Decreased levels of adiponectin in obese patients with gastroesophageal reflux evaluated by videoesophagography: possible relationship between gastroesophageal reflux and metabolic syndrome.
BACKGROUND
Body mass index (BMI) and obesity are reportedly associated with symptoms of gastroesophageal reflux disease (GERD). The present study was designed to investigate the effect of metabolic disorders including obesity on the levels of functional gastroesophageal reflux by videoesophagography.


METHODS
Twenty-one patients with GERD-associated symptoms were examined by videoesophagography. On their initial visit, all patients completed the Japanese version of the Carlsson-Dent self-administered questionnaire (QUEST). The findings of videoesophagography were evaluated by the X-ray severity scores for gastroesophageal reflux (XRSS), which were defined for the total diagnosis of functional gastroesophageal reflux. Correlation between XRSS scores and physical or metabolic markers was evaluated.


RESULTS
The mean XRSS in the QUEST-positive group (4.7+/-0.6) was significantly higher than that in the QUEST-negative group (3.3+/-0.5, P<0.05). XRSS correlated positively with BMI (P<0.05) and waist circumference (P<0.05), but negatively with high-density lipoprotein-cholesterol (P<0.05), serum adiponectin (P<0.05) and active ghrelin (P<0.05). In the multivariate analysis, serum adiponectin level, BMI and triglyceride independently affected the XRSS.


CONCLUSIONS
Videoesophagography is a useful diagnostic modality for the evaluation of patients with GERD symptoms. Functional gastroesophageal reflux is seen in obese patients, especially with decreased levels of adiponectin.
Iwasaki
Eisuke
E
Division of Gastroenterology and Hepatology, Department of Internal Medicine, Keio University School of Medcine, Shinjuku-ku, Tokyo, Japan.
Suzuki
Hidekazu
H
Sugino
Yoshinori
Y
Iida
Tsutomu
T
Nishizawa
Toshihiro
T
Masaoka
Tatsuhiro
T
Hosoda
Hiroshi
H
Kangawa
Kenji
K
Hibi
Toshifumi
T
D052242:Adiponectin / Q000097:blood; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001466:Barium Sulfate; D015415:Biomarkers / Q000097:blood; D015992:Body Mass Index; D015536:Down-Regulation; D005260:Female; D005764:Gastroesophageal Reflux / Q000097:blood / Q000150:complications / Q000000981:diagnostic imaging*; D006801:Humans; D007333:Insulin Resistance; D016014:Linear Models; D050356:Lipid Metabolism; D008297:Male; D024821:Metabolic Syndrome / Q000097:blood* / Q000150:complications / Q000000981:diagnostic imaging; D008875:Middle Aged; D009765:Obesity / Q000097:blood* / Q000150:complications / Q000000981:diagnostic imaging; D011237:Predictive Value of Tests; D011859:Radiography; D012720:Severity of Illness Index; D011795:Surveys and Questionnaires; D014741:Video Recording
C499918:ADIPOQ protein, human; D052242:Adiponectin; D015415:Biomarkers; D001466:Barium Sulfate