title: Clinical Characterization of Gastric Antral Vascular Ectasia: A Potential Manifestation of the Metabolic Syndrome.
abstract: OBJECTIVE
  Gastric antral vascular ectasia is a relatively common endoscopic finding. Past studies have shown an association of gastric antral vascular ectasia with cirrhosis and autoimmune disorders. We aimed to re-examine these associations and to investigate a possible association of gastric antral vascular ectasia with features of the metabolic syndrome.
  
  
  METHODS
  There were 135 patients with a diagnosis of gastric antral vascular ectasia from years 1995-2013 seen at the University of Virginia who were identified from a clinical data repository and age and sex matched to a cohort of patients without gastric antral vascular ectasia undergoing endoscopy within the same time frame as the index cases. The groups were compared for comorbidities including autoimmune disease, cirrhosis, vascular disease, body mass index (BMI), diabetes mellitus, and cirrhosis due to nonalcoholic steatohepatitis.
  
  
  RESULTS
  Sixty-four percent of gastric antral vascular ectasia patients were cirrhotic, compared with 14% of controls (P <.001). Vascular disease was more common in the gastric antral vascular ectasia cohort (57% vs 36%; P <.001). The mean BMI was also higher in the gastric antral vascular ectasia cohort (33.7 kg/m2vs 28.8 kg/m2; P <.001). Diabetes mellitus and nonalcoholic steatohepatitis cirrhosis were more frequently observed in gastric antral vascular ectasia subjects (64% vs 29% in controls [P <.001] and 28% vs 2% [P <.001], respectively). There was not an increased prevalence of autoimmune disease in gastric antral vascular ectasia patients vs controls (15% vs 13%; P = .861).
  
  
  CONCLUSIONS
  These results confirm the association of gastric antral vascular ectasia with underlying cirrhosis and revealed a significant correlation of gastric antral vascular ectasia with features of metabolic syndrome such as diabetes, BMI, vascular disease, and nonalcoholic steatohepatitis cirrhosis. The pathophysiology of gastric antral vascular ectasia remains uncertain, but we speculate that it may be a manifestation of the metabolic syndrome.
authors.affiliation: Division of Gastroenterology and Hepatology, University of Virginia, Charlottesville.
authors.forename: Elliot
authors.initials: E
authors.lastname: Smith
authors.affiliation: Division of Gastroenterology and Hepatology, University of Virginia, Charlottesville.
authors.forename: Bezawit
authors.initials: B
authors.lastname: Tekola
authors.affiliation: Division of Public Health, University of Virginia, Charlottesville.
authors.forename: James
authors.initials: J
authors.lastname: Patrie
authors.affiliation: Division of Internal Medicine, University of Virginia, Charlottesville.
authors.forename: Scott
authors.initials: S
authors.lastname: Cornella
authors.affiliation: Division of Gastroenterology and Hepatology, University of Virginia, Charlottesville. Electronic address: shc5c@virginia.edu.
authors.forename: Stephen
authors.initials: S
authors.lastname: Caldwell
mesh_terms: D000368:Aged; D015992:Body Mass Index; D016022:Case-Control Studies; D015897:Comorbidity; D003924:Diabetes Mellitus, Type 2 / Q000453:epidemiology*; D005260:Female; D020252:Gastric Antral Vascular Ectasia / Q000453:epidemiology*; D006785:Hospitals, University / Q000706:statistics & numerical data; D006801:Humans; D008103:Liver Cirrhosis / Q000453:epidemiology*; D008297:Male; D024821:Metabolic Syndrome / Q000453:epidemiology*; D008875:Middle Aged; D065626:Non-alcoholic Fatty Liver Disease / Q000453:epidemiology*; D009765:Obesity / Q000453:epidemiology*; D014652:Vascular Diseases / Q000453:epidemiology; D014768:Virginia / Q000453:epidemiology
keywords: Cirrhosis; Diabetes; Watermelon stomach