title: Risk factors for small bowel angioectasia: The impact of visceral fat accumulation.
abstract: OBJECTIVE
  To investigate visceral fat accumulation in association with the risk of small bowel angioectasia.
  
  
  METHODS
  We retrospectively investigated 198 consecutive patients who underwent both capsule endoscopy and CT for investigation of obscure gastrointestinal bleeding (OGIB) from January 2009 to September 2013. The visceral fat area (VFA) and subcutaneous fat area were measured by CT, and information on comorbidities, body mass index, and medications was obtained from their medical records. Logistic regression analysis was used to evaluate associations.
  
  
  RESULTS
  Capsule endoscopy revealed small bowel angioectasia in 18/198 (9.1%) patients with OGIB. Compared to patients without small bowel angioectasia, those with small bowel angioectasia had a significantly higher VFA (96 ± 76.0 cm(2) vs 63.4 ± 51.5 cm(2), P = 0.016) and a higher prevalence of liver cirrhosis (61% vs 22%, P < 0.001). The proportion of patients with chronic renal failure was higher in patients with small bowel angioectasia (22% vs 9%, P = 0.11). There were no significant differences in subcutaneous fat area or waist circumference. The prevalence of small bowel angioectasia progressively increased according to the VFA. Multivariate analysis showed that the VFA [odd ratio (OR) for each 10-cm(2) increment = 1.1; [95% confidence interval (CI): 1.02-1.19; P = 0.021] and liver cirrhosis (OR = 6.1, 95%CI: 2.2-18.5; P < 0.001) were significant risk factors for small bowel angioectasia.
  
  
  CONCLUSIONS
  VFA is positively associated with the prevalence of small bowel angioectasia, for which VFA and liver cirrhosis are independent risk factors in patients with OGIB.
authors.affiliation: Atsuo Yamada, Ryota Niikura, Yuka Kobayashi, Hirobumi Suzuki, Shuntaro Yoshida, Hirotsugu Watabe, Yutaka Yamaji, Yoshihiro Hirata, Kazuhiko Koike, Department of Gastroenterology, Graduate School of Medicine, The University of Tokyo, Tokyo 113-8655, Japan.
authors.forename: Atsuo
authors.initials: A
authors.lastname: Yamada
authors.affiliation: Atsuo Yamada, Ryota Niikura, Yuka Kobayashi, Hirobumi Suzuki, Shuntaro Yoshida, Hirotsugu Watabe, Yutaka Yamaji, Yoshihiro Hirata, Kazuhiko Koike, Department of Gastroenterology, Graduate School of Medicine, The University of Tokyo, Tokyo 113-8655, Japan.
authors.forename: Ryota
authors.initials: R
authors.lastname: Niikura
authors.affiliation: Atsuo Yamada, Ryota Niikura, Yuka Kobayashi, Hirobumi Suzuki, Shuntaro Yoshida, Hirotsugu Watabe, Yutaka Yamaji, Yoshihiro Hirata, Kazuhiko Koike, Department of Gastroenterology, Graduate School of Medicine, The University of Tokyo, Tokyo 113-8655, Japan.
authors.forename: Yuka
authors.initials: Y
authors.lastname: Kobayashi
authors.affiliation: Atsuo Yamada, Ryota Niikura, Yuka Kobayashi, Hirobumi Suzuki, Shuntaro Yoshida, Hirotsugu Watabe, Yutaka Yamaji, Yoshihiro Hirata, Kazuhiko Koike, Department of Gastroenterology, Graduate School of Medicine, The University of Tokyo, Tokyo 113-8655, Japan.
authors.forename: Hirobumi
authors.initials: H
authors.lastname: Suzuki
authors.affiliation: Atsuo Yamada, Ryota Niikura, Yuka Kobayashi, Hirobumi Suzuki, Shuntaro Yoshida, Hirotsugu Watabe, Yutaka Yamaji, Yoshihiro Hirata, Kazuhiko Koike, Department of Gastroenterology, Graduate School of Medicine, The University of Tokyo, Tokyo 113-8655, Japan.
authors.forename: Shuntaro
authors.initials: S
authors.lastname: Yoshida
authors.affiliation: Atsuo Yamada, Ryota Niikura, Yuka Kobayashi, Hirobumi Suzuki, Shuntaro Yoshida, Hirotsugu Watabe, Yutaka Yamaji, Yoshihiro Hirata, Kazuhiko Koike, Department of Gastroenterology, Graduate School of Medicine, The University of Tokyo, Tokyo 113-8655, Japan.
authors.forename: Hirotsugu
authors.initials: H
authors.lastname: Watabe
authors.affiliation: Atsuo Yamada, Ryota Niikura, Yuka Kobayashi, Hirobumi Suzuki, Shuntaro Yoshida, Hirotsugu Watabe, Yutaka Yamaji, Yoshihiro Hirata, Kazuhiko Koike, Department of Gastroenterology, Graduate School of Medicine, The University of Tokyo, Tokyo 113-8655, Japan.
authors.forename: Yutaka
authors.initials: Y
authors.lastname: Yamaji
authors.affiliation: Atsuo Yamada, Ryota Niikura, Yuka Kobayashi, Hirobumi Suzuki, Shuntaro Yoshida, Hirotsugu Watabe, Yutaka Yamaji, Yoshihiro Hirata, Kazuhiko Koike, Department of Gastroenterology, Graduate School of Medicine, The University of Tokyo, Tokyo 113-8655, Japan.
authors.forename: Yoshihiro
authors.initials: Y
authors.lastname: Hirata
authors.affiliation: Atsuo Yamada, Ryota Niikura, Yuka Kobayashi, Hirobumi Suzuki, Shuntaro Yoshida, Hirotsugu Watabe, Yutaka Yamaji, Yoshihiro Hirata, Kazuhiko Koike, Department of Gastroenterology, Graduate School of Medicine, The University of Tokyo, Tokyo 113-8655, Japan.
authors.forename: Kazuhiko
authors.initials: K
authors.lastname: Koike
mesh_terms: D050154:Adiposity; D000368:Aged; D053704:Capsule Endoscopy; D015897:Comorbidity; D004108:Dilatation, Pathologic; D005260:Female; D006471:Gastrointestinal Hemorrhage / Q000175:diagnosis / Q000453:epidemiology*; D006801:Humans; D007413:Intestinal Mucosa / Q000098:blood supply*; D007421:Intestine, Small / Q000098:blood supply*; D050152:Intra-Abdominal Fat / Q000000981:diagnostic imaging / Q000503:physiopathology*; D007564:Japan / Q000453:epidemiology; D008103:Liver Cirrhosis / Q000453:epidemiology; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D009765:Obesity / Q000175:diagnosis / Q000453:epidemiology* / Q000503:physiopathology; D016017:Odds Ratio; D015995:Prevalence; D012189:Retrospective Studies; D012307:Risk Factors; D014057:Tomography, X-Ray Computed
keywords: Capsule endoscopy; Obscure gastrointestinal bleeding; Small bowel angioectasia; Visceral fat accumulation