Supplementary Material for: Gastroesophageal Reflux Disease-Related Disorders of Systemic Sclerosis Based on the Analysis of 66 Patients

<b><i>Background/Aims:</i></b> Gastroesophageal reflux disease (GERD)-related disorders of systemic sclerosis (SSc) patients have not been adequately investigated. <b><i>Methods:</i></b> Sixty-six SSc patients (5 males and 61 females; 56.6 ± 14.6 years old) who underwent esophagogastroduodenoscopy were analyzed on the basis of 16 background factors. They were additionally compared with 116 matched non-SSc subjects controlling age, sex, and use of proton pump inhibitors (PPIs). <b><i>Results:</i></b> The mean disease duration of 66 patients was 5.1 ± 8.1 years, and their breakdown was as follows: 53 (80.3%) with GERD, 38 (57.6%) with GERD-related symptoms, and 20 (30.3%) with reflux esophagitis (RE; LA-A: 10, LA-B: 5, LA-C: 4, LA-D: 1). Use of PPI (<i>p</i> = 0.0455), complication of interstitial lung disease (<i>p</i> = 0.0242), and history of cyclophosphamide therapy (<i>p</i> = 0.0184) denoted significant association with GERD-related symptoms. Older age (<i>p</i> = 0.0211) was significantly associated with RE. None of GERD-related disorders showed any difference between 37 diffuse cutaneous SSc and 29 limited cutaneous SSc patients. The matched analysis indicated that SSc patients had higher prevalence of GERD (<i>p </i>&lt; 0.0001), GERD-related symptoms (<i>p</i> = 0.0034), and RE (<i>p </i>= 0.0002). <b><i>Conclusion:</i></b> SSc patients tend to have worse GERD symptoms and severer RE. However, most SSc-associated factors did not show significant association with GERD-related disorders, indicating the difficulty in predicting GERD-related disorders among SSc patients.

**背景与目的：** 系统性硬化症（systemic sclerosis, SSc）患者的胃食管反流病（gastroesophageal reflux disease, GERD）相关病症尚未得到充分研究。
**方法：** 本研究纳入66例接受食管胃十二指肠镜检查的SSc患者（男5例，女61例；年龄56.6±14.6岁），基于16项背景因素开展分析；同时纳入116例在年龄、性别及质子泵抑制剂（proton pump inhibitors, PPIs）使用情况上匹配的非SSc对照受试者，与上述患者进行对照比较。
**结果：** 66例患者的平均病程为5.1±8.1年，亚组分布如下：合并GERD者53例（占比80.3%），存在GERD相关症状者38例（占比57.6%），合并反流性食管炎（reflux esophagitis, RE）者20例（占比30.3%；洛杉矶分级LA-A级10例、LA-B级5例、LA-C级4例、LA-D级1例）。质子泵抑制剂使用（p=0.0455）、合并间质性肺疾病（interstitial lung disease，p=0.0242）以及环磷酰胺治疗史（p=0.0184）与GERD相关症状存在显著相关性；年龄较高（p=0.0211）则与RE显著相关。在37例弥漫型皮肤SSc患者与29例局限型皮肤SSc患者中，各类GERD相关病症的发生率均无显著差异。匹配对照分析结果显示，SSc患者的GERD患病率（p<0.0001）、GERD相关症状发生率（p=0.0034）以及RE患病率（p=0.0002）均显著高于对照组。
**结论：** SSc患者往往存在更严重的GERD相关症状与更重度的RE。但多数与SSc相关的临床因素与GERD相关病症均无显著关联，提示难以通过现有指标预测SSc患者的GERD相关病症。