胃食道逆流疾病發生率與季節性變化和氣候因素之
探討 - 以全民為基礎的研究
研究背景：研究台灣地區胃食道逆流疾病的發生率與季節變化的關聯性，並進一步分析不同年齡、
不同性別及五種氣候因子 ( 氣溫、相對溼度、大氣壓力、降雨量、日照時間 ) ，對胃食道逆流疾病 發生率的影響。
研究方法：從 2001 年 1 月至 2006 年 12 月間衛生署全民健康保險局健保費用申請資料庫中，挑選 出 76,636 名因胃食道逆流症來門診接受治療的病人納入本研究。除了計算 72 個月的胃食道逆流疾 病月發生率 ( 每 10,000 人口 ) ，並將這些資料依性別及年齡 (19-44 歲、 45-64 歲及 >64 歲 ) 區分成 子群。因季節是時間序列，所以運用自我迴歸整合移動平均模型 (ARIMA) 來評估季節月份及氣候 因素，對胃食道逆流疾病發生率的影響。
研究結果：經分析資料發現胃食道逆流疾病的發生率，在十月至十二月為發生率的高峰，其後在一 月逐漸減少，至二月為最低發生率，到三月才又明顯的增加發生率。這樣的趨勢在不同性別、不同 年齡族群或合併兩者都有相似性的季節變化。經過自我迴歸整合移動平均模型調整後，發現在全體 族群 (p<0.01) ，女性病患 (p<0.05) 及年齡 45-64 歲 (p<0.01) 、年齡 >64 歲 (p<0.01) 的族群都和季節 性有明顯的相關性，自我迴歸整合移動平均模型也發現相對溼度和男性及大於 64 歲族群 (p<0.01) 的每個月胃食道逆流疾病發生率呈負相關，而降雨量只和大於 64 歲的年齡族群 (p<0.05) 呈正相關。
結論：這是全世界第一個以全民為基礎，探討胃食道逆流症發生率和氣候變化及氣候因子關聯性的 研究。研究發現胃食道逆流症的發生率和台灣氣候的變化有關，相對濕度與男性、大於 64 歲的族 群的胃食道逆流症發生率呈負相關，而降雨量只和大於 64 歲的族群呈正相關。
Purpose: To examine the seasonal variation in the incidence of gastroesophageal reflux disease (GERD) for different gender and age groups and its association with climatic parameters (ambient temperature, relative humidity,atmospheric pressure, rainfall, hours of sunshine).
Methods: A total of 76,636 ambulatory care visits for the treatment of GERD between 2001 and 2006 were included. Monthly GERD incidence rates per 10,000 people were calculated over 72 months and categorize d by gender and age groupings (of 19-44, 45-64, and >= 64 years). Seasonality is a general component of ti me series patterns.
The Auto-Regressive Integrated Moving Average (ARIMA) regression method was used to evaluate the eff ects of climatic and monthly factors on GERD incidence rates after adjusting for the time-trend effect.
Results: Seasonal trends showed an incidence peak in October-December, followed by a sharp decrease in January and a trough in February; a fairly similar seasonal pattern of GERD incidence was apparent for ge nder, age and combined groups. The ARIMA test for seasonality found a significant association for the tota l group (p<0.01), and female (p<0.05) patients, and for the 45-64 (p<0.01) and >64 (p<0.01) age groups. T he ARIMA models also showed that relative humidity was negatively related to monthly GERD incidence rates for males (p<0.01) and the >64 (p<0.05) age group.
Conclusion: Data showed seasonal variations in GERD incidence. Relative humidity was associated with monthly GERD incidence rates for males and the >64 age group.
Seasonal variations in the incidence of gastro- esophageal reflux disease (GERD) and the ass ociation with climate:
A national population-base study
