Abdominal obesity is an independent risk factor for erosive esophagitis in a Korean population

Background:  The relationship between obesity and gastroesophageal reflux disease (GERD) is controversial. The aim of the present study was to investigate the potential roles of body mass index (BMI) and waist circumference on GERD in a Korean population. Methods:  A total of 2457 subjects who visited the Kangbuk Samsung Hospital medical screening center for esophagogastroduodenoscopy from September 2004 to April 2005 were enrolled. All participants were given a questionnaire to determine reflux symptoms. Abdominal obesity was defined as a waist circumference ≥80 cm in women and ≥90 cm in men. Results:  The proportion of subjects in each BMI group was 68.9%, 28.7% and 2.4% for BMI 30, respectively. The prevalence of abdominal obesity was 24.2%. The prevalence of reflux symptoms was 8.2%. Neither BMI nor abdominal obesity was significantly associated with reflux symptoms after adjustment. The prevalence of erosive esophagitis was 6.6%. There was a clear dose–response relationship between prevalence of erosive esophagitis and BMI (5.6%, 8.1% and 15.5% for BMI 30, respectively, P = 0.002). Abdominal obesity was also associated with erosive esophagitis (odds ratio, 2.3; 95% confidence interval, 1.6–3.1). However, only the association between abdominal obesity and erosive esophagitis remained strong after adjustments. Conclusions:  Abdominal obesity rather than BMI is an independent risk factor for erosive esophagitis in the Korean population.