Association Between Erosive Esophagitis and Visceral Fat Accumulation Quantified by Abdominal CT Scan

Lee, Hang Lak; Eun, Chang Soo; Lee, Oh Young; Jeon, Yong Cheol; Han, Dong Soo; Yoon, Byung Chul; Choi, Ho Soon; Hahm, Joon Soo; Ahn, You Hern; Song, Soon Young

doi:10.1097/mcg.0b013e318167b88a

Cited by 43 publications

(33 citation statements)

References 32 publications

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“…In addition to the high association of erosive esophagitis with decreasing levels of serum adiponectin, as also reported by Kato et al .,12, all patients with Barrett's esophagus were diagnosed with low serum adiponectin, as also reported by the study of Lee et al . 13. Our study was compatible with the study by Iwasaki et al 14,.…”

Section: Discussionsupporting

confidence: 92%

Adiponectin level changes among Egyptians with gastroesophageal reflux disease

et al. 2018

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Background and AimVisceral fat is an important endocrine organ that secretes different bioactive substances such as adipocytokines. The aim of this study was to investigate the adiponectin level changes among patients with erosive gastroesophageal reflux disease (GERD)and its consequence on pathogenesis.MethodsIn this study, 150 subjects were selected and divided into four groups: Group І (n = 40) were healthy individuals with an average body mass index and had no gastrointestinal tract symptoms; Group ІІ (n = 50) were patients with mild to moderate erosive esophagitis; Group ІІІ (n = 40) were patients with severe erosive esophagitis; and finally, Group ІV (n = 20) were patients with Barrett's esophagus. Upper gastrointestinal endoscopy was performed for Groups II, III, and IV only, and histopathological assessment was conducted for the suspicious cases of Barrett's esophagus. The measurement of serum adiponectin was performed for all groups using the ELISA test.ResultsOur results revealed that the serum level of adiponectin was significantly lower in patients with different grades of GERD as well Barrett's esophagus as compared to healthy controls (P‐value < 0.001). Additionally, the serum level of adiponectin was correlated with different grades of GERD as the highest level of the adiponectin was found in the control group (11.05 ± 2.58) followed by mild to moderate GERD (6.39 ± 1.64) and then severe GERD (2.42 ± 1.00); finally, the lowest level was detected in the Barrett's esophagus group (1.99 ± 0.47). Our study showed significant correlation between body mass index, waist circumference, and waist–hip ratio on one hand and serum adiponectin level on the other hand, with a statistically significant difference (P‐value < 0.001). The best cut‐off value for serum adiponectin was 7.7 (μg/mL), with a sensitivity of 91.8% and specificity of 97.5%.ConclusionsLow serum adiponectin level appears to be associated with an increased risk of erosive esophagitis, and visceral fat accumulation is related to the impaired secretion of adiponectin, which may have an influence on the pathogenesis of GERD.

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Section: Discussionsupporting

confidence: 92%

Adiponectin level changes among Egyptians with gastroesophageal reflux disease

et al. 2018

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“…Moreover, recent studies have elucidated that the accumulation of visceral fat is associated with GERD [7][8][9]. It is generally considered that visceral adiposity is associated with increased intra-abdominal and subsequent intragastric pressure which may increase the reflux of gastric acid to the esophagus and cause damage to the esophageal mucosa [21].…”

Section: Discussionmentioning

confidence: 99%

“…Obesity is an independent risk factor for GERD, and the odds ratio (OR) is approximately 1.5-fold for overweight [defined as body mass index (BMI) [25 kg/m 2 ], and two to threefold for obese (defined as BMI [30 kg/m 2 ) individuals [4][5][6]. In particular, not only simple obesity but also abdominal obesity or the accumulation of visceral fat is associated with GERD [7][8][9]. It is generally considered that abdominal obesity elevates intra-abdominal pressure, thereby increasing acid reflux to the esophagus, which results in GERD.…”

