Meta-Analysis
Copyright ©The Author(s) 2015. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastroenterol. Mar 14, 2015; 21(10): 3085-3092
Published online Mar 14, 2015. doi: 10.3748/wjg.v21.i10.3085
Association between diabetes mellitus and gastroesophageal reflux disease: A meta-analysis
Xiao-Meng Sun, Jia-Cheng Tan, Ying Zhu, Lin Lin
Xiao-Meng Sun, Jia-Cheng Tan, Ying Zhu, Lin Lin, Department of Gastroenterology, First Affiliated Hospital of Nanjing Medical University, Nanjing 210029, Jiangsu Province, China
Author contributions: Sun XM and Tan JC contributed equally to this work; Sun XM and Tan JC reviewed articles for inclusion and analyzed the data; Sun XM wrote the paper; Zhu Y performed the final consensus review and the final data analysis; Lin L designed the study, reviewed and revised the paper; and all authors approved the final version to be published.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Correspondence to: Lin Lin, MD, PhD, Department of Gastroenterology, First Affiliated Hospital of Nanjing Medical University, 300 Guangzhou Rd, Gulou District, Nanjing 210029, Jiangsu Province, China. linlin9100@sina.cn
Telephone: +86-25-68136920 Fax: +86-25-83674636
Received: April 19, 2014
Peer-review started: April 19, 2014
First decision: May 29, 2014
Revised: June 21, 2014
Accepted: August 13, 2014
Article in press: August 28, 2014
Published online: March 14, 2015
Abstract

AIM: To investigate whether there is a link between diabetes mellitus (DM) and gastroesophageal reflux disease (GERD).

METHODS: We conducted a systematic search of PubMed and Web of Science databases, from their respective inceptions until December 31, 2013, for articles evaluating the relationship between DM and GERD. Studies were selected for analysis based on certain inclusion and exclusion criteria. Data were extracted from each study on the basis of predefined items. A meta-analysis was performed to compare the odds ratio (OR) in DM between individuals with and without GERD using a fixed effect or random effect model, depending on the absence or presence of significant heterogeneity. Subgroup analyses were used to identify sources of heterogeneity. Publication bias was assessed by Begg’s test. To evaluate the results, we also performed a sensitivity analysis.

RESULTS: When the electronic database and hand searches were combined, a total of nine eligible articles involving 9067 cases and 81 968 controls were included in our meta-analysis. Based on the random-effects model, these studies identified a significant association between DM and the risk of GERD (overall OR = 1.61; 95%CI: 1.36-1.91; P = 0.003). Subgroup analyses indicated that this result persisted in studies on populations from Eastern countries (OR = 1.71; 95%CI: 1.38-2.12; P = 0.003) and in younger patients (mean age < 50 years) (OR = 1.70; 95%CI: 1.22-2.37; P = 0.001). No significant publication bias was observed in this meta-analysis using Begg’s test (P = 0.175). The sensitivity analysis also confirmed the stability of our results.

CONCLUSION: This meta-analysis suggests that patients with DM are at greater risk of GERD than those who do not have DM.

Keywords: Diabetes mellitus, Gastroesophageal reflux disease, Meta-analysis

Core tip: Based on a meta-analysis, we demonstrated that diabetes mellitus is associated with gastroesophageal reflux disease. Our findings suggested that this association was greater in patients aged < 50 years and in Asian populations.