Association between erosive esophagitis and visceral fat accumulation quantified by abdominal CT scan

There were no objective data presented about the association between erosive esophagitis and abdominal fat. We conducted this study to examine the association of abdominal fat and gastroesophageal reflux disease-related erosive esophagitis.

Between May 2004 and October 2005, a total of 100 erosive esophagitis patients diagnosed by upper endoscopy were evaluated in a prospective manner. All study patients and controls underwent abdominal computed tomography (CT) scan. Body fat distribution was assessed by CT with a 10-mm-thick slice at the level of the fourth lumbar vertebra.

Erosive esophagitis patients presented with a significantly higher mean visceral fat (VF) area (104.68+/-39.47 vs. 75.90+/-49.10 cm2, P=0.014) than the control group. However, there was no association between erosive esophagitis and subcutaneous fat area (109.72+/-49.09 vs. 98.66+/-52.43 cm2, P=0.379) or total fat area (214.41+/-78.78 vs. 172.59+/-90.49 cm2, P=0.054). Multivariate logistic regression analysis demonstrated that high VF areas (P=0.0035), VF/subcutaneous fat area (P=0.005), hiatal hernia (P=0.001), high body mass index (P=0.047), high waist-to-hip ratio (P=0.042), and smoking (P=0.005) are independent risk factors of erosive esophagitis.

These results suggest a role for visceral obesity, quantified by CT, as a risk factor for erosive esophagitis.