The Association of Metabolic Syndrome with Reflux Esophagitis: a Case-control Study

Background: Obesity has been associated with reflux esophagitis. However, the association of metabolic syndrome with reflux esophagitis remains unknown.

Methods: A case-control study of 372 subjects undergoing upper endoscopy during health checkups was conducted (182 patients with reflux esophagitis vs 190 age and gender-matched controls). We further measured their height, weight, waist circumference, hip circumference, blood pressure, triglyceride, high-density lipoprotein, and fasting blood glucose. Multivariable linear regression analysis was used to identify the independent risk factors associated with the presence of reflux esophagitis.

Key Results: Reflux esophagitis cases showed higher mean waist circumference (81.37 ± 0.68 vs 79.36 ± 0.70, P < 0.05), waist hip ratio (0.86 ± 0.01 vs 0.84 ± 0.01, P < 0.05) and fasting blood glucose (5.59 ± 0.10 vs 5.32 ± 0.08, P < 0.05) than those in controls. When adjusted for gender and age, multivariate analysis demonstrated that there was a positive dose-response relationship between reflux esophagitis and waist hip ratio (men: OR 3.41, 95% CI 1.52-7.62, women: OR 3.37, 95% CI 1.61-7.06), triglyceride (OR 2.07, 95% CI 1.12-3.82), fasting blood glucose (OR 1.81, 95% CI 1.12-2.94), and metabolic syndrome (OR 2.01, 95% CI 1.15-3.50), there was an inverse dose-response relationship between reflux esophagitis and high-density lipoprotein for men (OR 0.36, 95% CI 0.15-0.85).

Conclusions & Inferences: High waist hip ratio, triglyceride, fasting blood glucose, and metabolic syndrome were associated with increased risk factors for reflux esophagitis while high high-density lipoprotein for men correlated with a reduced risk of reflux esophagitis.