title: Nonalcoholic fatty liver disease vs. obesity on the risk of erosive oesophagitis.
abstract: BACKGROUND
  Erosive oesophagitis (EE) may be complicated by oesophageal ulcers, peptic stricture, Barrett's oesophagus and oesophageal adenocarcinoma. There have been few studies examining the influence of nonalcoholic fatty liver disease (NAFLD) on EE, and even fewer exploring the simultaneous effects of NAFLD, general and central obesity on EE. We thus aim to clarify the relationship between NAFLD and EE when general and/or central obesity are considered simultaneously.
  
  
  METHODS
  In this cross-sectional study, we enrolled 12 090 subjects who underwent a health check-up at the Health Examination Center of a university hospital between January 2000 and August 2009 for analysis. NAFLD was diagnosed using liver ultrasound and EE was defined according to the Los Angeles classification by oesophagogastroduodenoscopy.
  
  
  RESULTS
  Subjects with EE (1922; 15·9%) had a higher proportion of NAFLD, general and central obesity. With adjustment for age, gender, hypertension, diabetes mellitus, hiatal hernia, hypertriglyceridemia, high-density lipoprotein cholesterol, alcohol consumption, tea drinking, smoking and habitual exercise, the results of the multivariate analyses showed that general obesity, central obesity and NAFLD were all significantly associated with EE in their separate models. When considering general obesity, central obesity and NAFLD simultaneously, NAFLD, but neither general nor central obesity, remained positively correlated to EE. In addition, male gender, hiatal hernia and hypertriglyceridemia were all significantly associated with EE.
  
  
  CONCLUSIONS
  In addition to general and central obesity, NAFLD is independently associated with increased risk of EE, and the detrimental effect of NAFLD on EE might be greater than those of general and central obesity.
authors.affiliation: Department of Family Medicine, E-Da Hospital/I-Shou University, Kaohsiung; Department of Family Medicine, National Cheng Kung University Hospital, Tainan, Taiwan.
authors.forename: Wei-Chieh
authors.initials: WC
authors.lastname: Hung
authors.forename: Jin-Shang
authors.initials: JS
authors.lastname: Wu
authors.forename: Yi-Ching
authors.initials: YC
authors.lastname: Yang
authors.forename: Zih-Jie
authors.initials: ZJ
authors.lastname: Sun
authors.forename: Feng-Hwa
authors.initials: FH
authors.lastname: Lu
authors.forename: Chih-Jen
authors.initials: CJ
authors.lastname: Chang
mesh_terms: D015992:Body Mass Index; D003430:Cross-Sectional Studies; D004941:Esophagitis / Q000209:etiology*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D065626:Non-alcoholic Fatty Liver Disease / Q000150:complications*; D056128:Obesity, Abdominal / Q000150:complications*; D012307:Risk Factors
keywords: Body mass index; erosive oesophagitis; nonalcoholic fatty liver disease; obesity; waist circumference