Section: Introductionmentioning

confidence: 99%

Association of low serum adiponectin levels with erosive esophagitis in men: an analysis of 2405 subjects undergoing physical check-ups

et al. 2011

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Background Obesity is a risk factor for gastro-esophageal reflux disease (GERD). It is generally considered that intraabdominal pressure in obese subjects is involved in the pathogenesis of GERD through acid exposure to the esophagus. Recently, visceral fat has been recognized as an endocrine organ that secretes various adipocytokines including adiponectin. The aim of this study was to elucidate the relation between adiponectin and erosive esophagitis. Methods This was a cross-sectional retrospective observational study: 2405 consecutive subjects who underwent screening esophago-gastro-duodenoscopy with serum adiponectin measurement as part of their physical check-up programs were analyzed. Clinical factors were compared between subjects with and without erosive esophagitis. The association between adiponectin and erosive esophagitis was assessed using a bootstrapping re-sampling method after adjustment for factors that tended to be different in univariate analysis. Results Serum adiponectin levels were significantly lower in those with erosive esophagitis (8.17 lg/ml) than in those without (10.1). The erosive esophagitis group had a greater body mass index (BMI) and waist circumference (WC) and a higher prevalence of hiatal hernia. Using the bootstrap method, with a lower adiponectin cut-off value of 3-7 lg/ml, the lower limit of the 95% confidence interval of the adjusted odds ratio consistently exceeded 1 after adjustment for BMI and hiatal hernia in men. When adjusting for WC instead of BMI, the effect of adiponectin was reduced but remained significant at a lower cut-off value (3-3.5 lg/ml). Conclusions Low serum adiponectin levels may be associated with an increased risk for erosive esophagitis in men.

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“…The subgroup analysis showed that the FSSG score was exacerbated in subjects with a BMI greater than 30 kg/m 2 . Abdominal fat accumulation, as determined using a CT scan, was reported to closely correlate with GERD symptoms and Barrett esophagus (18,19). Several studies in Japan showed that increased BMI was a risk factor for GERD symptoms and reflux esophagitis, whereas other studies reported that the BMI was not correlated with GERD and GERD symptoms (5-11).…”

Section: Discussionmentioning

confidence: 90%

The Symptoms of Gastroesophageal Reflux Disease Correlate with High Body Mass Index, the Aspartate Aminotransferase/Alanine Aminotransferase Ratio and Insulin Resistance in Japanese Patients with Non-alcoholic Fatty Liver Disease

Eguchi

Fukumori

et al. 2015

Intern. Med.

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Objective This study was designed to compare the association between the body mass index (BMI) and symptoms of gastroesophageal reflux disease (GERD) in allegedly normal subjects undergoing regular medical checkups and subjects diagnosed with non-alcoholic fatty liver disease (NAFLD). Additionally, the correlation between the BMI and GERD symptoms was evaluated in subjects with NAFLD. Methods This study included 50 patients with NAFLD and 228 normal subjects evaluated during regular medical checkups. The height, weight, BMI, frequency scale for the symptoms of GERD (FSSG), and serum concentrations of triglycerides and γ-GTP were compared between the two groups. In the NAFLD group, aspartate aminotransferase (AST) and alanine aminotransferase (ALT) concentrations were measured and insulin resistance was calculated using the quantitative insulin sensitivity check index (QUICKI). Results The total FSSG score moderately correlated with the BMI in the NAFLD group (r=0.342, p= 0.015), but correlated negatively in the control group (r=-0.014, p=0.831). The FSSG score in the NAFLD group also negatively correlated with the AST/ALT ratio (r=-0.319) and insulin resistance calculated using the QUICKI score (r=-0.288). The BMI in the NAFLD group moderately correlated with the acid-reflux related score on the FSSG (r=0.389), and both the AST/ALT ratio (r=-0.344) and QUICKI score (r=-0.330) negatively correlated with the dyspepsia score on the FSSG. Conclusion Obesity evaluated by the BMI was a significant risk factor for the exacerbation of GERD symptoms in subjects with NAFLD.

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Association Between Erosive Esophagitis and Visceral Fat Accumulation Quantified by Abdominal CT Scan

Abstract: These results suggest a role for visceral obesity, quantified by CT, as a risk factor for erosive esophagitis.

Cited by 43 publications

References 32 publications

Adiponectin level changes among Egyptians with gastroesophageal reflux disease

Adiponectin level changes among Egyptians with gastroesophageal reflux disease

Association of low serum adiponectin levels with erosive esophagitis in men: an analysis of 2405 subjects undergoing physical check-ups

The Symptoms of Gastroesophageal Reflux Disease Correlate with High Body Mass Index, the Aspartate Aminotransferase/Alanine Aminotransferase Ratio and Insulin Resistance in Japanese Patients with Non-alcoholic Fatty Liver Disease

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