Association between Gastroesophageal Reflux Disease and Elastographic Parameters of Liver Steatosis and Fibrosis: Controlled Attenuation Parameter and Liver Stiffness Measurements

Abstract

Aim. Our aim was to investigate the association among elastographic parameters of liver steatosis and fibrosis, controlled attenuation parameter (CAP) and liver stiffness measurement (LSM), with gastroesophageal reflux disease (GERD). Methods. In this prospective, cross-sectional study, we have evaluated 937 patients with one or more components of the metabolic syndrome who had an esophagogastroduodenoscopy (EGD) due to GERD symptoms. In all patients, a laboratory analysis, an abdominal ultrasound, and FibroScan measurements were done. GERD was defined by EGD. Results. The mean body mass index (BMI) of the study population was 30.95 ± 5.45 kg/m2. The prevalence of increased CAP was 82.6% (774/937). Patients with increased CAP were younger, were more obese, had higher prevalence of hypertension, diabetes, and dyslipidemia, and had higher values of aminotransferases. Similar results of higher prevalence in patients with elevated CAP were observed with GERD, hiatal hernia, and insufficient cardia (defined as deficient or absent closure of the gastric inlet in relation to the esophagus). Additionally, patients with elevated CAP had a higher prevalence of GERD grades B and C in comparison to those without elevated CAP. Consequently, patients who did not have elevated CAP had a higher prevalence of GERD grade A. Even though we have found an upward trend in the prevalence of GERD, hiatal hernia, and insufficient cardia, there was no significant difference between subjects with fibrosis (F) 1-2 and F3-4 stage of fibrosis or F1 and F2-4. In a binary logistic regression, a significant positive association with GERD was obtained for CAP. Furthermore, a significant positive association with hiatal hernia was obtained for BMI and CAP. Finally, a significant positive association with hiatal hernia was obtained with CAP in multivariate analysis. Conclusion. To the best of our knowledge, our study is the first to reveal a positive association between CAP as a surrogate marker of liver steatosis and GERD after adjustments for other clinical variables.

Gastroesophageal reflux disease and Non-alcoholic fatty liver disease: A Two-Sample Mendelian randomization combined with Meta-analysis

“…To our knowledge, this study is the rst MR analysis to reveal the causation between GERD and NAFLD. We found the overall risk of getting NAFLD is about 71% in people with GERD (OR 1.71; 95% CI 1.40-2.09; P < 0.0001) in MR and meta analysis, by virtue of the GWAS and FinnGen databases [9]. This research is also consistent with Wijarnpreecha, K and Lee, S [12,30].…”

“…A lot of cohort and observational studies have displayed that people suffering from NAFLD had a higher susceptibility to GERD, and one clinical trial indicated that the risk of re ux esophagitis would increase 16% among people with NAFLD (OR 1.16; 95% CI 1.13-1.20) as compared to those without NAFLD [8,9,10,11]. In addition, a meta-analysis showed that the incidence of NAFLD was higher in people with GERD compared with healthy individuals, with an amalgamated OR of 2.07 (OR 2.07; 95% CI, 1.54-2.79) [12].…”

The association between Helicobacter pylori with nonalcoholic fatty liver disease assessed by controlled attenuation parameter and other metabolic factors

“…Moreover, the usefulness of CAP is not limited to the liver. The association between CAP-defined NAFLD and coronary artery plaques [ 15 ], increased arterial stiffness [ 30 ], and gastroesophageal reflux disease [ 31 ] has been reported, suggesting the role of CAP as extra-hepatic manifestations in individuals with NAFLD. When we used CAP for the diagnosis of NAFLD, obesity (BMI ≥25), serum triglyceride and the highest tertile of LSM value were significantly associated with NAFLD consistent with previous results [ 25 ], whereas Hp seropositivity was not.…”

Gastroesophageal reflux disease and non-alcoholic fatty liver disease: a two-sample Mendelian randomization combined with meta-analysis

“…To our knowledge, this study is the first MR analysis to reveal the causation between GERD and NAFLD. We found the overall risk of getting NAFLD is about 71% in people with GERD (OR 1.71 95% CI 1.40–2.09; P < 0.0001) in MR and meta analysis, by virtue of the GWAS and FinnGen databases 10 . This research is also consistent with Wijarnpreecha and Lee 13 , 33 .…”