Metabolic syndrome and visceral obesity as risk factors for reflux oesophagitis: a cross-sectional case-control study of 7078 health check-up Koreans

¹ Seoul National University Hospital Heathcare System Gangnam Center, Korea, Republic of
² Seoul National University College of Medicine, Korea, Republic of

^* To whom correspondence should be addressed. E-mail: messmd{at}chol.com.

Accepted 17 April 2008

	Abstract

Background: Obesity has been associated with reflux oesophagitis. However, the relationship between metabolic syndrome characterized by visceral obesity and reflux oesophagitis is unclear.

Aim: To investigate whether metabolic syndrome or visceral obesity is a risk factor for reflux oesophagitis.

Methods: A cross-sectional study of 7078 health check-up subjects undergoing upper endoscopy was conducted (3539 cases with reflux oesophagitis vs age and sex-matched controls). We further analyzed according to categories of visceral adipose tissue and subcutaneous adipose tissue area with 750 cases and age-, sex- and waist circumference-matched controls who underwent abdominal CT scan.

Results: The prevalence of metabolic syndrome was higher in cases than controls (26.9% vs 18.5%, p <0.001). Multivariate analysis demonstrated that metabolic syndrome is associated with reflux oesophagitis (OR = 1.42, 95% CI: 1.26-1.60). Among the individual components of metabolic syndrome, waist circumference (OR = 1.47, 95% CI: 1.30-1.65) and triglyceride (OR = 1.20, 95% CI: 1.05-1.36) independently increased the risk for reflux oesophagitis. On sub-analysis, cases showed higher mean visceral adipose tissue area (136.1 ± 57.8 vs 124.0 ± 54.7, p <0.001) and subcutaneous adipose tissue area (145.9 ± 56.8 vs 133.5 ± 50.7, p <0.001). However, only visceral adipose tissue area was an independent risk factor for reflux oesophagitis after adjusting for multiple confounders including smoking, alcohol, BMI and subcutaneous adipose tissue area (OR = 1.60, 95% CI: 1.03-2.48, lowest quartile vs highest quartile).

Conclusions: Metabolic syndrome was associated with reflux oesophagitis. Abdominal obesity, especially visceral obesity was an important risk factor for reflux oesophagitis.