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21 November 2020: Clinical Research

The Role of Salivary Pepsin in the Diagnosis of Gastroesophageal Reflux Disease (GERD) Evaluated Using High-Resolution Manometry and 24-Hour Multichannel Intraluminal Impedance-pH Monitoring

Zihao Guo 12ABCDEF , Yanhong Wu 2AB , Li Li 2C , Jing Chen 2C , Shutian Zhang 1AFG* , Chuan Zhang 2BDG*

DOI: 10.12659/MSM.927381

Med Sci Monit 2020; 26:e927381

Table 1 The demographic characteristics, endoscopy, 24-h pH-MII monitoring and HRM results of 130 patients with refractory GERD symptoms.

Conclusive GERD (n=48)Inconclusive GERD (n=58)Against GERD (n=24)PPaPbPc
Male gender, n (%)25 (52.1)17 (29.3)8 (33.3)0.0480.017NSNS
Age, Mean±SD58.8±13.457.5±12.253.1±12.50.203NSNSNS
BMI, Mean±SD24.6±3.023.8±3.723.2±4.20.235NSNSNS
GERD-Q9.0 (7.0–11.0)8.0 (6.0–11.0)8.0 (6.0–9.0)0.632NSNSNS
0.0000.032
 Normal, n (%)5 (10.4)16 (27.6)24 (100)
 LA-A&B, n (%)38 (79.2)42 (72.4)0
 LA-C&D&BE, n (%)5 (10.4)0 (0)0
 AET (%)8.9 (6.8–27.8)1.5 (0.5–4.3)1.0 (0.3–2.0)0.013
 DeMeester score31.2 (23.8–87.9)5.8 (1.8–13.3)4.1 (1.5–6.9)0.019
 Distal MNBI (Ω)1316.6±719.72246.9±596.52388.2±654.40.034
 PSPWI (%)19.0 (13.9–30.6)30.5 (23.2–36.7)43.9 (33.1–46.8)
 Total reflux event (n)44.5 (19–82.3)55.0 (32.5–84.5)22.5 (17.3–32.8)0.002NS
  At 17 cm above LES2.5 (1.0–13.8)9.0 (2.0–19.0)5.0 (1.5–8.0)0.017NSNS0.015
  At 15 cm above LES13.0 (2.0–24.8)16.5 (4.8–35.3)8.5 (5.0–14.0)0.114NSNS0.041
  At 9 cm above LES30.5 (6.3–57.0)46.0 (22.8–73.3)19.0 (12.5–27.8)0.011NSNS
  At 7 cm above LES38.0 (9.8–74.8)51.0 (30.0–79.3)22.0 (17.0–31.0)0.012NS0.031
  At 5 cm above LES44.5 (19–79.5)55.9 (30.8–84.5)22.5 (17.3–32.8)0.008NS0.012
  At 3 cm above LES44.5 (19–82.3)55.0 (32.5–84.5)22.5 (17.3–32.8)0.002NS
 LES pressure5.1 (1.4–9.8)8.5 (4.7–11.9)7.4 (4.1–11.5)0.028NSNSNS
 EGJ type0.0310.013NSNS
  Type 1, n(%)4 (8.3)12 (20.7)6 (25)
  Type 2, n(%)29 (60.4)40 (69.0)15 (62.5)
  Type 3, n(%)15 (31.3)6 (10.3)3 (12.5)
EGJ-CI (mmHg·cm)12.7 (8.5–22.8)16.5 (9.3–22.9)16.0 (11.2–24.7)0.648NSNSNS
Normal motility, n (%)14 (39.2)26 (44.8)16 (66.7)0.522NSNSNS
DCI400.5 (192.5–668.0)553.0 (306.8–849.0)462.5 (280.8–1043.3)0.0570.0170.041NS
 At waking6.4 (2.7–11.3)3.0 (2.2–7.4)2.2 (1.3–2.4)0.0110.0010.012NS
 After meal6.3 (3.2–12.7)3.3 (2.3–6.1)2.3 (2.2–3.0)0.024NS0.003NS
 The higher conc.8.2 (3.8–17.8)4.0 (2.3–6.1)2.4 (2.2–3.1)0.0070.0230.003NS
Values are presented as median and interquartile range, except for age, BMI, EGJ-CI, MNBI, and PSPWI (mean and standard deviation); and male sex, Lyon classification, EGJ type, and endoscopy (n and%). BMI – body mass index; GERD – gastroesophageal reflux disease; GERD-Q – gastroesophageal reflux disease questionnaire; BE – Barrett esophagus; AET – acid exposure time; MNBI – mean nocturnal baseline impedance; PSPWI – post-reflux swallow-induced peristaltic wave index; EGJ – esophagogastric junction; EGJ-CI – EGJ contractile integral; DCI – distal contractile integral. Differences were significant when

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Medical Science Monitor eISSN: 1643-3750
Medical Science Monitor eISSN: 1643-3750