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Metabolic syndrome and visceral obesity as risk factors for reflux oesophagitis: a cross-sectional case-control study of 7078 health check-up Koreans
  1. Su Jin Chung (medjsj7{at}hanmail.net)
  1. Seoul National University Hospital Heathcare System Gangnam Center, Korea, Republic of
    1. Donghee Kim (messmd{at}chol.com)
    1. Seoul National University Hospital Heathcare System Gangnam Center, Korea, Republic of
      1. Min Jung Park
      1. Seoul National University Hospital Heathcare System Gangnam Center, Korea, Republic of
        1. Young Sun Kim
        1. Seoul National University Hospital Heathcare System Gangnam Center, Korea, Republic of
          1. Joo Sung Kim
          1. Seoul National University College of Medicine, Korea, Republic of
            1. Hyun Chae Jung
            1. Seoul National University College of Medicine, Korea, Republic of
              1. In Sung Song
              1. Seoul National University College of Medicine, Korea, Republic of

                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.

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