Gender differences in the association of non-alcoholic fatty liver disease and metabolic syndrome with erosive oesophagitis: a cross-sectional study in a Taiwanese population

Abstract

ObjectivesAlthough metabolic syndrome correlates with erosive oesophagitis, few studies have examined the association between non-alcoholic fatty liver disease (NAFLD), associated with obesity and insulin resistance as metabolic syndrome, and erosive oesophagitis. The possible gender differences in risk factors of erosive oesophagitis should be considered. This study aimed to determine the concomitant effects of NAFLD and metabolic syndrome on erosive oesophagitis with respect to gender.Design, setting, participants and outcome measuresThis cross-sectional study, conducted between January 2000 and August 2009, included 12 090 participants from the health examination center of a tertiary hospital. NAFLD was diagnosed according to ultrasonographic findings after excluding participants with excessive alcohol consumption or other liver diseases. Metabolic syndrome was determined using the revised National Cholesterol Education Program Adult Treatment Panel III criteria. Erosive oesophagitis was defined according to the Los Angeles classification by oesophagogastroduodenoscopy.ResultsOn the basis of the oesophagogastroduodenoscopic findings, the prevalence of erosive oesophagitis was 20.1% (n=1427/7110) and 9.9% (n=477/4842) in males and females, respectively. After adjusting for other variables, metabolic syndrome (OR 1.26; 95% CI 1.09 to 1.45) but not NAFLD (OR 1.14; 95% CI 0.98 to 1.30) significantly correlated with erosive oesophagitis in males, while NAFLD (OR 1.50; 95% CI 1.21 to 1.86) but not metabolic syndrome (OR 1.24; 95% CI 0.94 to 1.63) positively correlated with erosive oesophagitis in females.ConclusionsThe detrimental effect on erosive oesophagitis is greater by metabolic syndrome than by NAFLD in males but greater by NAFLD than by metabolic syndrome in females.

The association between metabolic syndrome and erosive esophagitis: A systematic review and meta-analysis

“…Eight studies were excluded after full-text review because they did not meet the inclusion criteria. Finally, 12 studies entered the meta-analysis process after qualitative assessment (the study by Hung et al (2016[ 27 ]) was considered as two studies, since it reported the data in two different populations) (Figure 1 (Fig. 1) ).…”

“…All studies were conducted in Asia and had appropriate quality to be included in meta-analysis (Table 1 (Tab. 1) ; References in Table 1: Chua et al, 2009[ 9 ]; Chung et al, 2008[ 10 ]; Hsieh et al, 2019[ 25 ]; Hsu et al, 2011[ 26 ]; Hung et al, 2016[ 27 ]; Lee et al, 2017;[ 33 ] Loke et al, 2013[ 34 ]; Niigaki et al, 2013[ 39 ]; Park et al, 2008[ 41 ]; Tai et al, 2010[ 48 ]; Wu et al, 2011[ 53 ]).…”

“…Most studies that examine the association between obesity and GERD have shown that obesity can significantly increase the risk of GERD and EE symptoms (Bechade et al, 2009[ 4 ]; El-Serag, 2008[ 13 ][ 14 ]; Hampel et al, 2005[ 20 ]; Piretta et al, 2007[ 42 ]). Although several studies have shown that each of the MetS components can be a risk factor for EE, the association between MetS and EE is still a challenging subject, as studies about this association have shown inconsistent results (Chua et al, 2009[ 9 ]; Chung et al, 2008[ 10 ]; Hsieh et al, 2019[ 25 ]; Hsu et al, 2011[ 26 ]; Hung et al, 2016[ 27 ]; Lee et al, 2017[ 33 ]; Loke et al, 2013[ 34 ]; Niigaki et al, 2013[ 39 ]; Park et al, 2008[ 41 ]; Tai et al, 2010[ 48 ]; Wu et al, 2011[ 53 ]).…”

Nonalcoholic fatty liver disease increases the risk of gastroesophageal reflux disease: A systematic review and meta‐analysis

“…Table S2 summarized the main characteristics of these three studies [23][24][25] excluded at the stage of eligibility with the exact reasons for exclusion. Table S2 summarized the main characteristics of these three studies [23][24][25] excluded at the stage of eligibility with the exact reasons for exclusion.…”

“…Further, we excluded three studies for the reasons reported in the PRISMA diagram. Table S2 summarized the main characteristics of these three studies [23][24][25] excluded at the stage of eligibility with the exact reasons for exclusion.…”