Abstract
Background: Although several studies have shown that each of the metabolic syndrome (MetS) components can be a risk factor for erosive esophagitis (EE), the association between MetS and EE is still a challenging subject, as studies about this association have shown inconsistent results. Therefore, this study was conducted to evaluate the association between MetS and EE. Method: In this study, we followed the MOOSE protocol and the PRISMA guidelines for reporting the results. Web of Science (ISI), Cochrane Library (Cochrane Database of Systematic Reviews - CDSR), EMBASE, Scopus, Science Direct, PubMed/Medline, EBSCO, CINAHL, and Google Scholar search engine searched for articles published until July 2019. Heterogeneity between studies was estimated by I2 index and Q test. All analyses were performed using Comprehensive Meta-Analysis Software. Finding: MetS was significantly associated with increased risk of EE (OR=1.488 [95%CI: 1.352-1.638], P< 0.001; Heterogeneity: I2= 55.57, P< 0.001) in 12 studies with a sample size of 45285 (12825 cases and 29377 controls). In subgroup analysis based on types of studies (P=0.832), MetS diagnostic criteria (P=0.083) and studies quality (P=0.612), we not found significant difference. Meta-regression for the association between MetS and EE based on year of publication was not significant (meta-regression coefficient: -0.009 [95% CI: -0.037 to 0.019], P = 0.529). Sensitivity analysis was used to omit one study to show the overall estimation power and showed that the overall estimation is still robust. Publication bias based on the Begg's test (P = 0.945) and Egger's test (P = 0.753) were not significant. Interpretation: MetS increases the risk of EE compared to control groups. Future studies should examine if MetS treatment reduces the risk of EE. Funding Statement: Ilam University of Medical Sciences. Declaration of Interests: The authors declare no competing interests. Ethical Approval Statement: Not required.
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