What is the impact of metabolic syndrome and its components on reflux esophagitis? A cross-sectional study

Abstract

Background The prevalence rate of reflux esophagitis (RE) in Asia, including Taiwan, has increased dramatically in recent years. However, few studies have discussed on its relationship with metabolic syndrome (MetS). This study aimed to evaluate the correlation between RE and MetS and its components. Methods We conducted a cross-sectional study during 2013 to 2014 in Taiwan. A total of 4895 subjects who completed upper gastrointestinal endoscopy at the Health Examination Center of Changhua Christian Hospital were enrolled. RE was defined according to the upper gastrointestinal endoscopic findings and MetS was defined according to the Taiwanese criteria. Univariate and multivariate logistic regression analyses were applied to calculate odds ratios and 95% confidence intervals for each variable to assess the associated features for RE. We analyzed the relationship between the number of MetS components and the severity of RE using the chi-square test for trend. Results The prevalence rates of MetS and RE were respectively 28.5 and 59.6%. According to univariate logistic regression analysis, MetS was significantly associated with RE and remained a positive association in multivariate logistic regression analysis (adjusted OR ß = 1.251; 95% CI = 1.071–1.462; p = 0.005). Furthermore, among the five MetS components, elevated blood pressure (adjusted OR γ = 1.163; 95% CI = 1.023–1.323; p = 0.021), abdominal obesity (adjusted OR γ = 1.173; 95% CI = 1.020–1.349; p = 0.026) and hyperglycemia (adjusted OR γ = 1.306; 95% CI = 1.142–1.495; p < 0.001) were positively associated with the presence of RE. A weak association was also found between elevated triglycerides and RE after adjusting for age and gender (adjusted OR α = 1.171; 95% CI = 1.022–1.343; p = 0.023). Reduced high-density lipoprotein cholesterol showed no significant difference between groups with and without RE. Older age (≥65 years), male gender, higher body mass index, higher uric acid, smoking, alcohol drinking, and hiatal hernia were found to be significant associated factors for RE. In addition, a dose-response relation between the number of MetS components and the presence of RE was demonstrated in the multivariate analysis. Furthermore, we performed a trend analysis and found the severity of RE got worse as the number of MetS components increased ( p < 0.001). Conclusion This study suggests that MetS is significantly related to the presence and the severity of RE.

Associations between Lifestyle Habits, Perceived Symptoms and Gastroesophageal Reflux Disease in Patients Seeking Health Check-Ups

“…The incidence of GERD was slightly higher in the subjects who chewed Areca catechu than in those who did not chew Areca catechu . Hsieh et al [ 19 ] showed that the probability of GERD caused by chewing Areca catechu daily was 1.496 times higher than that not caused by chewing Areca catechu daily (95% CI: 1.02–2.21). Wang et al [ 20 ] showed that people who chewed Areca catechu every day were two times more likely to have GERD than those who did not chew Areca catechu daily (95% CI: 1.2–3.2).…”

Cough Hypersensitivity in Patients With Metabolic Syndrome: A Clinical Finding and Its Possible Mechanisms

“…Second, high blood glucose levels can cause autonomic neuropathy, which in turn affects esophageal motility and gastrointestinal emptying. In patients with diabetes, esophageal motility is reduced, peristaltic waves are reduced or absent, reverse peristalsis can occur, and gastroesophageal re ux-related symptoms are present [29,30] . In addition, hypertension and gastroesophageal re ux have many common risk factors, such as age, obesity, smoking, and drinking [28,31,32] .…”

Gastroesophageal Reflux Disease and Coronary Heart Disease: Is There a “Mutual Burden” Syndrome?

“…С одной стороны, мужской пол, ожирение, сахарный диабет, артериальная гипертензия, курение и злоупотребление алкоголем непосредственно влияют на ГЭРБ; клинические проявления и тяжесть РЭ связаны с метаболическими факторами. Продемонстрирована прямая зависимость между количеством компонентов метаболического синдрома, наличием и степенью тяжести РЭ [54][55][56][57]. Среди перечисленных состояний самым значимым независимым предиктором развития РЭ считается абдоминальное ожирение [54].…”

“…В дополнение к механическому влиянию увеличенной массы тела на появление рефлюкса, значительную роль в возникновении РЭ играет провоспалительная активность адипоцитов. Из отдельных метаболических показателей положительная корреляция рефлюксных симптомов обнаружена с гипертриглицеридемией, а обратная связь -с уровнем ЛПВП [55,57].…”