title: Effect of abdominal visceral fat on the development of new erosive oesophagitis: a prospective cohort study.
abstract: OBJECTIVE
  Although abdominal visceral fat has been associated with erosive oesophagitis in cross-sectional studies, there are no data that describe its longitudinal effects. We aimed to evaluate the longitudinal effects of abdominal visceral fat on the development of new erosive oesophagitis in patients who did not have erosive oesophagitis at baseline.
  
  
  METHODS
  This was a single-centre prospective study. A total of 1503 participants without erosive oesophagitis at baseline were followed up for 34 months and they underwent oesophagogastroduodenoscopy and computed tomography at both baseline and during follow-up. The longitudinal effects of abdominal visceral fat on the development of new erosive oesophagitis were evaluated using odds ratios (ORs) and 95% confidence intervals (CIs).
  
  
  RESULTS
  New oesophagitis developed in 83 patients. Compared with the first quartile, the third (OR=3.96, 95% CI: 1.54-10.18) and the fourth (OR=4.67, 95% CI: 1.79-12.23) of baseline visceral fat quartiles, the third (OR=3.03, 95% CI: 1.14-8.04) and the fourth (OR=7.50, 95% CI: 2.92-19.25) follow-up visceral fat quartiles, and the fourth visceral fat change quartile (OR=2.76, 95% CI: 1.47-5.21) were associated with increased development of new erosive oesophagitis, and the P value for each trend was less than 0.001. New erosive oesophagitis was inversely related to the follow-up Helicobacter pylori status and it was associated positively with the presence of a hiatal hernia and smoking during follow-up, but it was not associated with reflux symptoms, the H. pylori status, presence of a hiatal hernia or smoking at baseline.
  
  
  CONCLUSIONS
  Higher level of visceral fat at baseline and follow-up visceral fat, and greater changes in the visceral level were associated linearly with the development of new erosive oesophagitis in this longitudinal study.
authors.affiliation: aDepartment of Gastroenterology, Center for Gastric Cancer, Kyungpook National University Medical Center, Kyungpook National University School of Medicine, Daegu bCenter for Cancer Prevention & Detection cCenter for Gastric Cancer dCenter for Clinical Trials eDepartment of Diagnostic Radiology, National Cancer Center, Goyang, Korea.
authors.forename: Su Youn
authors.initials: SY
authors.lastname: Nam
authors.forename: Young-Woo
authors.initials: YW
authors.lastname: Kim
authors.forename: Bum Joon
authors.initials: BJ
authors.lastname: Park
authors.forename: Kum Hei
authors.initials: KH
authors.lastname: Ryu
authors.forename: Il Ju
authors.initials: IJ
authors.lastname: Choi
authors.forename: Byung-Ho
authors.initials: BH
authors.lastname: Nam
authors.forename: Hyun Boem
authors.initials: HB
authors.lastname: Kim
mesh_terms: D000328:Adult; D015992:Body Mass Index; D016145:Endoscopy, Digestive System; D004942:Esophagitis, Peptic / Q000175:diagnosis / Q000209:etiology*; D005260:Female; D016481:Helicobacter Infections / Q000150:complications; D016480:Helicobacter pylori; D006551:Hernia, Hiatal / Q000150:complications; D006801:Humans; D050152:Intra-Abdominal Fat / Q000473:pathology*; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D056128:Obesity, Abdominal / Q000150:complications* / Q000473:pathology; D011446:Prospective Studies; D012307:Risk Factors; D014057:Tomography, X-Ray Computed