{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,23]],"date-time":"2026-10-23T20:35:43Z","timestamp":1792787743493,"version":"4.5.0"},"reference-count":85,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2025,11,26]],"date-time":"2025-11-26T00:00:00Z","timestamp":1764115200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Physiol."],"abstract":"<jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>Although obesity is widely reported as an established risk factor for gastroesophageal reflux disease (GERD), divergent findings exist across studies. To address the problems of obsolete data and conflicting findings in previous studies, we conducted a systematic review and meta-analysis to explore the association between body mass index (BMI) and GERD.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We searched Pubmed, Embase, Cochrane Library, and Web of Science for relevant studies, and obtained the prevalence of symptomatic gastroesophageal reflux (symptomatic GER) or GERD from the original studies for the different BMI groups. International BMI cut-off points were adopted to define underweight, overweight, and obesity. Meta-analysis of this association was performed by calculating the combined relative risk (RR) and 95% confidence intervals (95% CI) using a random-effects model. In addition, subgroup and dose-response analyses were performed to explore subgroup differences and the association between BMI and GERD.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Analysis of 43 papers (39 cross-sectional studies, 4 case-control studies) with a total of 484,219 study participants showed that BMI was associated with the risk of symptomatic GER (RR = 2.041, 95% CI: 1.507\u20132.763) and GERD (RR = 1.374, 95% CI: 1.260\u20131.499). The results of the meta-analysis across different BMI groups suggest that, overweight (BMI \u226525 kg\/m\n                      <jats:sup>2<\/jats:sup>\n                      ) was an important inflection point for the risk of the diseases. In subgroup analyses comparing obese and non-obese populations, we incorporated other obesity diagnostic indicators and found that these might be a significant source of heterogeneity (p = 0.015). Dose-response analysis showed that for every 10 kg\/m\n                      <jats:sup>2<\/jats:sup>\n                      increase in BMI, the risk of prevalence of gastroesophageal reflux disease increased by 68% (RR = 1.681, 95% CI: 1.326\u20132.131).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Elevated BMI increases the risk of symptomatic GER and GERD, and BMI is positively and linearly correlated with the risk of GERD. Overweight is an important inflection point for disease risk. High-quality prospective cohort studies are needed to explore the causality between the two factors and underlying mechanisms in the future.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fphys.2025.1675457","type":"journal-article","created":{"date-parts":[[2025,11,26]],"date-time":"2025-11-26T05:15:52Z","timestamp":1764134152000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":9,"title":["Association between body mass index at different levels and risk of gastroesophageal reflux disease: a systematic review with dose-response meta-analysis"],"prefix":"10.3389","volume":"16","author":[{"given":"Mao","family":"Yiqing","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zhang","family":"Yangyang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hu","family":"Lanshuo","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zhang","family":"Wenhao","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"An","family":"Yixin","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zhao","family":"Yingpan","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tang","family":"Xudong","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2025,11,26]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"169","DOI":"10.1186\/s12876-024-03259-y","article-title":"The association between night eating syndrome and GERD symptoms among university students at An-Najah national university in palestine: a cross-sectional study","volume":"24","author":"Abed","year":"2024","journal-title":"BMC Gastroenterol."