Authors: T Yamaguchi T Sugimoto H Yamada M Kanzawa S Yano M Yamauchi K Chihara
Publish Date: 2014/02/14
Volume: 13, Issue: 4, Pages: 331-336
Abstract
We examined the relationship between the presence of esophageal hiatal hernia HH assessed by endoscopy and the presence of vertebral fractures VFs in 87 Japanese postmenopausal women age range 52–87 years We found that 29 63 of 46 patients with HH 712 ± 61 years mean ± SD had one or more VFs compared with 14 34 of 41 patients without HH 708 ± 68 years which was a significant difference in the frequency of VFs c2= 7242 p= 00071 The average number of VFs per patient was significantly higher for the patients with HH than for those without HH 167 ± 175 vs 068 ± 121 p= 00032 There were no significant differences in absolute or agematched bone mineral density BMD values at the lumbar spine 0656 ± 0131 vs 0662 ± 0148 g/cm2 Zscore –035 ± 117 vs –026 ± 100 and there were no significant differences in biochemical parameters age years since menopause or body mass index BMI between the two groups When patients were divided into those with reflux esophagitis RE n= 30 702 ± 73 years and those without RE n= 57 714 ± 59 years no significant differences were detected in any of the above parameters including the presence or number of VFs The patients were further subdivided into four groups those with ‘HH only’ n= 23 723 ± 46 years with ‘RE only’ n= 7 709 ± 77 years with ‘both’ n= 23 700 ± 73 years and with ‘neither’ n= 34 708 ± 67 years One or more VFs were found in 12 52 1 14 17 74 and 13 38 patients in each group respectively and the difference in frequency was significant c2= 10748 p= 00132 The average number of VFs per patient in each group was 157 ± 206 014 ± 038 178 ± 141 and 079 ± 130 respectively and there were significant differences between the ‘both’ and ‘neither’ groups and between the ‘both’ and ‘RE only’ groups p005 When univariate logistic regression analysis was performed with the presence of HH as a dependent variable and each of the presence of VFs the number of VFs per patient absolute or agematched BMD values at the lumbar spine BMI and plasma albumin as independent variables the presence of VFs and the number of VFs per patient were selected as indices affecting the presence of HH odds ratio 329 and 159 95 confidence interval 136–794 and 114–223 p = 00080 and 00064 respectively These results show that the presence and severity of VFs are associated with the presence of HH but not of RE in Japanese postmenopausal women and suggest that kyphosis induced by multiple VFs might predispose elderly women to a complication with HH
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