Visceral fat obesity is the key risk factor for the development of reflux erosive esophagitis in 40\u201369-years subjects

Shinya Ohashi,Mayumi Inoue,Masahiro Yakami,Hiroyoshi Isoda,Yuki Kondo,Aki Matsushima,Fumika Usui,Shigemi Matsumoto,Takahisa Maruno,Seiichiro Imai,Osamu Kikuchi,Manabu Muto,Keita Fukuyama,Hiroshi Seno,Tomohiko Sunami,Atsushi Yamada,Kazuyo Suzuki

doi:10.1007/s10388-021-00859-5

Shinya Ohashi, Mayumi Inoue + Show 15 more

Open Access

https://doi.org/10.1007/s10388-021-00859-5

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Journal: Esophagus	Publication Date: Jun 12, 2021
Citations: 3	License type: open-access

Affiliation: Kyoto University Hospital, Kyoto University

Abstract

BackgroundVisceral fat obesity can be defined quantitatively by abdominal computed tomography, however, the usefulness of measuring visceral fat area to assess the etiology of gastrointestinal reflux disease has not been fully elucidated.MethodsA total of 433 healthy subjects aged 40–69 years (234 men, 199 women) were included in the study. The relationship between obesity-related factors (total fat area, visceral fat area, subcutaneous fat area, waist circumference, and body mass index) and the incidence of reflux erosive esophagitis was investigated. Lifestyle factors and stomach conditions relevant to the onset of erosive esophagitis were also analyzed.ResultsThe prevalence of reflux erosive esophagitis was 27.2% (118/433; 106 men, 12 women). Visceral fat area was higher in subjects with erosive esophagitis than in those without (116.6 cm2 vs. 64.9 cm2, respectively). The incidence of erosive esophagitis was higher in subjects with visceral fat obesity (visceral fat area ≥ 100 cm2) than in those without (61.2% vs. 12.8%, respectively). Visceral fat obesity had the highest odds ratio (OR) among obesity-related factors. Multivariate analysis showed that visceral fat area was associated with the incidence of erosive esophagitis (OR = 2.18), indicating that it is an independent risk factor for erosive esophagitis. In addition, daily alcohol intake (OR = 1.54), gastric atrophy open type (OR = 0.29), and never-smoking history (OR = 0.49) were also independently associated with the development of erosive esophagitis.ConclusionsVisceral fat obesity is the key risk factor for the development of reflux erosive esophagitis in subjects aged 40–69 years.

Highlights

The prevalence of gastroesophageal reflux disease (GERD) has clearly increased over the past 20 years in Japan [1, 2]
We evaluated the relationship between visceral fat obesity as defined by abdominal computed tomography (CT) and the risk of reflux erosive esophagitis in age-specific (40–69 years) healthy Japanese subjects and further assessed the various factors involved in the development of erosive esophagitis
The median body mass index (BMI), abdominal diameter, Total fat area (TFA), visceral fat area (VFA), and fat area ratio values were significantly higher in men than in women, there was no difference in the median subcutaneous fat area (SFA) value

Summary

Introduction

The prevalence of gastroesophageal reflux disease (GERD) has clearly increased over the past 20 years in Japan [1, 2]. According to the diagnostic criteria of the Japan Society for the Study of Obesity, individuals with visceral fat area (VFA) ≥ 100 cm are diagnosed as visceral fat obese [5]. This criterion is used for risk assessment of obesity-related disorders [12, 13]. We evaluated the relationship between visceral fat obesity as defined by abdominal CT and the risk of reflux erosive esophagitis in age-specific (40–69 years) healthy Japanese subjects and further assessed the various factors involved in the development of erosive esophagitis

Study design

Results

Discussion