},{"key":"B2","doi-asserted-by":"publisher","first-page":"2736","DOI":"10.3390\/ejihpe13120189","article-title":"Diets including animal food are associated with gastroesophageal reflux disease","volume":"13","author":"Baroni","year":"2023","journal-title":"Eur. J. Investig. Health Psychol. Educ."},{"key":"B3","doi-asserted-by":"publisher","first-page":"e13758","DOI":"10.1111\/ijcp.13758","article-title":"Prevalence of gastro-oesophageal reflux symptoms: an Italian cross-sectional survey focusing on knowledge and attitudes towards lifestyle and nutrition","volume":"75","author":"Bert","year":"2021","journal-title":"Int. J. Clin. Pract."},{"key":"B4","doi-asserted-by":"publisher","first-page":"1060","DOI":"10.1080\/00365520903093728","article-title":"The impact of body mass index and Helicobacter pylori infection on gastro-oesophageal reflux symptoms: a population-based study in northern Norway","volume":"44","author":"Breckan","year":"2009","journal-title":"Scand. J. Gastroenterol."},{"key":"B5","doi-asserted-by":"publisher","first-page":"2545","DOI":"10.3748\/wjg.v18.i20.2545","article-title":"Association between body mass index and erosive esophagitis: a meta-analysis","volume":"18","author":"Cai","year":"2012","journal-title":"World J. Gastroenterol."},{"key":"B6","doi-asserted-by":"publisher","first-page":"936792","DOI":"10.1155\/2013\/936792","article-title":"Lifestyle characteristics and gastroesophageal reflux disease: a population-based study in Albania","volume":"2013","author":"Cela","year":"2013","journal-title":"Gastroenterol. Res. Pract."},{"key":"B7","doi-asserted-by":"publisher","first-page":"920","DOI":"10.1016\/j.soard.2013.03.013","article-title":"Prevalence of hiatal hernia in the morbidly Obese","volume":"9","author":"Che","year":"2013","journal-title":"Surg. Obes. Relat. Dis."},{"key":"B8","doi-asserted-by":"publisher","first-page":"161","DOI":"10.1186\/1471-230X-12-161","article-title":"Prevalence and risk factors of gastroesophageal reflux symptoms in a Chinese retiree cohort","volume":"12","author":"Chen","year":"2012","journal-title":"BMC Gastroenterol."},{"key":"B9","doi-asserted-by":"publisher","first-page":"4901","DOI":"10.1007\/s00405-021-06999-9","article-title":"An epidemiological survey of gastroesophageal reflux disease at the digestive endoscopy center in guangzhou","volume":"278","author":"Chen","year":"2021","journal-title":"Eur. Arch. Otorhinolaryngol."},{"key":"B10","doi-asserted-by":"publisher","first-page":"491","DOI":"10.1159\/000540281","article-title":"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","volume":"17","author":"Chen","year":"2024","journal-title":"Obes. facts"},{"key":"B11","doi-asserted-by":"publisher","first-page":"414","DOI":"10.1016\/j.cmet.2023.02.003","article-title":"The global burden of metabolic disease: data from 2000 to 2019","volume":"35","author":"Chew","year":"2023","journal-title":"Cell Metab."},{"key":"B12","doi-asserted-by":"publisher","first-page":"649","DOI":"10.3760\/cma.j.cn311367-20200918-00558","article-title":"Chinese expert consensus on gastroesophageal reflux disease","volume":"40","year":"2020","journal-title":"Chin. J. Gastroenterology"},{"key":"B13","doi-asserted-by":"publisher","first-page":"2619","DOI":"10.1111\/j.1572-0241.2006.00849.x","article-title":"Body mass index and gastroesophageal reflux disease: a systematic review and meta-analysis","volume":"101","author":"Corley","year":"2006","journal-title":"Am. J. Gastroenterol."},{"key":"B14","doi-asserted-by":"publisher","first-page":"311","DOI":"10.1155\/2014\/960520","article-title":"High prevalence of esophageal dysmotility in asymptomatic obese patients","volume":"28","author":"Cote-Daigneault","year":"2014","journal-title":"Can. J. Gastroenterol. Hepatol."},{"key":"B15","doi-asserted-by":"publisher","first-page":"116","DOI":"10.1590\/s0004-28032005000200010","article-title":"Gastroesophageal reflux disease: prevalence and associated factors","volume":"42","author":"de Oliveira","year":"2005","journal-title":"Arq. Gastroenterol."},{"key":"B16","doi-asserted-by":"publisher","first-page":"351","DOI":"10.1007\/s11605-020-04849-3","article-title":"The role of the transdiaphragmatic pressure gradient (TGP) in the pathophysiology of proximal reflux","volume":"25","author":"Del","year":"2021","journal-title":"J. Gastrointest. Surg."