Gastro-oesophageal reflux and respiratory symptoms in Busselton adults: the effects of bodyweight and sleep apnoea
Article first published online: 18 JUL 2012
© 2011 The Authors. Internal Medicine Journal © 2011 Royal Australasian College of Physicians
Internal Medicine Journal
Volume 42, Issue 7, pages 772–779, July 2012
How to Cite
Mulrennan, S. A., Knuiman, M. W., Divitini, M. L., Cullen, D. J., Hunter, M., Hui, J., Musk, A. W. and James, A. L. (2012), Gastro-oesophageal reflux and respiratory symptoms in Busselton adults: the effects of bodyweight and sleep apnoea. Internal Medicine Journal, 42: 772–779. doi: 10.1111/j.1445-5994.2011.02535.x
Conflict of interest: None.
- Issue published online: 18 JUL 2012
- Article first published online: 18 JUL 2012
- Accepted manuscript online: 1 JUN 2011 01:36AM EST
- Received 28 February 2011; accepted 18 May 2011.
- respiratory symptom;
Background/Aim: Respiratory symptoms and gastro-oesophageal reflux disease (GORD) are common within the general population. Although a number of epidemiological studies have addressed their relationship, none has investigated the confounding effects of body mass index (BMI) and obstructive sleep apnoea (OSA), both of which are associated with reflux.
Methods: Men and women (2700) from the 2005–2007 cross-sectional Busselton health survey were included. Questionnaire data included demography, information on general health, asthma, cough, wheeze, dyspnoea and reflux symptoms (never, monthly or less often and weekly or more often). BMI, risk of OSA (Berlin questionnaire definition), spirometry and airway hyperresponsiveness (AHR) were recorded. The effects of BMI and OSA on the relationship between respiratory and reflux symptoms were examined using logistic regression models, expressed as adjusted odds ratios for risk of respiratory symptoms by reflux symptom category.
Results: Fifty per cent had reflux symptoms (5–10% weekly or more often). Reflux symptoms had strong positive, dose-related associations with cough/phlegm, breathlessness, chest tightness and wheeze in the last 12 months (P < 0.001), but were not related to diagnosed asthma or AHR. Twenty-three per cent were at high risk of OSA and 63% had a BMI of >25 (22% > 30). Increased weight or high risk of OSA did not affect the relationship between respiratory symptoms and reflux symptoms.
Conclusion: The relationship between reflux and respiratory symptoms was independent of BMI, high risk of OSA or AHR. These findings suggest that reflux contributes directly to respiratory symptoms.