title: Association of Visceral Fat Area, Smoking, and Alcohol Consumption with Reflux Esophagitis and Barrett's Esophagus in Japan.
abstract: BACKGROUND
  Central obesity has been suggested as a risk factor for gastroesophageal reflux disease. The aim of this study was to evaluate the association of visceral fat area and other lifestyle factors with reflux esophagitis or Barrett's esophagus in Japanese population.
  
  
  METHODS
  Individuals who received thorough medical examinations including the measurement of visceral fat area by abdominal computed tomography were enrolled. Factors associated with the presence of reflux esophagitis, the severity of reflux esophagitis, or the presence of Barrett's esophagus were determined using multivariable logistic regression models.
  
  
  RESULTS
  A total of 2608 individuals were eligible for the analyses. Visceral fat area was associated with the presence of reflux esophagitis both in men (odds ratio, 1.21 per 50 cm2; 95% confident interval, 1.01 to 1.46) and women (odds ratio, 2.31 per 50 cm2; 95% confident interval, 1.57 to 3.40). Current smoking and serum levels of triglyceride were also associated with the presence of reflux esophagitis in men. However, significant association between visceral fat area and the severity of reflux esophagitis or the presence of Barrett's esophagus was not shown. In men, excessive alcohol consumption on a drinking day, but not the frequency of alcohol drinking, was associated with both the severity of reflux esophagitis (odds ratio, 2.13; 95% confident interval, 1.03 to 4.41) and the presence of Barrett's esophagus (odds ratio, 1.71; 95% confident interval, 1.14 to 2.56).
  
  
  CONCLUSIONS
  Visceral fat area was independently associated with the presence of reflux esophagitis, but not with the presence of Barrett's esophagus. On the other hand, quantity of alcohol consumption could play a role in the development of severe reflux esophagitis and Barrett's esophagus in Japanese population.
authors.affiliation: Center for Preventive Medicine, Keio University Hospital, Tokyo, Japan.
authors.forename: Juntaro
authors.initials: J
authors.lastname: Matsuzaki
authors.affiliation: Division of Gastroenterology and Hepatology, Department of Internal Medicine, Keio University School of Medicine, Tokyo, Japan.
authors.forename: Hidekazu
authors.initials: H
authors.lastname: Suzuki
authors.affiliation: Department of Gastroenterology, National Center for Global Health and Medicine, Tokyo, Japan.
authors.forename: Masao
authors.initials: M
authors.lastname: Kobayakawa
authors.affiliation: Division of Gastroenterology, Department of Internal Medicine, University of Washington Medical School, Seattle, Washington, United States of America.
authors.forename: John M
authors.initials: JM
authors.lastname: Inadomi
authors.affiliation: Center for Preventive Medicine, Keio University Hospital, Tokyo, Japan.
authors.forename: Michiyo
authors.initials: M
authors.lastname: Takayama
authors.affiliation: Center for Preventive Medicine, Keio University Hospital, Tokyo, Japan.
authors.forename: Kanako
authors.initials: K
authors.lastname: Makino
authors.affiliation: Center for Preventive Medicine, Keio University Hospital, Tokyo, Japan.
authors.forename: Yasushi
authors.initials: Y
authors.lastname: Iwao
authors.affiliation: Center for Preventive Medicine, Keio University Hospital, Tokyo, Japan.
authors.forename: Yoshinori
authors.initials: Y
authors.lastname: Sugino
authors.affiliation: Division of Gastroenterology and Hepatology, Department of Internal Medicine, Keio University School of Medicine, Tokyo, Japan.
authors.forename: Takanori
authors.initials: T
authors.lastname: Kanai
mesh_terms: D000428:Alcohol Drinking / Q000009:adverse effects*; D001471:Barrett Esophagus / Q000209:etiology* / Q000473:pathology; D015992:Body Mass Index; D004942:Esophagitis, Peptic / Q000209:etiology* / Q000473:pathology; D005260:Female; D006801:Humans; D050152:Intra-Abdominal Fat / Q000000981:diagnostic imaging / Q000473:pathology*; D007564:Japan / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D012307:Risk Factors; D012737:Sex Factors; D012907:Smoking / Q000009:adverse effects*; D014057:Tomography, X-Ray Computed