Huang², Yuanyuan Sun³, Wenbo Li⁴, Chun Li², Xuzhen Qin⁵, Yanhong Wang³, Xiao Zhang², Zhenping Zhao², Limin Wang⁶, Li Wang⁷, Jiaming Qian⁸

Affiliations

¹ Department of Gastroenterology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100730, China.
² National Center for Chronic and Noncommunicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing 100050, China.
³ Department of Epidemiology and Biostatistics, Institute of Basic Medical Sciences Chinese Academy of Medical Sciences, School of Basic Medicine Peking Union Medical College, Beijing 100005, China.
⁴ Department of Ultrasound, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100730, China.
⁵ Department of Laboratory Medicine, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100730, China.
⁶ National Center for Chronic and Noncommunicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing 100050, China. Electronic address: wanglimin@ncncd.chinacdc.cn.
⁷ Department of Epidemiology and Biostatistics, Institute of Basic Medical Sciences Chinese Academy of Medical Sciences, School of Basic Medicine Peking Union Medical College, Beijing 100005, China. Electronic address: liwang@ibms.pumc.edu.cn.
⁸ Department of Gastroenterology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100730, China. Electronic address: qianjm@pumch.cn.

PMID: 39562185
DOI: 10.1016/j.scib.2024.07.048

Abstract

To investigate the prevalence of gastroesophageal reflux disease (GERD), reflux esophagitis (RE), digestive ulcer gastric ulcer (GU), duodenal ulcer (DU), and Helicobacter pylori infection in Chinese adults aged 18-64 years and their associated factors, a community-based cross-sectional study using a stratified multistage sampling method was conducted. A standardized questionnaire survey, the ¹³C-urea breath test, and gastroscopy were performed. Weighted methods were used to estimate the prevalence of diseases or infection mentioned above and their risk factors. Finally, 27,637 participants aged 18-64 years were enrolled from 2017 to 2018. The prevalence (95% confidence interval) of GERD, RE, GU, DU, and H. pylori infection was estimated to be 10.5% (7.8%-14.2%), 5.4% (3.9%-7.3%), 2.5% (1.7%-3.7%), 4.5% (3.6%-5.4%), and 41.5% (36.7%-46.4%), respectively. The fraction of H. pylori infection reached 58.6% and 61.1% among the GU and DU patients, respectively. Weighted multivariable logistic regression models showed that GERD, RE, and GU shared the common risk factors of age and obesity. Dose-response relationships were observed between smoking and all four diseases, as well as alcohol consumption and GERD and H. pylori infection. Northwest China had the highest prevalence of GERD (23.9%), RE (8.7%), GU (7.8%), DU (7.3%), and H. pylori infection (63.6%); however, the southwest region had the highest prevalence of GU but the lowest of DU, RE, and H. pylori infection. Non-steroidal anti-inflammatory drugs were positively associated with GERD risk. On the contrary, a reduced risk of GU was observed among H. pylori-infected patients taking this drug. In summary, the prevalence of GERD, RE, and H. pylori infection still appears high in China. H. pylori infection eradication remains the priority to reduce the burden of peptic ulcer disease. The aging population, high prevalence of overweight or obesity, smoking, and drinking in China could explain the high burden of these diseases, thus suggesting the targeted preventive measures for upper gastrointestinal diseases in the future.

Keywords: Gastroesophageal reflux disease; Helicobacter pylori; Peptic ulcer; Prevalence; Reflux esophagitis.