Skip to main content

Advertisement

SpringerLink
Log in

Risk factors for erosive esophagitis: a cross-sectional study of a large number of Japanese males

  • Original Article—Alimentary Tract
  • Published:
Journal of Gastroenterology Aims and scope Submit manuscript

Abstract

Background

The impact of obesity on gastroesophageal reflux disease remains controversial. We undertook this study, with a large sample size, to investigate risk factors for endoscopic erosive esophagitis by multivariate analysis, including visceral adipose tissue (VAT) and subcutaneous adipose tissue (SAT) as covariates.

Methods

Japanese males who visited our institute for a comprehensive medical survey between 2007 and 2010 were enrolled. All subjects voluntarily participated in a self-paid health check-up program including blood test screening, physical examinations, and esophagogastroduodenoscopy. VAT and SAT were measured by computed tomography at the navel level. Independent and significant predictors of erosive esophagitis were determined by multivariate analysis.

Results

Of 9840 eligible subjects, 1831 (18.6%) were diagnosed with erosive esophagitis. Body mass index and triglyceride were predictors of an increased prevalence of erosive esophagitis (odds ratios [ORs] = 1.063 and 1.001; 95% confidence intervals [CIs] = 1.020–1.108 and 1.001–1.002; p = 0.004 and <0.001, respectively). Heavy alcohol consumption, heavy smoking, and hiatal hernia were also associated with an increased prevalence of erosive esophagitis (ORs = 1.276, 1.399, and 2.758; 95% CIs = 1.085–1.501, 1.220–1.605, and 2.474–3.075; p < 0.001 for all). Helicobacter pylori infection significantly and independently decreased the prevalence of erosive esophagitis (OR = 0.346, 95% CI = 0.299–0.401, p < 0.001). Central obesity, as determined by VAT and waist girth, did not confer an increased risk of erosive esophagitis after adjusting for confounders.

Conclusions

Lifestyle factors including heavy alcohol consumption, heavy smoking, metabolic disorders, and hiatal hernia increased the risk of erosive esophagitis, but central obesity did not.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  1. Locke GR 3rd, Talley NJ, Fett SL, Zinsmeister AR, Melton LJ 3rd. Prevalence and clinical spectrum of gastroesophageal reflux: a population-based study in Olmsted Country, Minnesota. Gastroenterology. 1997;112:1448–56.

    Article  PubMed  Google Scholar 

  2. Vakil N. Dyspepsia, peptic ulcer, and H. pylori: a remembrance of things past. Am J Gastroenterol. 2010;105:572–4.

    Article  PubMed  Google Scholar 

  3. Wu JC. Gastroesophageal reflux disease: an Asian perspective. J Gastroenterol Hepatol. 2008;23:1785–93.

    Article  PubMed  Google Scholar 

  4. Miyamoto M, Haruma K, Kuwabara M, Nagano M, Okamoto T, Tanaka M. High incidence of newly developed gastroesophageal reflux disease in the Japanese community: a 6-year follow-up study. J Gastroenterol Hepatol. 2008;23:393–7.

    Article  PubMed  Google Scholar 

  5. Shim KN, Hong SJ, Sung JK, Park KS, Kim SE, Park HS, et al. Clinical spectrum of reflux esophagitis among 25536 Koreans who underwent a health check-up: a nationwide multicenter prospective, endoscopy-based study. J Clin Gastroenterol. 2009;43:632–8.

    Article  PubMed  Google Scholar 

  6. Lagergren J, Bergström R, Lindgren A, Nyrén O. Symptomatic gastroesophageal reflux as a risk factor for esophageal adenocarcinoma. N Engl J Med. 1999;340:825–31.

    Article  PubMed  CAS  Google Scholar 

  7. Grande M, Cadeddu F, Villa M, Attinà GM, Muzi MG, et al. Helicobacter pylori and gastroesophageal reflux disease. World J Surg Oncol. 2008;6:74.

    Article  PubMed  Google Scholar 

  8. Nordenstedt H, Nilsson M, Johnsen R, Lagergren J, Hveem K. Helicobacter pylori infection and gastroesophageal reflux in a population-based study (The HUNT Study). Helicobacter. 2007;12:16–22.

    Article  PubMed  Google Scholar 

  9. El-Serag HB, Ergun GA, Pandolfino J, Fitzgerald S, Tran T, Kramer JR. Obesity increased oesophageal acid exposure. Gut. 2007;56:749–55.

    Article  PubMed  Google Scholar 

  10. El-Serag HB, Tran T, Richardson P, Ergun G. Anthropometric correlates of intragastric pressure. Scand J Gastroenterol. 2006;41:887–91.

