Large Waist Circumference Is a Risk Factor for Reflux Esophagitis in Japanese Males

Yasuhara, Hisae; Miyake, Yasuhiro; Toyokawa, Tatsuya; Matsumoto, Kazuyuki; Takahara, Masakazu; Imada, Takayuki; Yagi, Shunjiro; Miyatake, Hirokazu; Nakatsu, Morihito; Ando, Masaharu; Hirohata, Mamoru

doi:10.1159/000235919

Cited by 21 publications

(18 citation statements)

References 81 publications

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“…The prevalence of erosive GERD in Japanese was approximately 10 % [8][9][10] in studies involving 1000 or more subjects after 2008. Although only a small number of Fig.…”

Section: Summary Of Epidemiologymentioning

confidence: 99%

“…1 Algorithm for diagnosis and treatment of gastroesophageal reflux disease (GERD). a Diagnosis of GERD, b initial treatment for GERD, c long-term treatment strategy for GERD and therapeutic strategy for proton pump inhibitor (PPI)-resistant GERD reports described the endoscopic severity of erosive GERD, the frequency of severe erosive GERD (grade C or D of Los Angeles (LA) classification) cases was reported to be only 3 % [9], similar to that in previous reports, and the prevalence of GERD has been reported to reach an about two times higher level when heartburn symptoms are taken into account in the diagnosis [11].…”

Section: Summary Of Epidemiologymentioning

confidence: 99%

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Evidence-based clinical practice guidelines for gastroesophageal reflux disease 2015

et al. 2016

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As an increase in gastroesophageal reflux disease (GERD) has been reported in Japan, and public interest in GERD has been increasing, the Japanese Society of Gastroenterology published the Evidence-based Clinical Practice Guidelines for GERD (1st edition) in 2009. Six years have passed since its publication, and there have been a large number of reports in Japan concerning the epidemiology, pathophysiology, treatment, and Barrett's esophagus during this period. By incorporating the contents of these reports, the guidelines were completely revised, and a new edition was published in October 2015. The revised edition consists of eight items: epidemiology, pathophysiology, diagnosis, internal treatment, surgical treatment, esophagitis after surgery of the upper gastrointestinal tract, extraesophageal symptoms, and Barrett's esophagus. This paper summarizes these guidelines, particularly the parts related to the treatment for GERD. In the present revision, aggressive proton pump inhibitor (PPI) maintenance therapy is recommended for severe erosive GERD, and on-demand therapy or continuous maintenance therapy is recommended for mild erosive GERD or PPI-responsive non-erosive GERD. Moreover, PPI-resistant GERD (insufficient symptomatic improvement and/or esophageal mucosal break persisting despite the administration of PPI at a standard dose for 8 weeks) is defined, and a standard-dose PPI twice a day, change in PPI, change in the PPI timing of dosing, addition of a prokinetic drug, addition of rikkunshito (traditional Japanese herbal medicine), and addition of histamine H2-receptor antagonist are recommended for its treatment. If no improvement is observed even after these treatments, pathophysiological evaluation with esophageal impedancepH monitoring or esophageal manometry at an expert facility for diseases of the esophagus is recommended.

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“…The prevalence of erosive GERD in Japanese was approximately 10 % [8][9][10] in studies involving 1000 or more subjects after 2008. Although only a small number of Fig.…”

Section: Summary Of Epidemiologymentioning

confidence: 99%

Section: Summary Of Epidemiologymentioning

confidence: 99%

Evidence-based clinical practice guidelines for gastroesophageal reflux disease 2015

et al. 2016

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“…Observational studies from Asia have reported a consistent association between WC or VAT and RE [32,33]. Two studies of RE in a Japanese population showed that abdominal obesity may be an important risk factor for RE in males, but not in females [34,35], but another report did not show this association [36], which has led to some controversy about the association between obesity and RE. The present study clearly demonstrated that RE was an independent risk factor for ESBE, while obesity was not a risk factor for RE.…”

