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      Anthropometric indices and gastro-esophageal reflux disease in adult population in Tirana, Albania.

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      Adult, Albania, epidemiology, Body Mass Index, Female, Gastroesophageal Reflux, Humans, Life Style, Male, Middle Aged, Waist-Hip Ratio

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          To assess the association of Gastro-Esophageal Reflux Disease (GERD) with anthropometric indices [body mass index (BMI) and waist-to-hip ratio (W/H)] in the adult population of Tirana, the Albanian capital. A case-control study was conducted in Tirana in 2005-2007 including 126 consecutive patients diagnosed with GERD at the Endoscopy Unit of the University Hospital Center (77 men aged 54.95 +/- 14.58 years; 49 women aged 50.33 +/- 15.42 years), and 252 GERD-free hospital based controls (150 men aged 54.55 +/- 6.78 years; 102 women aged 50.30 +/- 11.00 years; 84% response). A structured questionnaire included information about socioeconomic characteristics and behavioral factors. Physical examination included measurement of height and weight, and waist and hip circumferences. Multivariable-adjusted binary logistic regression was used to assess the independent associations of anthropometric indices with GERD. GERD was positively associated with BMI (age-adjusted OR = 2.49, 95% CI = 1.40-4.43 for BMI > or = 30 vs.< 30), but less so with W/H (OR = 1.33, 95% CI = 0.85-2.09 for values above cutoff vs. values below cutoff). Upon adjustment for socioeconomic characteristics and behavioral factors, the association with BMI persisted strongly (OR = 2.12, 95% CI = 1.13-3.98), whereas the relationship with W/H was slightly attenuated (OR = 1.22, 95% CI = 0.73-2.02). Our findings indicate that BMI is a strong predictor of symptomatic GERD, independent of animal fat intake, smoking, alcohol consumption and physical exercise. The positive relationship of BMI with symptomatic GERD is also confirmed in the adult population of transitional Albania.

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