title: Abdominal obesity is an independent risk factor for erosive esophagitis in a Korean population.
abstract: BACKGROUND
  The relationship between obesity and gastroesophageal reflux disease (GERD) is controversial. The aim of the present study was to investigate the potential roles of body mass index (BMI) and waist circumference on GERD in a Korean population.
  
  
  METHODS
  A total of 2457 subjects who visited the Kangbuk Samsung Hospital medical screening center for esophagogastroduodenoscopy from September 2004 to April 2005 were enrolled. All participants were given a questionnaire to determine reflux symptoms. Abdominal obesity was defined as a waist circumference > or =80 cm in women and > or =90 cm in men.
  
  
  RESULTS
  The proportion of subjects in each BMI group was 68.9%, 28.7% and 2.4% for BMI <25, 25-30 and >30, respectively. The prevalence of abdominal obesity was 24.2%. The prevalence of reflux symptoms was 8.2%. Neither BMI nor abdominal obesity was significantly associated with reflux symptoms after adjustment. The prevalence of erosive esophagitis was 6.6%. There was a clear dose-response relationship between prevalence of erosive esophagitis and BMI (5.6%, 8.1% and 15.5% for BMI <25, 25-30 and >30, respectively, P = 0.002). Abdominal obesity was also associated with erosive esophagitis (odds ratio, 2.3; 95% confidence interval, 1.6-3.1). However, only the association between abdominal obesity and erosive esophagitis remained strong after adjustments.
  
  
  CONCLUSIONS
  Abdominal obesity rather than BMI is an independent risk factor for erosive esophagitis in the Korean population.
authors.affiliation: Department of Internal Medicine, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Korea.
authors.forename: Mun Su
authors.initials: MS
authors.lastname: Kang
authors.forename: Dong Il
authors.initials: DI
authors.lastname: Park
authors.forename: Se Yong
authors.initials: SY
authors.lastname: Oh
authors.forename: Tae Woo
authors.initials: TW
authors.lastname: Yoo
authors.forename: Seung Ho
authors.initials: SH
authors.lastname: Ryu
authors.forename: Jung Ho
authors.initials: JH
authors.lastname: Park
authors.forename: Hong Joo
authors.initials: HJ
authors.lastname: Kim
authors.forename: Yong Kyun
authors.initials: YK
authors.lastname: Cho
authors.forename: Chong Il
authors.initials: CI
authors.lastname: Sohn
authors.forename: Woo Kyu
authors.initials: WK
authors.lastname: Jeon
authors.forename: Byung Ik
authors.initials: BI
authors.lastname: Kim
mesh_terms: D050153:Abdominal Fat; D000328:Adult; D015992:Body Mass Index; D003430:Cross-Sectional Studies; D016099:Endoscopy, Gastrointestinal; D004941:Esophagitis / Q000453:epidemiology / Q000209:etiology*; D005260:Female; D005764:Gastroesophageal Reflux / Q000453:epidemiology / Q000209:etiology; D006801:Humans; D007723:Korea / Q000453:epidemiology; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D009765:Obesity / Q000150:complications* / Q000453:epidemiology; D015995:Prevalence; D012307:Risk Factors; D011795:Surveys and Questionnaires