Section: Discussionmentioning

confidence: 99%

Association between obesity and Barrett’s esophagus in a Japanese population: a hospital-based, cross-sectional study

et al. 2013

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BackgroundThe association between obesity and Barrett’s esophagus (BE) in the Japanese population remains unclear. The prevalence of BE and its associated risk factors was examined.MethodsA cross-sectional study of 1581 consecutive individuals who underwent upper gastrointestinal endoscopy was conducted. The prevalence of endoscopically suspected BE (ESBE) was evaluated. Obesity was evaluated by body mass index (BMI, ≥ 25 kg/m2) and waist circumference (WC) (males, ≥ 85 cm; females, ≥ 90 cm). Because endoscopic diagnosis of ultra-short ESBE (<1 cm in extent) is difficult and highly unreliable, this type of ESBE was excluded from the study.ResultsIn proton pump inhibitor (PPI) non-users, the prevalence of ESBE ≥ 1 cm was 5.6%. In univariate analysis, male sex and reflux esophagitis (RE) were significantly associated with BE, but BMI, WC, and reflux symptoms were not. In multivariate logistic regression analysis, only RE (odds ratio [OR] = 3.48, 95% confidence interval [CI] 1.89-6.41, p < 0.0001) was an independent risk factor for BE; obesity and the other factors were not. In contrast, RE (OR 5.67, p = 0.0004) and large WC (OR 5.09, p = 0.0005) were significant risk factors for ESBE ≥ 1 cm in PPI users. Only male sex, but not obesity or the other risk factors, was associated with an increased risk of RE in patients not taking PPIs.ConclusionsRE, but not obesity, may have an independent association with the risk of ESBE in the Japanese population. Furthermore, obesity measures were not independent risks for RE. Interestingly, PPI-refractory RE and large WC were risk factors for ESBE ≥1 cm in patients taking PPIs.

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“…Abdominal obesity is a related prominent risk factor [49,50,51,52]. For example, the risk of EAC increased 3-fold for individuals with body mass indices >30 [50].…”

Section: Esophageal Adenocarcinomamentioning

confidence: 99%

“…In another study, abdominal obesity was found to be more important, as the risk of BE was more closely associated with waist-to-hip ratio than with body mass index [51]. A large waist circumference was also found to be a risk factor for reflux esophagitis [52]. Such types of obesity not only physically increase the episode of gastroesophageal reflux, but may also contribute to carcinogenesis by enhancing inflammation.…”

Section: Esophageal Adenocarcinomamentioning

confidence: 99%

Etiology and Prevention of Esophageal Cancer

Yang

Chen

2016

Gastrointest Tumors

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Background: Esophageal cancer (EC) occurs commonly, especially in Asia, and is the sixth leading cause of cancer deaths worldwide. Recently, great progress has been made in research on the etiology and prevention of EC. Summary: The major risk factors for esophageal squamous cell carcinoma (ESCC) are tobacco smoking and alcohol drinking, which act synergistically. Dietary parameters, including dietary carcinogens and insufficiency of micronutrients, could also be important risk factors in certain areas. A common etiological factor for both EC and some other cancers are low levels of intake of fruits and vegetables. With improvements in diet and drinking water in developing countries, the incidence of ESCC decreased. However, in economically well-developed countries, the incidence of esophageal adenocarcinoma (EAC) has markedly increased in the past 40 years. The major etiological factor for EAC is gastroesophageal reflux, which is also an etiological factor for gastric cardia adenocarcinoma (GCA). In certain areas of China, the occurrence of GCA is closely related to ESCC. Susceptibility genes for EC are starting to be discovered, and this may help to identify high-risk groups that have more need for preventive measures. Mitigation of the risk factors, early detection and treatment of precancerous lesions are effective approaches for prevention. Smoking cessation, avoidance of excessive alcohol, meat and caloric consumption, increasing physical activity and frequent consumption of vegetables and fruits are prudent lifestyle modifications for the prevention of EC as well as other diseases. Key Message: The etiology of EC includes tobacco smoking, alcohol drinking, low levels of intake of fruits and vegetables as well as gastroesophageal reflux and susceptibility genes. Practical Implications: A healthy lifestyle including smoking cessation, increasing physical activity, consumption of vegetables as well as reduction of alcohol intake and caloric consumption are major approaches to the prevention of EC.

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Large Waist Circumference Is a Risk Factor for Reflux Esophagitis in Japanese Males

Cited by 21 publications

References 81 publications

Evidence-based clinical practice guidelines for gastroesophageal reflux disease 2015

Evidence-based clinical practice guidelines for gastroesophageal reflux disease 2015

Association between obesity and Barrett’s esophagus in a Japanese population: a hospital-based, cross-sectional study

Etiology and Prevention of Esophageal Cancer

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