},{"key":"B18","doi-asserted-by":"publisher","first-page":"2027","DOI":"10.1007\/s10620-007-0108-7","article-title":"Diet, lifestyle and gender in gastro-esophageal reflux disease","volume":"53","author":"Dore","year":"2008","journal-title":"Dig. Dis. Sci."},{"key":"B19","doi-asserted-by":"publisher","first-page":"443","DOI":"10.3923\/pjbs.2008.443.447","article-title":"Is there any association between overweight, obesity and symptoms of reflux disease?","volume":"11","author":"Ebrahimi-Mameghani","year":"2008","journal-title":"Pak J. Biol. Sci."},{"key":"B20","doi-asserted-by":"publisher","first-page":"1243","DOI":"10.1111\/j.1572-0241.2005.41703.x","article-title":"Obesity is an independent risk factor for GERD symptoms and erosive esophagitis","volume":"100","author":"El-Serag","year":"2005","journal-title":"Am. J. Gastroenterol."},{"key":"B21","doi-asserted-by":"publisher","first-page":"887","DOI":"10.1080\/00365520500535402","article-title":"Anthropometric correlates of intragastric pressure","volume":"41","author":"El-Serag","year":"2006","journal-title":"Scand. J. Gastroenterol."},{"key":"B22","doi-asserted-by":"publisher","first-page":"871","DOI":"10.1136\/gutjnl-2012-304269","article-title":"Update on the epidemiology of gastro-oesophageal reflux disease: a systematic review","volume":"63","author":"El-Serag","year":"2014","journal-title":"Gut J. Br. Soc. Gastroenterology"},{"key":"B23","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1155\/2012\/287457","article-title":"Leptin in anorexia and cachexia syndrome","volume":"2012","author":"Engineer","year":"2012","journal-title":"Int. J. peptides"},{"key":"B24","doi-asserted-by":"publisher","first-page":"132","DOI":"10.1186\/s12876-017-0699-1","article-title":"Dietary habits and obesity indices in patients with gastro-esophageal reflux disease: a comparative cross-sectional study","volume":"17","author":"Eslami","year":"2017","journal-title":"BMC Gastroenterol."},{"key":"B25","doi-asserted-by":"publisher","first-page":"430","DOI":"10.1136\/gutjnl-2016-313589","article-title":"Global prevalence of, and risk factors for, gastro-oesophageal reflux symptoms: a meta-analysis","volume":"67","author":"Eusebi","year":"2018","journal-title":"Gut"},{"key":"B26","doi-asserted-by":"publisher","first-page":"E261","DOI":"10.1016\/j.orcp.2010.06.001","article-title":"Prevalence and risk factors for gastroesophageal reflux disease in an impoverished minority population","volume":"4","author":"Friedenberg","year":"2010","journal-title":"Obes. Res. and Clin. Pract."},{"key":"B27","doi-asserted-by":"publisher","first-page":"464","DOI":"10.1007\/s10900-014-9958-z","article-title":"Measuring the food environment and its effects on obesity in the United States: a systematic review of methods and results","volume":"40","author":"Gamba","year":"2015","journal-title":"J. community health"},{"key":"B28","doi-asserted-by":"publisher","first-page":"229","DOI":"10.1016\/j.cgh.2013.07.038","article-title":"Circulating inflammatory cytokines and adipokines are associated with increased risk of barrett\u2019s esophagus: a case\u2013control study","volume":"12","author":"Garcia","year":"2014","journal-title":"Clin. gastroenterology hepatology"},{"key":"B29","doi-asserted-by":"publisher","first-page":"56","DOI":"10.1007\/s12664-020-01135-7","article-title":"Prevalence and risk factors of gastroesophageal reflux disease in a rural Indian population","volume":"40","author":"Ghoshal","year":"2021","journal-title":"Indian J. gastroenterology official J. Indian Soc. Gastroenterology"},{"key":"B30","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1093\/oxfordjournals.epirev.a036298","article-title":"Quantitative methods in the review of epidemiologic literature","volume":"9","author":"Greenland","year":"1987","journal-title":"Epidemiol. Rev."},{"key":"B31","doi-asserted-by":"publisher","first-page":"1351","DOI":"10.1136\/gutjnl-2017-314722","article-title":"Modern diagnosis of GERD: the Lyon consensus","volume":"67","author":"Gyawali","year":"2018","journal-title":"Gut"},{"key":"B32","doi-asserted-by":"publisher","first-page":"3745","DOI":"10.3748\/wjg.v16.i30.3745","article-title":"Gastroesophageal reflux disease: from pathophysiology to treatment","volume":"16","author":"Herbella","year":"2010","journal-title":"World J. Gastroenterol."