title: Abdominal obesity as a risk factor for the development of erosive esophagitis in subjects with a normal esophago-gastric junction.
abstract: OBJECTIVE
  Obesity is reported to be associated with erosive esophagitis (EE). However, the temporal association of obesity and abdominal obesity with EE is unclear. We conducted this study to investigate the temporal association of obesity, especially abdominal obesity with EE.
  
  
  METHODS
  Among 1,182 subjects who underwent health screening examinations including upper endoscopy in both 2003 and 2006, a total 1,029 subjects with a normal esophagogastric junction on upper endoscopy in 2003 were enrolled. All subjects completed questionnaires and anthropometric measurements were obtained twice by trained personnels. The patients with newly developed EE were compared to the subjects without newly developed EE.
  
  
  RESULTS
  Among 1,029 subjects, 42 (4.1%) were newly diagnosed with EE and 82 (8.0%) with hiatal hernia. The mean body mass index (BMI) in both examinations was significantly different between the two groups based on the development of erosive esophagitis (p<0.05 in both examinations). The mean waist circumference (WC) in both examinations was also significantly different between the two groups (p<0.01 in both examinations). The multivariate analysis demonstrated that EE was not associated with the BMI in 2003 and the increase of BMI; however, it was associated with the WC in 2003 (Odds ratio, 7.21; 95% CI, 1.78 to 29.19; >90 cm vs <80 cm).
  
  
  CONCLUSIONS
  Our study showed that abdominal circumference is an independent risk factor for EE, demonstrating a temporal relationship between abdominal obesity and EE.
authors.affiliation: Department of Internal Medicine, Institute of Digestive Diseases and Nutrition, Korea University College of Medicine, Seoul, Korea.
authors.forename: Ja Seol
authors.initials: JS
authors.lastname: Koo
authors.forename: Sang Woo
authors.initials: SW
authors.lastname: Lee
authors.forename: Sun Min
authors.initials: SM
authors.lastname: Park
authors.forename: Sung Woo
authors.initials: SW
authors.lastname: Jung
authors.forename: Hyung Joon
authors.initials: HJ
authors.lastname: Yim
authors.forename: Jong Jae
authors.initials: JJ
authors.lastname: Park
authors.forename: Hoon Jai
authors.initials: HJ
authors.lastname: Chun
authors.forename: Hong Sik
authors.initials: HS
authors.lastname: Lee
authors.forename: Jai Hyun
authors.initials: JH
authors.lastname: Choi
authors.forename: Chang Duck
authors.initials: CD
authors.lastname: Kim
authors.forename: Ho Sang
authors.initials: HS
authors.lastname: Ryu