Table 4.
Association Between Obesity Change at 1 Year and Incidence and Change of Symptomatic Gastroesophageal Reflux (GER) in the Combined Estrogen and Estrogen Plus Progestin Trials
| Symptomatic GER incidence | Existing symptomatic GER change‡ |
|||||
|---|---|---|---|---|---|---|
| No GER symptoms at baseline n |
Incident GER n (%) |
Odds ratio* (95% CI) |
Odds ratio† (95% CI) |
n | Odds ratio† (95% CI) |
|
| Change in BMI at 1 y | ||||||
| <−2.5 | 771 | 23 (2.9) | 1.16 (0.74–1.81) | 1.02 (0.62–1.66) | 290 | 0.38 (0.26–0.55) |
| −2.5 to <−0.8 | 2379 | 48 (2.0) | 0.80 (0.58–1.11) | 0.77 (0.54–1.11) | 913 | 0.73 (0.56–0.95) |
| −0.8 to <0.8 | 6263 | 156 (2.4) | 1.0 (reference) | 1.0 (reference) | 2566 | 1.0 (reference) |
| 0.8 to <2.5 | 2215 | 83 (3.6) | 1.45 (1.11–1.91) | 1.47 (1.09–1.98) | 1010 | 1.20 (0.92–1.57) |
| ≥2.5 | 482 | 33 (6.4) | 2.59 (1.75–3.81) | 2.35 (1.53–3.63) | 219 | 0.98 (0.59–1.62) |
| P value for trend | <.0001 | <.0001 | <.0001 | |||
| Change in waist circumference at 1 y (cm) |
||||||
| <−9 | 590 | 17 (2.8) | 1.19 (0.71–1.98) | 0.72 (0.39–1.34) | 250 | 0.64 (0.42–0.98) |
| −9 to <−3 | 2526 | 69 (2.7) | 1.15 (0.86–1.54) | 1.11 (0.80–1.52) | 1039 | 0.79 (0.61–1.02) |
| −3 to <3 | 5887 | 140 (2.3) | 1.0 (reference) | 1.0 (reference) | 2321 | 1.0 (reference) |
| 3 to <9 | 2531 | 85 (3.2) | 1.40 (1.07–1.84) | 1.47 (1.09–1.98) | 1081 | 1.15 (0.88–1.49) |
| ≥9 | 496 | 32 (6.1) | 2.66 (1.79–3.95) | 2.31 (1.46–3.64) | 260 | 0.96 (0.61–1.51) |
| P value for trend | .0025 | .0004 | .0078 | |||
| Change in waist-to-hip ratio at 1 y |
||||||
| <−0.08 | 510 | 21 (4.0) | 1.67 (1.05–2.66) | 1.20 (0.69–2.07) | 247 | 1.12 (0.69–1.80) |
| −0.08 to <−0.03 | 2148 | 56(2.5) | 1.06 (0.78–1.44) | 0.86 (0.61–1.22) | 895 | 0.82 (0.63–1.07) |
| −0.03 to <0.03 | 6725 | 167 (2.4) | 1.0 (reference) | 1.0 (reference) | 2594 | 1.0 (reference) |
| 0.03 to <0.08 | 2117 | 78 (3.6) | 1.49 (1.14–1.96) | 1.44 (1.06–1.95) | 967 | 1.22 (0.93–1.60) |
| ≥0.08 | 499 | 20 (3.9) | 1.62 (1.01–2.61) | 1.37 (0.79–2.37) | 237 | 0.70 (0.44–1.10) |
| P value for trend | .17 | .04 | .53 | |||
BMI, body mass index.
Adjusted for age only.
Adjusted for age, trial assignment, corresponding baseline measure, race or ethnicity, education, income, smoking status, physical activity, and history of gastric ulcer, gallbladder disease, or gallstone.
Only women reporting heartburn symptom at baseline were included. The odds ratio, derived from cumulative logistic regression model, indicates, for example, that the odds of women whose BMI increased by >2.5 had 1.25 the odds of those women with stable BMI (−0.8 to <0.8) for having worsening symptomatic GER. (To avoid potential misclassification, the scores −1 and 1 were excluded from the analyses; −2 and −3 were treated equally [recoding to −1] as an improvement; and 2 [recoding to 1] as a worsening.)