Abdominal Visceral to Subcutaneous Adipose Tissue Ratio Is Associated with Increased Risk of Erosive Esophagitis

To investigate the association between abdominal fat distribution represented by the visceral fat area (VFA) to subcutaneous fat area (SFA) ratio, and erosive esophagitis (EE). Seven hundred and twenty-eight participants aged > 40 years underwent physical examination, blood tests, esophagogastroduodenoscopy, and abdominal computer tomography at Chung-Ang University Hospital from 2007 to 2012. Of 728 subjects, 65 (8.9%) had EE. The EE patients had higher body mass index, metabolic syndrome prevalence, triglyceride levels, and blood pressure (P < 0.05). The mean VFA/SFA ratio was higher in the EE group than in the non-EE group (1.30 vs. 0.92, P < 0.001). The predominance of EE in the group with higher VFA/SFA ratio was higher than in the group with lower VFA/SFA ratio (P < 0.001). A VFA/SFA ratio ae<yen>1.165 had good accuracy to predict EE (area under the receiver-operating characteristic curve, 0.643). The VFA/SFA ratio and visceral fat volume were positively correlated with the severity of EE (P = 0.002), and a VFA/SFA ratio ae<yen>1.165 was strongly correlated with the severity of EE (P < 0.001). The high VFA/SFA ratio can be a useful clinical predictor of EE.