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

Abstract

Background and Aims: There were no objective data presented about the association between erosive esophagitis and abdominal fat. We conducted this study to examine the association of abdominal fat and gastroesophageal reflux disease-related erosive esophagitis.

Methods: Between May 2004 and October 2005, a total of 100 erosive esophagitis patients diagnosed by upper endoscopy were evaluated in a prospective manner. All study patients and controls underwent abdominal computed tomography (CT) scan. Body fat distribution was assessed by CT with a 10-mm-thick slice at the level of the fourth lurnbar vertebra.

Results: Erosive esophagilis patients presented with a significantly higher mean visceral fat (VF) area (104.68 +/- 39.47 vs. 75.90 +/- 49.10 cm(2), P = 0.014) than the control group. However, there was no association between erosive esophagitis and subcutaneous fat area (109.72 +/- 49.09 vs. 98.66 +/- 52.43cm(2), P = 0.379) or total fat area (214.41 +/- 78.78 vs. 172,59 +/- 90.49 cm(2), P = 0.054). Multivariate logistic regression analysis demonstrated that high VF areas (P = 0.0035), VF/subcutaneous fat area (P = 0.005), hiatal hernia (P = 0.001) high body mass index (P = 0.047) high waist-to-hip ratio (P = 0.042), and smoking (P = 0.005) are independent risk factors of erosive esophagitis.

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