},{"key":"B33","doi-asserted-by":"publisher","first-page":"1007","DOI":"10.1055\/s-2002-28325","article-title":"Pr\u00e4valenz der Refluxkrankheit in einer Allgemeinpraxis","volume":"127","author":"Hollenz","year":"2002","journal-title":"Dtsch. Med. Wochenschr"},{"key":"B34","doi-asserted-by":"publisher","first-page":"1164","DOI":"10.1111\/j.1440-1746.2011.06750.x","article-title":"Prevalence of gastroesophageal reflux disease in a general population in Taiwan","volume":"26","author":"Hung","year":"2011","journal-title":"J. Gastroenterol. Hepatol."},{"key":"B35","doi-asserted-by":"publisher","first-page":"e89256","DOI":"10.1371\/journal.pone.0089256","article-title":"Determinants of gastroesophageal reflux disease, including hookah smoking and opium use-a cross-sectional analysis of 50,000 individuals","volume":"9","author":"Islami","year":"2014","journal-title":"PLoS One"},{"key":"B60","doi-asserted-by":"publisher","first-page":"1030","DOI":"10.1111\/j.1365-2036.2009.04142.x","article-title":"Development of the GerdQ, a tool for the diagnosis and management of gastro-oesophageal reflux disease in primary care","volume":"30","author":"Jones","year":"2009","journal-title":"Alimentary Pharmacol. and Ther."},{"key":"B36","doi-asserted-by":"publisher","first-page":"2340","DOI":"10.1056\/NEJMoa054391","article-title":"Body-mass index and symptoms of gastroesophageal reflux in women","volume":"354","author":"Jacobson","year":"2006","journal-title":"N. Engl. J. Med."},{"key":"B37","doi-asserted-by":"publisher","first-page":"1982","DOI":"10.1053\/gast.1996.1101982","article-title":"Clinical esophageal pH recording: a technical review for practice guideline development","volume":"110","author":"Kahrilas","year":"1996","journal-title":"Gastroenterology"},{"key":"B38","doi-asserted-by":"publisher","first-page":"27","DOI":"10.14309\/ajg.0000000000001538","article-title":"ACG clinical guideline for the diagnosis and management of gastroesophageal reflux disease","volume":"117","author":"Katz","year":"2022","journal-title":"Am. J. Gastroenterol."},{"key":"B39","doi-asserted-by":"publisher","first-page":"767","DOI":"10.1016\/j.cgh.2019.07.015","article-title":"Phenotypes of gastroesophageal reflux disease: where rome, Lyon, and Montreal meet","volume":"18","author":"Katzka","year":"2020","journal-title":"Clin. gastroenterology hepatology"},{"key":"B40","doi-asserted-by":"publisher","first-page":"761","DOI":"10.1007\/s00464-006-9102-y","article-title":"Esophageal motility disorders in the morbidly Obese population","volume":"21","author":"Koppman","year":"2007","journal-title":"Surg. Endosc."},{"key":"B41","doi-asserted-by":"publisher","first-page":"62","DOI":"10.22159\/ijpps.2018v10i8.25894","article-title":"Prevalence and risk factors of gastroesophageal reflux disease (gerd) in adult kashmiri population","volume":"10","author":"Koul","year":"2018","journal-title":"Int. J. Pharm. Pharm. Sci."},{"key":"B42","first-page":"160","article-title":"Investigation on prevalence and influencing factors of gastroesophageal reflux disease based on symptoms in shiyan area","volume":"24","author":"Lin","year":"2019"},{"key":"B43","doi-asserted-by":"publisher","first-page":"235","DOI":"10.2147\/JIR.S395777","article-title":"Prevalence, general and periodontal risk factors of gastroesophageal reflux disease in China","volume":"16","author":"Liu","year":"2023","journal-title":"J. Inflamm. Res."},{"key":"B44","doi-asserted-by":"publisher","first-page":"642","DOI":"10.1016\/s0002-9343(99)00121-7","article-title":"Risk factors associated with symptoms of gastroesophageal reflux","volume":"106","author":"Locke","year":"1999","journal-title":"Am. J. Med."