Obesity and hiatal hernia may be non-allergic risk factors for esophageal eosinophilia in Japanese adults

Abstract

Background Esophageal eosinophilia (EE) is a basal condition of eosinophilic esophageal disorders including eosinophilic esophagitis (EoE) and asymptomatic EE. EoE is considered as an allergic disorder, while it is unclear whether other non-allergic conditions are involved in the pathophysiology of EE. The aim of this study is to investigate the non-allergic risk factors for EE. Methods This cross-sectional study included subjects who underwent esophagogastroduodenoscopy on a medical health checkup. We compared clinical characteristics between subjects with EE (n=27) and those without EE (n=5,937). Results The detection rate of EE was 0.45% (27/5,964 persons). Of 27 subjects with EE, 20 subjects were symptomatic and 7 were asymptomatic. On univariate analysis, subjects with EE significantly had higher body mass index (BMI) compared to those without EE; 23.4 (4.4) vs 22.3 (4.5) kg/m 2 , median (interquartile range), p=0.005. Endoscopic findings revealed that subjects with EE had significantly higher proportion of hiatal hernia (29.6% vs 14.7%; p=0.049). Subjects with EE were significantly younger and had higher proportion of bronchial asthma; 45 (11.5) vs 51 (18) years, p=0.013; 25.9% vs 5.2%, p<0.001, respectively. Multivariate analysis showed that subjects with EE were positively associated with BMI (odds ratio [OR], 1.11; 95% confidence interval [CI], 1.03-1.20; p=0.010) and hiatal hernia (OR, 2.63; 95% CI, 1.12-6.18; p=0.026) compared to those without EE. On trend test, advanced BMI classification had significant trend for increased prevalence of EE (p=0.002). Conclusions Obesity and hiatal hernia may be non-allergic risk factors for EE in Japanese adults.

High‐fat diet‐induced obesity worsens TH2 immune response and immunopathologic characteristics in murine model of eosinophilic oesophagitis

“…It is noteworthy that, regardless of allergy protocol induction, obese mice (OB group) displayed higher number of eosinophils and mast cells, associated with increased oesophagus diameter when compared to saline challenged mice (CN group). These data indicate obesity can be considered an important risk factor for EoE development, which can also contribute for symptoms exacerbation through immunopathologic modifications associated with the intensified inflammatory influx. In addition, EoE induction also affected lung and gut, enhancing mast cell and eosinophil influx to these organs, and increasing IL‐4, IL‐13 and CCL11 levels in the lungs.…”

Association of plasma xanthine oxidoreductase activity with blood pressure affected by oxidative stress level: MedCity21 health examination registry

“…Study design. The MedCity21 health examination registry was initiated in April 2015 in a comprehensive manner to elucidate the causes of various diseases occurring in adults, including cancer, diabetes mellitus, cardiovascular disease, cerebrovascular disease, mental disorders, dyslipidemia, hypertension, hyperuricemia, obesity, chronic respiratory disease, liver disease, digestive disease, gynecological diseases, and skin disease, for development of advanced diagnostic techniques, as well as treatment and prevention methods for affected patients 11,[41][42][43] . Individuals who underwent comprehensive medical examinations as part of MedCity21 at the Osaka City University Hospital Advanced Medical Center for Preventive Medicine (Osaka, Japan) were registered.…”

Insulin Resistance Associated with Plasma Xanthine Oxidoreductase Activity Independent of Visceral Adiposity and Adiponectin Level: MedCity21 Health Examination Registry

“…e MedCity21 health examination registry was instituted from April 2015 in a comprehensive manner to elucidate the causes of various diseases occurring in adults (cancer, diabetes mellitus (DM), cardiovascular disease, cerebrovascular disease, mental disorders, dyslipidemia, hypertension, hyperuricemia, obesity, chronic respiratory disease, liver disease, digestive disease, gynecological diseases, skin disease, etc.) for the development of advanced diagnostic techniques, treatment methods, and prevention methods for patients with those diseases [18][19][20]. Individuals who underwent comprehensive medical examinations at MedCity21 at the Osaka City University Hospital Advanced Medical Center for Preventive Medicine (Osaka, Japan) were registered.…”