Association Between Erosive Esophagitis and Visceral Fat Accumulation Quantified by Abdominal CT Scan

BACKGROUND AND AIMS: 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. METHODS: 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. RESULTS: 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. CONCLUSIONS: These results suggest a role for visceral obesity, quantified by CT, as a risk factor for erosive esophagitis.