Meta-Analysis
Copyright ©The Author(s) 2022. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastroenterol. Dec 7, 2022; 28(45): 6410-6420
Published online Dec 7, 2022. doi: 10.3748/wjg.v28.i45.6410
Meta-analysis on the epidemiology of gastroesophageal reflux disease in China
Tai-Liang Lu, Shao-Rong Li, Jia-Min Zhang, Chao-Wu Chen
Tai-Liang Lu, Chao-Wu Chen, Department of Gastrointestinal Surgery, Hunan Provincial People's Hospital, The First Affiliated Hospital of Hunan Normal University, Changsha 410005, Hunan Province, China
Shao-Rong Li, Jia-Min Zhang, Operating Room, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou 510120, Guangdong Province, China
Author contributions: Lu TL and Chen CW contributed to the study design and drafting of the manuscript; Lu TL, Zhang JM, Li SR and Chen CW contributed to the data collection; Lu TL and Li SR contributed to the analysis and interpretation of data; Zhang JM and Li SR contributed to the critical revision of the manuscript; All the authors did approval of the final version for publication.
Conflict-of-interest statement: The authors declare no conflict of interest.
PRISMA 2009 Checklist statement: The authors have read the PRISMA 2009 Checklist, and the manuscript was prepared and revised according to the PRISMA 2009 Checklist.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Chao-Wu Chen, MD, Chief Physician, Department of Gastrointestinal Surgery, Hunan Provincial People's Hospital, The First Affiliated Hospital of Hunan Normal University, No. 139 Renmin Road, Changsha 410005, Hunan Province, China. dr.chencw@hunnu.edu.cn
Received: September 7, 2022
Peer-review started: September 7, 2022
First decision: October 19, 2022
Revised: October 27, 2022
Accepted: November 16, 2022
Article in press: November 16, 2022
Published online: December 7, 2022
Abstract
BACKGROUND

No large-scale epidemiological survey on the prevalence of gastroesophageal reflux disease (GERD) in China has been conducted. China has a large population and a complex geographical environment. It is important to understand the prevalence and spatial distribution of GERD in China.

AIM

To explore the prevalence and the spatial, temporal, and population distributions of GERD in the natural Chinese population.

METHODS

We searched Chinese and English databases for literature on the prevalence of GERD in the natural Chinese population. The prevalence of GERD was pooled using a random-effects meta-analysis model. Subgroup analysis was performed according to time, region, and population. We used ArcGIS software to draw statistical maps and trend analysis charts. Spatial autocorrelation analysis was carried out using Geoda software. Spearman correlation analysis was used to assess the spatial distribution relationship between GERD and upper digestive tract tumours.

RESULTS

Altogether, 70 studies involving 276014 individuals from 24 provinces of China were included. The overall pooled prevalence of GERD was 8.7% (95%CI: 7.5%-9.9%) in mainland China. Over the past two decades, the prevalence of GERD in China has increased from 6.0% to 10.6%. GERD was more common in people aged 40-60, with body mass index ≥ 24, and of Uygur ethnicity. The prevalence was higher in the west and east than in the centre, and there may be a local spatial autocorrelation between the Qinghai-Tibet Plateau and the southeast. GERD was correlated with gastric (r = 0.421, P = 0.041) and oesophageal tumours (r = 0.511, P = 0.011) in spatial distribution.

CONCLUSION

GERD is becoming common in China. The prevalence differs by region and population. The development of appropriate strategies for the prevention and treatment of GERD is needed.

Keywords: China, Meta-analysis, Gastroesophageal reflux disease, Prevalence, Epidemiology, Spatiotemporal trends

Core Tip: The overall pooled prevalence of gastroesophageal reflux disease (GERD) was 8.7% in China. The prevalence was higher in the west and east than in the centre, and there may be a local spatial autocorrelation between the Qinghai-Tibet Plateau and the southeast. GERD was correlated with gastric and oesophageal tumours in spatial distribution.