NEW ORLEANS — Both gastroesophageal reflux disease and erosive esophagitis were associated with obesity in a study of 453 hospital employees.
The results also showed that neither the amount of certain foods nor the composition of the individual's diet was related to reflux or erosive esophagitis, suggesting that the link between obesity, reflux, and esophagitis may be mechanical or hormonal, Hashem B. El-Serag, M.D., said at the annual Digestive Disease Week.
Several prior studies by other investigators had divergent findings on the links between obesity, reflux, and esophagitis. One strength of the study was that it collected information about diet and so was able to rule out the amounts of certain foods in the diet as a cause, said Dr. El-Serag, head of the GI outcome research unit at the of the Veterans Affairs Medical Center in Houston.
The study focused on a sample of the employees who worked at the center. Questionnaires were sent to 915 of the approximately 3,000 employees at the center regarding their symptoms of gastroesophageal reflux disease (GERD), their diet during the past year, and their height and weight. Completed questionnaires were returned by 453 employees; this group also underwent endoscopy to see if they had erosive esophagitis.
The 453 participants had a mean age of 44 years, and 70% were women; 43% were African American, 33% were white, and 24% were from other racial groups, a split that roughly matched the demographics of the full group of 3,000 employees. The questionnaire results showed that 118 people had at least weekly symptoms of GERD.
In a multivariate analysis that adjusted for several potential confounders—including age, gender, race, education, smoking, diet, and family history—subjects with a body mass index (BMI) of more than 30 kg/m
The analysis showed that subjects with a BMI of 25–30 kg/m
The endoscopy results showed that 43 subjects had erosive esophagitis and 410 did not. In an unadjusted analysis, people with a BMI of at least 25 kg/m
However, when two or three confounders were factored in at a time, including age, diet, and severity of GERD symptoms, none altered the significant effect of BMI on erosive esophagitis.