Article Search
검색
검색 팝업 닫기

Metrics

Help

  • 1. Aims and Scope

    Gut and Liver is an international journal of gastroenterology, focusing on the gastrointestinal tract, liver, biliary tree, pancreas, motility, and neurogastroenterology. Gut atnd Liver delivers up-to-date, authoritative papers on both clinical and research-based topics in gastroenterology. The Journal publishes original articles, case reports, brief communications, letters to the editor and invited review articles in the field of gastroenterology. The Journal is operated by internationally renowned editorial boards and designed to provide a global opportunity to promote academic developments in the field of gastroenterology and hepatology. +MORE

  • 2. Editorial Board

    Editor-in-Chief + MORE

    Editor-in-Chief
    Yong Chan Lee Professor of Medicine
    Director, Gastrointestinal Research Laboratory
    Veterans Affairs Medical Center, Univ. California San Francisco
    San Francisco, USA

    Deputy Editor

    Deputy Editor
    Jong Pil Im Seoul National University College of Medicine, Seoul, Korea
    Robert S. Bresalier University of Texas M. D. Anderson Cancer Center, Houston, USA
    Steven H. Itzkowitz Mount Sinai Medical Center, NY, USA
  • 3. Editorial Office
  • 4. Articles
  • 5. Instructions for Authors
  • 6. File Download (PDF version)
  • 7. Ethical Standards
  • 8. Peer Review

    All papers submitted to Gut and Liver are reviewed by the editorial team before being sent out for an external peer review to rule out papers that have low priority, insufficient originality, scientific flaws, or the absence of a message of importance to the readers of the Journal. A decision about these papers will usually be made within two or three weeks.
    The remaining articles are usually sent to two reviewers. It would be very helpful if you could suggest a selection of reviewers and include their contact details. We may not always use the reviewers you recommend, but suggesting reviewers will make our reviewer database much richer; in the end, everyone will benefit. We reserve the right to return manuscripts in which no reviewers are suggested.

    The final responsibility for the decision to accept or reject lies with the editors. In many cases, papers may be rejected despite favorable reviews because of editorial policy or a lack of space. The editor retains the right to determine publication priorities, the style of the paper, and to request, if necessary, that the material submitted be shortened for publication.

Search

Search

Year

to

Article Type

Original Article

Split Viewer

Weight Loss as a Nonpharmacologic Strategy for Erosive Esophagitis: A 5-Year Follow-up Study

Ki Bae Bang1, and Jung Ho Park2

1Department of Internal Medicine, Dankook University College of Medicine, Cheonan, Korea, 2Department of Internal Medicine, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Korea

Correspondence to:Correspondence to: Jung Ho Park
Department of Internal Medicine, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, 29 Saemunan-ro, Jongno-gu, Seoul 03181, Korea
Tel: +82-2-2001-2059, Fax: +82-2-2001-8340, E-mail: jungho3.park@samsung.com

Received: March 22, 2018; Revised: May 3, 2018; Accepted: May 14, 2018

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Gut and Liver 2018; 12(6): 633-640

Published online December 1, 2018 https://doi.org/10.5009/gnl18148

Copyright © Gut and Liver.

Abstract

Background/Aims

Obesity is a risk factor for gastroesophageal reflux disease (GERD), with several studies demonstrating positive associations between body mass index (BMI) and GERD symptoms. However, little is known about the effect of BMI changes on erosive esophagitis (EE). In this study, we investigated whether BMI reduction could resolve EE.

Methods

A retrospective cohort study was performed to assess the natural course of EE according to changes in BMI. Participants undergoing health check-ups from 2006 to 2012 were enrolled, and 1,126 subjects with EE were included. The degree of esophagitis was measured by upper endoscopy and serially checked over a 5-year follow-up. Logistic regression and Cox proportional hazards models were used to investigate the association between BMI reduction and EE resolution.

Results

Substantial weight loss is associated with EE resolution. The adjusted odds ratio for EE resolution was 1.44 (95% confidence interval [CI], 1.09 to 1.92) among participants with a decrease in BMI compared to those with no decrease in BMI. The EE resolution rate was related to the degree of BMI reduction. The effect of weight loss on EE resolution was higher among subjects who lost more weight. Compared with subjects with no decrease in BMI, the hazard ratios for EE resolution were 1.09 (95% CI, 0.89 to 1.35), 1.31 (95% CI, 1.01 to 1.72) and 2.12 (95% CI, 1.44 to 3.12) in subjects with BMI reductions of ≤1, 1–2, and >2 kg/m2, respectively.

Conclusions

EE resolution is associated with a decrease in BMI, and weight loss is potentially an effective GERD treatment.

Keywords: Gastroesophageal reflux, Body mass index, Erosive esophagitis, Weight loss


Article

Original Article

Gut and Liver 2018; 12(6): 633-640

Published online December 1, 2018 https://doi.org/10.5009/gnl18148

Copyright © Gut and Liver.

