Tu1096 Postprandial Pepsin in Saliva in Healthy Subjects and Patients With GERD. Relationship With Postprandial Reflux

Abstract

BACKGROUND: The Controlled Attenuation Parameter (CAP) is promising tool for the noninvasive detection of hepatic steatosis using a process based on transient elastography. The relationship between CAP and erosive esophagitis (EE) was investigated. METHODS: A total of 1,139 subjects from a health promotion center at Yonsei University Health System, Seoul, Korea were enrolled. Esophagogastroduodenoscopy (EGD) and liver transient elastography were done in all participants. The association between EE and hepatic steatosis was estimated with odds ratios (ORs) and 95% confidence intervals (CIs). Blood pressure, body mass index (BMI), skeletal muscle mass, body fat mass, percent body fat, waist-hip ratio (WHR), serum total cholesterol, high-density lipoprotein cholesterol (HDL-C), lowdensity lipoprotein cholesterol (LDL-C), triglyceride (TG), fasting glucose, HbA1c were compared between individuals with and without EE. Risk factors for EE were evaluated by multivariate logistic regression. Severity of hepatic steatosis by CAP score was defined as S0 (less than 270 dB/m), S1 (270-299 dB/m), S2 (300-319 dB/m), and S3 (≥300 dB/m). RESULTS:: The prevalence of erosive esophagitis was 6.6% (75/1,139). Severity of hepatic steatosis and was positively associated with prevalence (3.8% in S0, 12.5% in S1, 18.4% in S3, and 27.8% in S4, p<0.001), as well as severity of erosive esophagitis (p<0.001). Male gender, high CAP score, high waist-hip ratio, high diastolic blood pressure, high BMI, high TG level and hiatus hernia was associated with EE (p<0.001 for each factor). In a multivariate analysis, male gender (OR, 2.45, 95% CI, 1.37-4.38, p= 0.003), central obesity (OR, 1.41, 95% CI, 1.02-1.91, p= 0.024), hiatus hernia (OR, 3.79, 95% CI, 1.05-13.59, p=0.031), and hepatic steatosis were significantly associated with erosive esophagitis. The OR of EE for hepatic steatosis was 3.08 (95% CI, 1.68-5.67) for S1, 5.77 (95% CI, 2.55-13.41) for S2, and 8.79 (95%CI, 4.32-17.85) for S3, compared with participants with S0 (p<0.001) CONCLUSION:: Hepatic steatosis is associated with increased risk and severity of erosive esophagitis. In addition, male gender, central obesity and hiatus hernia were also positively associated with erosive esophagitis.