Metabolic risk factors associated with erosive esophagitis

Background and Aim: Our aim was to determine associations between metabolic risk factors and erosive esophagitis. Methods: In this retrospective case-control study, diagnosis of erosive esophagitis was based on the Los Angeles classification. Endoscopic findings in subjects with erosive esophagitis were reviewed by two experienced endoscopists and those with agreement of diagnosis were enrolled for study. Body mass index (BMI), abdominal girdle, blood pressure, and serum triglyceride, glucose, and beta-lipoprotein levels were compared between individuals with and without erosive esophagitis. Multivariate binary logistic regression analysis was used to identify independent metabolic risk factors associated with erosive esophagitis. Results: Between October 2004 and April 2006, 518 of 4206 subjects who underwent endoscopic examination were diagnosed as having erosive esophagitis. After expert review, 427 (male : female = 365:62) individuals met the study criteria of having erosive esophagitis (10.5%). Compared with age- and gender-matched controls, patients with erosive esophagitis had significantly higher BMI, abdominal girdle, blood pressure, and triglyceride levels, and lower levels of high density lipoprotein (HDL) cholesterol (P < 0.05). More subjects with metabolic syndrome had erosive esophagitis than without metabolic syndrome (OR: 1.76, 95% CI: 1.27-2.44, P = 0.001). Multivariate logistic regression analysis revealed that central obesity (OR: 1.41, 95% CI: 05-1.89, P = 0.023) and hypertriglyceridemia (OR: 1.57, 95% CI: 1.19-2.13, P = 0.004) were significantly associated with erosive esophagitis. Conclusions: Obesity and hypertriglyceridemia, which are key components of metabolic syndrome, are moderate independent risk factors for erosive esophagitis.