},{"key":"B45","doi-asserted-by":"publisher","first-page":"317","DOI":"10.1111\/j.1442-2050.2008.00904.x","article-title":"Prevalence of, and factors associated with, gastroesophageal reflux disease: a population-based study in shanghai, China","volume":"22","author":"Ma","year":"2009","journal-title":"Dis. ESOPHAGUS"},{"key":"B46","doi-asserted-by":"publisher","first-page":"280","DOI":"10.22088\/cjim.15.2.280","article-title":"Prevalence and risk factors of gastroesophageal reflux disease symptoms in Mazandaran, North of Iran: a Tabari cohort study","volume":"15","author":"Maleki","year":"2024","journal-title":"Casp. J. Intern Med."},{"key":"B47","doi-asserted-by":"publisher","first-page":"376","DOI":"10.1038\/ajg.2012.466","article-title":"Weight loss and reduction in gastroesophageal reflux. A prospective population-based cohort study: the HUNT study","volume":"108","author":"Ness-Jensen","year":"2013","journal-title":"Am. J. Gastroenterol."},{"key":"B48","doi-asserted-by":"publisher","first-page":"66","DOI":"10.1001\/jama.290.1.66","article-title":"Obesity and estrogen as risk factors for gastroesophageal reflux symptoms","volume":"290","author":"Nilsson","year":"2003","journal-title":"JAMA-JOURNAL Am. Med. Assoc."},{"key":"B49","doi-asserted-by":"publisher","first-page":"169","DOI":"10.1111\/j.1365-2036.2006.02727.x","article-title":"Lifestyle factors and symptoms of gastro-oesophageal reflux \u2013 a population-based study","volume":"23","author":"Nocon","year":"2006","journal-title":"Aliment. Pharmacol. Ther."},{"key":"B50","doi-asserted-by":"publisher","first-page":"e20325","DOI":"10.7759\/cureus.20325","article-title":"Prevalence of gastroesophageal disease and associated risk factors among the population in Al-Qunfudah","volume":"13","author":"Odah","year":"2021","journal-title":"Cureus"},{"key":"B51","doi-asserted-by":"publisher","first-page":"e22500","DOI":"10.7759\/cureus.22500","article-title":"Prevalence and risk factors of gastroesophageal reflux among Jazan university students, Saudi Arabia: a cross-sectional study","volume":"14","author":"Otayf","year":"2022","journal-title":"Cureus"},{"key":"B52","doi-asserted-by":"publisher","first-page":"621","DOI":"10.1053\/j.gastro.2021.10.017","article-title":"Burden and cost of gastrointestinal, liver, and pancreatic diseases in the United States: update 2021","volume":"162","author":"Peery","year":"2022","journal-title":"Gastroenterology"},{"key":"B53","doi-asserted-by":"publisher","first-page":"n160","DOI":"10.1136\/bmj.n160","article-title":"PRISMA 2020 explanation and elaboration: updated guidance and exemplars for reporting systematic reviews","volume":"372","author":"Page","year":"","journal-title":"BMJ"},{"key":"B54","doi-asserted-by":"publisher","first-page":"573","DOI":"10.1111\/j.1442-2050.2011.01287.x","article-title":"Prevalence and determinants of frequent gastroesophageal reflux symptoms in the Australian community","volume":"25","author":"Pandeya","year":"2012","journal-title":"Dis. Esophagus"},{"key":"B55","doi-asserted-by":"publisher","first-page":"5195","DOI":"10.3390\/jcm10215195","article-title":"Associations of obstructive sleep apnea, obestatin, leptin, and ghrelin with gastroesophageal reflux","volume":"10","author":"Pardak","year":"2021","journal-title":"J. Clin. Med."},{"key":"B56","doi-asserted-by":"publisher","first-page":"884","DOI":"10.1016\/j.cgh.2014.08.029","article-title":"Parameters on esophageal pH-impedance monitoring that predict outcomes of patients with gastroesophageal reflux disease","volume":"13","author":"Patel","year":"2015","journal-title":"Clin. Gastroenterol. Hepatol."},{"key":"B57","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.n160","article-title":"The PRISMA 2020 statement: an updated guideline for reporting systematic reviews","volume":"10","author":"Page","year":"","journal-title":"Syst. Rev."},{"key":"B58","doi-asserted-by":"publisher","first-page":"739","DOI":"10.1007\/s00464-005-0268-5","article-title":"Impaired esophageal function in morbidly Obese patients with gastroesophageal reflux disease: evaluation with multichannel intraluminal impedance","volume":"20","author":"Quiroga","year":"2006","journal-title":"Surg. Endosc."},{"key":"B59","doi-asserted-by":"publisher","first-page":"94","DOI":"10.1016\/j.jpeds.2017.10.039","article-title":"Gastric emptying time, esophageal pH-Impedance parameters, quality of life, and gastrointestinal comorbidity in obese children and adolescents","volume":"194","author":"Quitadamo","year":"2018","journal-title":"J. Pediatr."