Association between Abdominal Obesity and Reflux Esophagitis and Hiatal Hernia Among Korean Men

Chun, Jee Hyun; Yun, Kytung Eun; Kim, Dae Kyoum; Park, Hye Soon

Abstract

BACKGROUND: The prevalence of obesity is increasing worldwide and recent studies have shown inconsistent results over the relationship between obesity and reflux esophagitis. The aim of this study was to investigate the relationship between anthropometric parameters, reflux esophagitis, and hiatal hernia.
METHODS
A total of 18,167 men who underwent gastroscopy at the Health Promotion Center of Asan Medical Center were included in this study. The grading of esophagitis was based on the LA classification and hiatal hernia was defined as a circular protrusion of the gastric mucosa at least 2 cm above the esophageal hiatus of the diaphragm.
RESULTS
The mean body mass index (BMI) was 24.6 +/- 2.7 kg/m2, and the mean waist circumference (WC) was 85.0 +/- 7.2 cm. The prevalence of reflux esophagitis was 17.4% in LA-minimal change and hiatal hernia was found in 2.3% of subjects. Compared with the lowest quartile of BMI and WC, the adjusted odds ratio (OR) of the highest quartile of BMI and WC for reflux esophagitis was 1.12 (95% CI, 1.01~1.46) and 1.31 (1.10~1.57), respectively. Hiatal hernia was a strong risk factor for reflux esophagitis (adjusted OR 4.35, 95% CI, 3.49~5.49). In multiple logistic regression analysis, Subjects in the fourth quartile of WC, compared with those in the first quartile, were at increased risk of hiatal hernia with the adjusted odds ratio of 2.03 (95% CI, 1.38~2.97), 2.05 (1.34~3.16), and 2.16 (1.35~3.50).
CONCLUSION
The BMI, WC, and hiatal hernia are highly associated with the development of reflux esophagitis in Koreanmen and central obesity is a significant independent risk factor for hiatal hernia.