title: The relationship between visceral adiposity and the risk of erosive esophagitis in severely obese Chinese patients.
abstract: A higher prevalence of erosive esophagitis is found in obese than in nonobese patients; however, it remains unclear why some obese patients develop this disease, whereas others do not. Accordingly, we elucidated the risk factors associated with erosive esophagitis in severely obese Chinese patients. Between June 2007 and January 2009, a total of 260 Chinese patients with morbid obesity referred for bariatric surgery were enrolled in this cross-sectional study. All patients received preoperative endoscopy for evaluation of the presence and severity of erosive esophagitis. Demographic variables, anthropometric measurements, and metabolic factors were included in a logistic regression model to identify the factors predictive of erosive esophagitis. The prevalence of erosive esophagitis was 32.3%. Multiple logistic regression showed that increased waist circumference (odds ratio (OR) = 1.03, 95% confidence interval (CI) = 1.01-1.04), increased insulin resistance (OR = 1.57, 95% CI = 1.06-2.31), and presence of reflux symptoms (OR = 2.40, 95% CI = 1.22-4.74) were independent risk factors associated with erosive esophagitis. In conclusion, among Chinese patients with morbid obesity, increased waist circumference and insulin resistance were risk factors for erosive esophagitis, which highlights the critical role of visceral adiposity in the pathogenesis of erosive esophagitis.
authors.affiliation: Department of Internal Medicine, E-Da Hospital, I-Shou University, Kaohsiung, Taiwan.
authors.forename: Chi-Ming
authors.initials: CM
authors.lastname: Tai
authors.forename: Yi-Chia
authors.initials: YC
authors.lastname: Lee
authors.forename: Hung-Pin
authors.initials: HP
authors.lastname: Tu
authors.forename: Chih-Kun
authors.initials: CK
authors.lastname: Huang
authors.forename: Ming-Tin
authors.initials: MT
authors.lastname: Wu
authors.forename: Chi-Yang
authors.initials: CY
authors.lastname: Chang
authors.forename: Ching-Tai
authors.initials: CT
authors.lastname: Lee
authors.forename: Ming-Shiang
authors.initials: MS
authors.lastname: Wu
authors.forename: Jaw-Town
authors.initials: JT
authors.lastname: Lin
authors.forename: Wen-Ming
authors.initials: WM
authors.lastname: Wang
mesh_terms: D050154:Adiposity; D000328:Adult; D000704:Analysis of Variance; D050110:Bariatric Surgery; D002681:China; D003430:Cross-Sectional Studies; D004942:Esophagitis, Peptic / Q000209:etiology* / Q000473:pathology; D004945:Esophagoscopy; D005260:Female; D005764:Gastroesophageal Reflux / Q000150:complications* / Q000453:epidemiology; D006801:Humans; D015994:Incidence; D007333:Insulin Resistance; D050152:Intra-Abdominal Fat; D016015:Logistic Models; D008297:Male; D056128:Obesity, Abdominal / Q000150:complications* / Q000453:epidemiology; D009767:Obesity, Morbid / Q000150:complications*; D016017:Odds Ratio; D015995:Prevalence; D012307:Risk Factors; D055105:Waist Circumference; D055815:Young Adult