},{"key":"B61","doi-asserted-by":"publisher","first-page":"4619","DOI":"10.2147\/RMHP.S335142","article-title":"Assessing the frequency and risk factors associated with gastroesophageal reflux disease (GERD) in southern Punjab, Pakistan","volume":"14","author":"Rasool","year":"2021","journal-title":"RISK Manag. Healthc. POLICY"},{"key":"B62","doi-asserted-by":"publisher","first-page":"G571","DOI":"10.1152\/ajpgi.00454.2009","article-title":"Inflammatory mediators in gastroesophageal reflux disease: impact on esophageal motility, fibrosis, and carcinogenesis","volume":"298","author":"Rieder","year":"2010","journal-title":"Am. J. physiology Gastrointest. liver physiology"},{"key":"B63","doi-asserted-by":"publisher","first-page":"495","DOI":"10.1097\/00042737-200405000-00010","article-title":"Gastro-oesophageal reflux disease, reflux oesophagitis and non-erosive reflux disease in a multiracial Asian population: a prospective, endoscopy based study","volume":"16","author":"Rosaida","year":"2004","journal-title":"Eur. J. Gastroenterol. Hepatol."},{"key":"B17","doi-asserted-by":"publisher","first-page":"2008","DOI":"10.1001\/jama.283.15.2008","article-title":"Meta-analysis of observational studies in epidemiology: a proposal for reporting. Meta-analysis of observational studies in epidemiology (MOOSE) group","volume":"283","author":"Stroup","year":"2000","journal-title":"JAMA J. Am. Med. Assoc."},{"key":"B64","doi-asserted-by":"publisher","first-page":"64","DOI":"10.1186\/s12876-024-03143-9","article-title":"Risk factors for gastroesophageal reflux disease: a population-based study","volume":"24","author":"Sadafi","year":"2024","journal-title":"BMC Gastroenterol."},{"key":"B65","doi-asserted-by":"publisher","first-page":"e0306223","DOI":"10.1371\/journal.pone.0306223","article-title":"Prevalence and risk factors of gastroesophageal reflux disease in Iran: a cross-sectional analysis from the PERSIAN cohort","volume":"19","author":"Sadeghi","year":"2024","journal-title":"PLOS ONE"},{"key":"B66","doi-asserted-by":"publisher","first-page":"128","DOI":"10.1007\/s12664-010-0065-5","article-title":"Prevalence, severity, and risk factors of symptomatic gastroesophageal reflux disease among employees of a large hospital in northern India","volume":"30","author":"Sharma","year":"2011","journal-title":"Indian J. gastroenterology official J. Indian Soc. Gastroenterology"},{"key":"B67","doi-asserted-by":"publisher","first-page":"153","DOI":"10.11591\/eecsi.1.392","article-title":"Gastro-esophageal reflux symptoms and body mass index: no relation among the Iranian population","volume":"27","author":"Solhpour","year":"2008","journal-title":"Indian J. gastroenterology official J. Indian Soc. Gastroenterology"},{"key":"B68","doi-asserted-by":"publisher","first-page":"603","DOI":"10.1007\/s10654-010-9491-z","article-title":"Critical evaluation of the Newcastle-Ottawa scale for the assessment of the quality of nonrandomized studies in meta-analyses","volume":"25","author":"Stang","year":"2010","journal-title":"Eur. J. Epidemiol."},{"key":"B69","doi-asserted-by":"publisher","first-page":"70","DOI":"10.1007\/s10620-015-3867-6","article-title":"Ghrelin and leptin have a complex relationship with risk of barrett\u2019s esophagus","volume":"61","author":"Thomas","year":"2016","journal-title":"Dig. Dis. Sci."},{"key":"B70","doi-asserted-by":"publisher","first-page":"18269","DOI":"10.1038\/s41598-024-69253-2","article-title":"Incorporating body mass index into esophageal manometry metrics and mean nocturnal baseline impedance for the evaluation of gastro-esophageal reflux disease","volume":"14","author":"Tong","year":"2024","journal-title":"Sci. Rep."},{"key":"B71","doi-asserted-by":"publisher","first-page":"1125","DOI":"10.1055\/s-2007-963633","article-title":"The Montreal definition and classification of gastroesophageal reflux disease: a global, evidence-based consensus paper","volume":"45","author":"Vakil","year":"2007","journal-title":"Z Gastroenterol."