    Article  PubMed  Google Scholar 

  11. DeVault KR, Castell DO. Updated guidelines for the diagnosis and treatment of gastroesophageal reflux disease. Am J Gastroenterol. 2005;100:190–200.

    Article  PubMed  Google Scholar 

  12. Labenz J, Jaspersen D, Kulig M, Leodolter A, Lind T, Meyer-Sabellek W, et al. Risk factors for erosive esophagitis: a multivariate analysis based on the ProGERD study initiative. Am J Gastroenterol. 2004;99:1652–6.

    Article  PubMed  Google Scholar 

  13. Breckan RK, Paulssen EJ, Asfeldt AM, Mortensen L, Straume B, Florholmen J. The impact of body mass index and Helicobacter pylori infection on gastro-oesophageal reflux symptoms: a population-based study in Northern Norway. Scand J Gastroenterol. 2009;44:1060–6.

    Article  PubMed  Google Scholar 

  14. Corley DA, Kubo A. Body mass index and gastroesophageal reflux disease: a systematic review and meta-analysis. Am J Gastroenterol. 2006;101:2619–28.

    Article  PubMed  Google Scholar 

  15. El-Serag HB, Graham DY, Satia JA, Rabeneck L. Obesity is an independent risk factor for GERD symptoms and erosive esophagitis. Am J Gastroenterol. 2005;100:1243–50.

    Article  PubMed  Google Scholar 

  16. Lee SJ, Song CW, Jeen YT, Chun HJ, Lee HS, Um SH, et al. Prevalence of endoscopic reflux esophagitis among Koreans. J Gastroenterol Hepatol. 2001;16:373–6.

    Article  PubMed  CAS  Google Scholar 

  17. Chang CS, Poon SK, Lien HC, Chen GH. The incidence of reflux esophagitis among the Chinese. Am J Gastroenterol. 1997;92:668–71.

    PubMed  CAS  Google Scholar 

  18. Kang MS, Park DI, Oh SY, Yoo TW, Ryu SH, Park JH, et al. Abdominal obesity is an independent risk factor for erosive esophagitis in a Korean population. J Gastroenterol Hepatol. 2007;22:1656–61.

    Article  PubMed  Google Scholar 

  19. Lagergren J, Bergstrom R, Nyren O. No relation between body mass and gastro-oesophageal reflux symptoms in a Swedish population based study. Gut. 2000;47:26–9.

    Article  PubMed  CAS  Google Scholar 

  20. Corley DA, Kubo A, Zhao W. Abdominal obesity, ethnicity and gastro-oesophageal reflux symptoms. Gut. 2007;56:756–62.

    Article  PubMed  Google Scholar 

  21. Chung SJ, Kim D, Park MJ, Kim YS, Kim JS, Jung HC, et al. Metabolic syndrome and visceral obesity as risk factors for reflux oesophagitis: a cross-sectional case–control study of 7078 Koreans undergoing health check-ups. Gut. 2008;57:1360–5.

    Article  PubMed  CAS  Google Scholar 

  22. Woodward M, Morrison C, McColl K. An investigation into factors associated with Helicobacter pylori infection. J Clin Epidemiol. 2000;53:175–81.

    Article  PubMed  CAS  Google Scholar 

  23. Longo-Mbenza B, Nsenga NJ, Ngoma VD. Prevention of the metabolic syndrome insulin resistance and the atherosclerotic diseases in Africans infected by Helicobacter pylori infection and treated by antibiotics. Int J Cardiol. 2007;118:1–10.

    Article  Google Scholar 

  24. Thaete FL, Colberg SR, Burke T, Kelley DE. Reproducibility of computed tomography of visceral adipose tissue area. Int J Obes Relat Metab Disord. 1995;19:464–7.

    PubMed  CAS  Google Scholar 

  25. Brinkman GL, Coates EO Jr. The effect of bronchitis, smoking, and occupation on ventilation. Am Rev Respir Dis. 1963;87:684–93.

    PubMed  CAS  Google Scholar 

  26. Hoshihara Y. Endoscopic findings of GERD (in Japanese with English abstract). Nippon Rinsho. 2004;62:1459–64.

    PubMed  Google Scholar 

  27. Eckel RH, Grundy SM, Zimmet P. The metabolic syndrome. Lancet. 2005;365:1415–28.

    Article  PubMed  CAS  Google Scholar 

  28. Alberti KG, Zimmet P, Shaw J. The metabolic syndrome––a new worldwide definition. Lancet. 2005;366:1059–62.

    Article  PubMed  Google Scholar 

  29. Weiss R, Dziura J, Burgert TS, Tamborlane WV, Taksali SE, Yeckel CW, et al. Obesity and the metabolic syndrome in children and adolescents. N Engl J Med. 2004;350:2362–74.

