Supplementary Material for: High obesity indices are associated with gastroesophageal reflux disease, but low obesity indices are associated with peptic ulcer disease in a large Taiwanese population study

Introduction: Gastro-esophageal reflux disease (GERD) and peptic ulcer disease (PUD) are prevalent in Taiwan. Few studies have investigated the associations between obesity indices with GERD and PUD simultaneously. This study aimed to investigate the correlations among obesity indices with GERD and PUD in a large cohort of participants, around 120,000, in the Taiwan Biobank (TWB).
Methods: A total of 121,583 participants (male: 43,698; female: 77,885; mean age 49.9 ± 11.0 years) were included to analyze the associations among obesity indices, including body mass index (BMI), waist–hip ratio (WHR), waist-to-height ratio (WHtR), body roundness index (BRI), abdominal volume index (AVI), lipid accumulation product (LAP), visceral adiposity index (VAI) and triglyceride–glucose Index (TyG index), with GERD and PUD. Self-reported GERD and PUD were obtained by questionnaires. Multivariate logistic regression analysis was employed to analyze the relationship between obesity indices with GERD and PUD.
Results: The prevalence of GERD and PUD was 13.7% and 14.6%, respectively. After multivariable analysis, high WHR (odds ratio [OR] = 1.009, p < 0.001), WHtR (OR = 1.005, p = 0.003), BRI (OR = 1.022, p =0.005), AVI (OR = 1.013, p < 0.001), LAP (OR = 1.001, p < 0.001), TyG index (OR = 1.068, p < 0.001) and VAI (OR = 1.013, p = 0.002) were significantly associated with GERD, except BMI (p = 0.384). On the other hand, low BMI (OR = 0.984; p < 0.001), and AVI (OR = 0.994; p = 0.036) were significantly associated with PUD. However, the value of WHR (p = 0.151), WHtR (p = 0.304), BRI (p = 0.452), LAP (p = 0.799), VAI (p = 0.347), and TyG index (p = 0.642) were not.
Conclusion: This study found that high obesity indices are associated with GERD, but low obesity indices are associated with PUD in a large Taiwanese population study. Our findings may alert physicians to notice that different obesity index may be associated with different gastrointestinal disorder.

引言：胃食管反流病（Gastro-esophageal reflux disease, GERD）与消化性溃疡病（peptic ulcer disease, PUD）在台湾地区患病率较高。目前鲜有研究同时探讨各类肥胖指标与GERD、PUD之间的关联。本研究旨在依托台湾生物样本库（Taiwan Biobank, TWB）中约12万名参与者组成的大型队列，分析肥胖指标与GERD、PUD的相关性。
方法：本研究共纳入121583名参与者（男性43698例，女性77885例；平均年龄49.9±11.0岁），分析包括体重指数（body mass index, BMI）、腰臀比（waist–hip ratio, WHR）、腰围身高比（waist-to-height ratio, WHtR）、身体圆度指数（body roundness index, BRI）、腹部体积指数（abdominal volume index, AVI）、脂质蓄积指数（lipid accumulation product, LAP）、内脏脂肪指数（visceral adiposity index, VAI）以及甘油三酯-葡萄糖指数（triglyceride–glucose Index, TyG指数）在内的各类肥胖指标与GERD、PUD的关联。研究通过调查问卷收集受试者自我报告的GERD与PUD患病情况，并采用多因素logistic回归分析肥胖指标与GERD、PUD之间的关联。
结果：本研究中GERD与PUD的患病率分别为13.7%和14.6%。经多变量校正分析后，除BMI（p=0.384）外，高WHR（比值比[OR]=1.009，p<0.001）、WHtR（OR=1.005，p=0.003）、BRI（OR=1.022，p=0.005）、AVI（OR=1.013，p<0.001）、LAP（OR=1.001，p<0.001）、TyG指数（OR=1.068，p<0.001）以及VAI（OR=1.013，p=0.002）均与GERD存在显著关联。另一方面，低BMI（OR=0.984；p<0.001）与低AVI（OR=0.994；p=0.036）与PUD存在显著关联，但WHR（p=0.151）、WHtR（p=0.304）、BRI（p=0.452）、LAP（p=0.799）、VAI（p=0.347）及TyG指数（p=0.642）则与PUD无显著关联。
结论：本研究在大型台湾人群队列中发现，高水平肥胖指标与GERD相关，而低水平肥胖指标则与PUD相关。本研究结果可提醒临床医师关注不同肥胖指标与不同胃肠道疾病的潜在关联。