},{"key":"B72","doi-asserted-by":"publisher","first-page":"949","DOI":"10.1089\/lap.2018.0395","article-title":"Gastroesophageal reflux disease in Obese patients","volume":"28","author":"Valezi","year":"2018","journal-title":"J. Laparoendosc. Adv. Surg. Tech. A"},{"key":"B73","doi-asserted-by":"publisher","first-page":"268","DOI":"10.7326\/M16-2607","article-title":"Sensitivity analysis in observational research: introducing the E-Value","volume":"167","author":"VanderWeele","year":"2017","journal-title":"Ann. Intern Med."},{"key":"B74","doi-asserted-by":"publisher","first-page":"321","DOI":"10.1111\/j.1442-2050.2006.00602.x","article-title":"Obesity and lifestyle risk factors for gastroesophageal reflux disease, barrett esophagus and esophageal adenocarcinoma","volume":"19","author":"Veugelers","year":"2006","journal-title":"Dis. Esophagus"},{"key":"B75","article-title":"Assessing the risk of bias of individual studies in systematic reviews of health care interventions","author":"Viswanathan","year":"2008"},{"key":"B76","doi-asserted-by":"publisher","first-page":"36","DOI":"10.1186\/s12876-016-0452-1","article-title":"Prevalence of gastro-esophageal reflux disease and its risk factors in a community-based population in southern India","volume":"16","author":"Wang","year":"2016","journal-title":"BMC Gastroenterol."},{"key":"B77","doi-asserted-by":"publisher","first-page":"807","DOI":"10.1080\/00365520310004506","article-title":"Cigarette smoking and alcohol consumption associated with gastro-oesophageal reflux disease in Japanese men","volume":"38","author":"Watanabe","year":"2003","journal-title":"Scand. J. Gastroenterol."},{"key":"B78","doi-asserted-by":"publisher","first-page":"154","DOI":"10.1007\/s12664-021-01156-w","article-title":"Low prevalence of gastroesophageal reflux symptoms in vegetarians","volume":"40","author":"Wenzl","year":"2021","journal-title":"Indian J. Gastroenterol."},{"key":"B79","doi-asserted-by":"publisher","first-page":"157","DOI":"10.1016\/S0140-6736(03)15268-3","article-title":"Appropriate body-mass index for Asian populations and its implications for policy and intervention strategies","volume":"363","year":"2004","journal-title":"Lancet"},{"key":"B80","volume-title":"World obesity atlas 2025","year":"2025"},{"key":"B81","doi-asserted-by":"publisher","first-page":"883","DOI":"10.1053\/j.gastro.2006.12.032","article-title":"Obesity is associated with increased transient lower esophageal sphincter relaxation","volume":"132","author":"Wu","year":"2007","journal-title":"Gastroenterology"},{"key":"B82","doi-asserted-by":"publisher","first-page":"e13848","DOI":"10.1111\/ijcp.13848","article-title":"Rotating night shift work is associated with an increased risk of gastroesophageal reflux disease (GERD) symptoms among workers in China: a cross-sectional study","volume":"75","author":"Xue","year":"2021","journal-title":"Int. J. Clin. Pract."},{"key":"B83","doi-asserted-by":"publisher","first-page":"6718","DOI":"10.19082\/6718","article-title":"Iranian lifestyle factors affecting reflux disease among healthy people in Qom","volume":"10","author":"Yadegarfar","year":"2018","journal-title":"Electron Physician"},{"key":"B84","doi-asserted-by":"publisher","first-page":"1690","DOI":"10.1001\/jama.280.19.1690","article-title":"What\u2019s the relative risk? A method of correcting the odds ratio in cohort studies of common outcomes","volume":"280","author":"Zhang","year":"1998","journal-title":"JAMA"},{"key":"B85","doi-asserted-by":"publisher","first-page":"4154","DOI":"10.7150\/ijbs.65066","article-title":"Current advancement on the dynamic mechanism of gastroesophageal reflux disease","volume":"17","author":"Zheng","year":"2021","journal-title":"Int. J. Biol. Sci."}],"container-title":["Frontiers in Physiology"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fphys.2025.1675457\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,11,26]],"date-time":"2025-11-26T05:15:55Z","timestamp":1764134155000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fphys.2025.1675457\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,11,26]]},"references-count":85,"alternative-id":["10.3389\/fphys.2025.1675457"],"URL":"https:\/\/doi.org\/10.3389\/fphys.2025.1675457","relation":{},"ISSN":["1664-042X"],"issn-type":[{"value":"1664-042X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,11,26]]},"article-number":"1675457"}}