    Article  PubMed  CAS  Google Scholar 

  30. Watanabe S, Hojo M, Nagahara A. Metabolic syndrome and gastrointestinal diseases. J Gastroenterol. 2007;42:267–74.

    Article  PubMed  Google Scholar 

  31. Nakamura T, Shirakawa K, Masuyama H, Sugaya H, Hiraishi H, Terano A. Minimal change oesophagitis: a disease with characteristic differences to erosive oesophagitis. Aliment Pharmacol Ther. 2005;21:19–26.

    Article  PubMed  Google Scholar 

  32. Furukawa N, Iwakiri R, Koyama T, Okamoto K, Yoshida T, Kashiwagi Y, et al. Proportion of reflux esophagitis in 6010 Japanese adults: prospective evaluation by endoscopy. J Gastroenterol. 1999;34:441–4.

    Article  PubMed  CAS  Google Scholar 

  33. Fujiwara Y, Arakawa T. Epidemiology and clinical characteristics of GERD in the Japanese population. J Gastroenterol. 2009;44:518–34.

    Article  PubMed  Google Scholar 

  34. Dent J. Gastro-oesophageal reflux disease. Digestion. 1998;59:433–45.

    Article  PubMed  CAS  Google Scholar 

  35. Rajendra S, Ackroyd R, Robertson IK, Ho JJ, Karim N, Kutty KM. Helicobacter pylori, ethnicity, and the gastroesophageal reflux disease spectrum: a study from the East. Helicobacter. 2007;12:177–83.

    Article  PubMed  Google Scholar 

  36. Shahabi S, Rasmi Y, Jazani NH, Hassan ZM. Protective effects of Helicobacter pylori against gastroesophageal reflux disease may be due to a neuroimmunological anti-inflammatory mechanism. Immunol Cell Biol. 2008;86:175–8.

    Article  PubMed  CAS  Google Scholar 

  37. Peng S, Cui Y, Xiao YL, Xiong LS, Hu PJ, Li CJ, et al. Prevalence of erosive esophagitis and Barrett’s esophagus in the adult Chinese population. Endoscopy. 2009;41:1011–7.

    Article  PubMed  CAS  Google Scholar 

  38. Corley DA, Kubo A, Levin TR, Block G, Habel L, Rumore G, et al. Helicobacter pylori and gastroesophageal reflux disease: a case–control study. Helicobacter. 2008;13:352–60.

    Article  PubMed  Google Scholar 

  39. Yaghoobi M, Farrokhyar F, Yuan Y, Hunt RH. Is there an increased risk of GERD after Helicobacter pylori eradication? A meta-analysis. Am J Gastroenterol. 2010;105:1007–13.

    Article  PubMed  Google Scholar 

  40. Meining A, Classen M. The role of diet and lifestyle measures in the pathogenesis and treatment of gastroesophageal reflux disease. Am J Gastroenterol. 2000;95:2692–7.

    Article  PubMed  CAS  Google Scholar 

  41. El-Serag HB, Johanson JF. Risk factors for the severity of erosive esophagitis in Helicobacter pylori-negative patients with gastroesophageal reflux disease. Scand J Gastroenterol. 2002;37:899–904.

    Article  PubMed  CAS  Google Scholar 

  42. Moki F, Kusano M, Mizuide M, et al. Association between reflux oesophagitis and features of the metabolic syndrome in Japan. Aliment Pharmacol Ther. 2007;26:1069–75.

    Article  PubMed  CAS  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Center for Preventive Medicine, Kanto Medical Center, NTT East, Tokyo, Japan

    Toshiaki Gunji, Kimiko Iijima, Kazutoshi Fujibayashi, Mitsue Okumura, Noriko Sasabe & Akio Urabe

  2. Department of Public Health, Graduate School of Medicine, University of Tokyo, Tokyo, Japan

    Hajime Sato

  3. Department of Gastroenterology, Kanto Medical Center, NTT East, 5-9-22 Higashi-gotanda, Shinagawa-ku, Tokyo, 141-8625, Japan

    Nobuyuki Matsuhashi

Authors
  1. Toshiaki Gunji
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Hajime Sato
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Kimiko Iijima
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Kazutoshi Fujibayashi
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Mitsue Okumura
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Noriko Sasabe
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. Akio Urabe
    View author publications

    You can also search for this author in PubMed Google Scholar

  8. Nobuyuki Matsuhashi
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Nobuyuki Matsuhashi.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Gunji, T., Sato, H., Iijima, K. et al. Risk factors for erosive esophagitis: a cross-sectional study of a large number of Japanese males. J Gastroenterol 46, 448–455 (2011). https://doi.org/10.1007/s00535-010-0359-5

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00535-010-0359-5

Keywords

Search

Navigation