High Prevalence of Gastroesophageal Reflux Symptoms in Patients with Non-Alcoholic Fatty Liver Disease Associated with Serum Levels of Triglyceride and Cholesterol but Not Simple Visceral Obesity

Abstract

Background/Aims: Visceral obesity is commonly involved in the pathogenesis of gastroesophageal reflux disease (GERD) and non-alcoholic fatty liver disease (NAFLD). However, other characteristic factors different from visceral obesity are associated with the pathogenesis of NAFLD. We investigated the prevalence of GERD symptoms in patients with NAFLD and its associated risk factors. Methods: NAFLD (n = 96) and controls (n = 139) were enrolled in this study. GERD symptoms were evaluated by using a frequency scale for the symptoms of GERD. Results: GERD symptom score and its prevalence rate were higher in the NAFLD group (7.4 ± 0.7, 37%) than those seen in the control groups (4.5 ± 0.4, 20%), which was independent of sex, age, and body mass index (BMI). GERD symptoms were correlated with insulin resistance (r = 0.167, p = 0.011), total cholesterol (T-CHO) (r = 0.138, p = 0.034), triglyceride (TG) (r = 0.178, p = 0.006), or immunoreactive insulin (r = 0.173, p = 0.008) but not BMI (r = 0.089, p = 0.175). GERD symptoms of the NAFLD group were significantly severer in the higher group of T-CHO and TG levels than those in the lower group. Multivariate analysis proved that risk factors related to GERD symptoms were TG (OR 3.96, 95% CI 1.31–11.9) and T-CHO (OR 3.39, 95% CI 1.11–10.3). Conclusion: The severity and prevalence of GERD symptoms in patients with NAFLD were high, which was associated with serum levels of TG and T-CHO but not BMI.

The role of obesity in oesophageal cancer development

“…However, other studies have also failed to find an association between BMI and GORD [Solhpour et al 2008;Fujikawa et al 2012]. Other studies have found a positive association but found it to be more robust or only positive in women [Zheng et al 2007;Piretta et al 2007;Breckan et al 2009].…”

Differences in the Insulin Resistance Levels Measured by HOMA-IR between Patients with Erosive and Non-Erosive Gastroesophageal Reflux Disease

“…This finding was consistent with other study in non-alcoholic fatty liver disease population, which described that the severity of GERD was positively correlated with insulin resistance, but not with BMI. 33 Although the obesity proportion based on BMI was equal, there was a prominent difference of waist circumference between groups. Waist circumference is more sensitive than BMI in predicting insulin resistance.…”

Clinical application of kampo medicine (rikkunshito) for common and/or intractable symptoms of the gastrointestinal tract

“…At the same time, the rate of H. pylori infection in Japan is on the decrease. Under these circumstances, the prevalence of GERD is expected to increase in Japan, as has been seen in Western countries ( Fujiwara and Arakawa, 2009 ; Fujikawa et al, 2012 ). The reflux of gastric contents, consisting primarily of gastric acid, is reported to be principal source of the pathogenesis of GERD ( Vakil et al, 2006 ).…”