Brief Article
Copyright ©2013 Baishideng Publishing Group Co., Limited. All rights reserved.
World J Gastroenterol. Sep 21, 2013; 19(35): 5883-5888
Published online Sep 21, 2013. doi: 10.3748/wjg.v19.i35.5883
Erosive esophagitis associated with metabolic syndrome, impaired liver function, and dyslipidemia
Song-Seng Loke, Kuender D Yang, Kuang-Den Chen, Jung-Fu Chen
Song-Seng Loke, Department of Family Medicine, Kaohsiung Chang Gung Memorial Hospital, Chang Gung University College of Medicine, Kaohsiung 833, Taiwan
Kuender D Yang, Department of Medical Research, Show Chwan Memorial Hospital, Taichung 40601, Taiwan
Kuang-Den Chen, Center for Translational Research in Biomedical Science, Kaohsiung Chang Gung Memorial Hospital, Kaohsiung 833, Taiwan
Jung-Fu Chen, Division of Endocrinology and Metabolism, Department of Internal Medicine, Kaohsiung Chang Gung Memorial Hospital, Kaohsiung 833, Taiwan
Author contributions: Loke SS, Chen KD and Chen JF contributed to design the study. Loke SS wrote this manuscript and performed the research; Yang KD contributed to design the study and revised the paper critically; Chen KD analyzed the data; Chen JF performed the research.
Correspondence to: Song-Seng Loke, MD, Department of Family Medicine, Kaohsiung Chang Gung Memorial Hospital, Chang Gung University College of Medicine, 123, Dapi Road, Niaosong District, Kaohsiung 833, Taiwan. loke@adm.cgmh.org.tw
Telephone: +886-7-7317123 Fax: +886-7-7317123
Received: February 26, 2013
Revised: June 13, 2013
Accepted: July 18, 2013
Published online: September 21, 2013
Processing time: 210 Days and 14.7 Hours
Abstract

AIM: To investigate whether erosive esophagitis is correlated with metabolic syndrome and its components, abnormal liver function, and lipoprotein profiles.

METHODS: We conducted a cross-sectional, case control study of subjects who underwent upper endoscopy during a health examination at the Health Management and Evaluation Center of a tertiary medical care facility located in Southern Taiwan. Metabolic syndrome components, body mass index (BMI), liver function, dyslipidemia, and cardiovascular risk factors, as defined by the ratio of total cholesterol to high-density lipoprotein cholesterol (HDL-C), and the ratio of low-density lipoprotein cholesterol to HDL-C were compared between individuals with and without erosive esophagitis. Risk factors for erosive esophagitis were evaluated by multivariate logistic regression.

RESULTS: Erosive esophagitis was diagnosed in 507 of 5015 subjects who were individually age and sex matched to 507 esophagitis-free control subjects. In patients with erosive esophagitis, BMI, waist circumference, blood pressure, fasting plasma glucose, triglyceride levels, aspartate aminotransferase, alanine aminotransferase, the ratio of total cholesterol to HDL-C, and the ratio of low-density lipoprotein cholesterol to HDL-C were significantly higher and HDL-C was significantly lower compared to patients without erosive esophagitis (all P < 0.05). In a multivariate analysis, central obesity (OR = 1.38; 95%CI: 1.0-1.86), hypertension (OR = 1.35; 95%CI: 1.04-1.76), hypertriglyceridemia (OR = 1.34; 95%CI: 1.02-1.76), cardiovascular risk factors as defined by a ratio of total cholesterol to HDL-C > 5 (OR = 1.45; 95%CI: 1.06-1.97), and aspartate aminotransferase (OR = 1.59; 95%CI: 1.08-2.34) were significantly associated with erosive esophagitis.

CONCLUSION: Metabolic syndrome, impaired liver function, and a higher ratio of total cholesterol to HDL-C were associated with erosive esophagitis.

Keywords: Erosive esophagitis; Metabolic syndrome; Central obesity; Abnormal liver function; Dyslipidemia

Core tip: A cross-sectional, case control study of subjects who underwent upper endoscopy during a health examination was conducted. Metabolic syndrome components, body mass index, liver function, and dyslipidemia were compared between individuals with and without erosive esophagitis. Risk factors for erosive esophagitis were evaluated. Erosive esophagitis was diagnosed in 507 of 5015 subjects who were individually age- and sex-matched to 507 esophagitis-free control subjects. In addition to metabolic syndrome, we also found that abnormal liver function and predictors of future coronary heart disease were associated with erosive esophagitis.