Weight Loss as a Nonpharmacologic Strategy for Erosive Esophagitis: A 5-Year Follow-up Study

Ki Bae Bang1, and Jung Ho Park2

1Department of Internal Medicine, Dankook University College of Medicine, Cheonan, Korea, 2Department of Internal Medicine, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Korea

Correspondence to:Correspondence to: Jung Ho Park
Department of Internal Medicine, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, 29 Saemunan-ro, Jongno-gu, Seoul 03181, Korea
Tel: +82-2-2001-2059, Fax: +82-2-2001-8340, E-mail: jungho3.park@samsung.com

Received: March 22, 2018; Revised: May 3, 2018; Accepted: May 14, 2018

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Background/Aims

Obesity is a risk factor for gastroesophageal reflux disease (GERD), with several studies demonstrating positive associations between body mass index (BMI) and GERD symptoms. However, little is known about the effect of BMI changes on erosive esophagitis (EE). In this study, we investigated whether BMI reduction could resolve EE.

Methods

A retrospective cohort study was performed to assess the natural course of EE according to changes in BMI. Participants undergoing health check-ups from 2006 to 2012 were enrolled, and 1,126 subjects with EE were included. The degree of esophagitis was measured by upper endoscopy and serially checked over a 5-year follow-up. Logistic regression and Cox proportional hazards models were used to investigate the association between BMI reduction and EE resolution.

Results

Substantial weight loss is associated with EE resolution. The adjusted odds ratio for EE resolution was 1.44 (95% confidence interval [CI], 1.09 to 1.92) among participants with a decrease in BMI compared to those with no decrease in BMI. The EE resolution rate was related to the degree of BMI reduction. The effect of weight loss on EE resolution was higher among subjects who lost more weight. Compared with subjects with no decrease in BMI, the hazard ratios for EE resolution were 1.09 (95% CI, 0.89 to 1.35), 1.31 (95% CI, 1.01 to 1.72) and 2.12 (95% CI, 1.44 to 3.12) in subjects with BMI reductions of ≤1, 1–2, and >2 kg/m2, respectively.

Conclusions

EE resolution is associated with a decrease in BMI, and weight loss is potentially an effective GERD treatment.

Keywords: Gastroesophageal reflux, Body mass index, Erosive esophagitis, Weight loss

Fig 1.

Figure 1.Flowchart of the enrolled study population.
UGI, upper gastrointestinal.
Gut and Liver 2018; 12: 633-640https://doi.org/10.5009/gnl18148

Fig 2.

Figure 2.Resolution rate of erosive esophagitis according to the decrease in body mass index (BMI).
Gut and Liver 2018; 12: 633-640https://doi.org/10.5009/gnl18148

Fig 3.

Figure 3.Cumulative resolution rate of erosive esophagitis according to a decrease or no decrease in body mass index (BMI) (A) and according to changes in BMI of 0, ≤1, 1–2, and >2 kg/m2 (B).
Gut and Liver 2018; 12: 633-640https://doi.org/10.5009/gnl18148

Table 1 Characteristics of Subjects According to the Resolution of Erosive Esophagitis

CharacteristicsOverall (n=1,126)Resolution of EEp-value

No resolution (n=481)Resolution (n=645)
Age, yr41.02±7.6341.14±7.7140.86±7.520.54
Male sex90.394.687.1<0.001
BMI, kg/m224.70±2.7724.54±2.7724.92±2.770.021
Obesity, BMI ≥25 kg/m242.645.340.60.128
Subjects with reduced BMI50.546.653.50.022
Waist circumference, cm86.62±8.8385.97±9.2687.66±7.990.010
Smoking (current)44.749.641.00.005
Hypertension17.617.517.70.947
Alcohol, g/day14.38±15.213.85±15.0215.08±15.420.182
Hiatal hernia3.63.43.70.497
Fatty liver on USG44.942.847.80.093
Regular exercise19.421.117.10.094
Education (≥college)81.582.480.40.457
Metabolic syndrome14.716.213.60.235

Data are presented as the mean±SD or percentage.

EE, erosive esophagitis; BMI, body mass index; USG, ultrasonography.


Table 2 Resolution of Erosive Esophagitis According to BMI Reduction

VariableOR (95% CI)

UnadjustedAdjusted 1Adjusted 2
Decrease in BMI1.32 (1.04–1.67)1.36 (1.06–1.73)1.44 (1.09–1.92)
Sex-0.47 (0.28–0.78)0.49 (0.27–0.86)
Age-1.00 (0.99–1.02)1.01 (0.99–1.03)
Smoking status-0.82 (0.64–1.06)0.93 (0.69–1.26)
Alcohol intake-1.00 (0.99–1.01)1.00 (0.99–1.01)
BMI-0.97 (0.92–1.01)0.96 (0.90–1.02)
Education--1.31 (0.90–1.91)
Regular exercise--1.06 (0.72–1.55)
Fatty liver--1.05 (0.76–1.45)
Metabolic syndrome--0.72 (0.46–1.11)

Adjusted 1 was adjusted for sex, age, smoking status, alcohol intake and body mass index (BMI). Adjusted 2 was adjusted for all variables in adjusted 1 plus education status, regular exercise, fatty liver, and metabolic syndrome.

OR, odds ratio; CI, confidence interval.


Table 3 Resolution of Erosive Esophagitis According to Obesity Status

VariableOR (95% CI)

BMI <25 kg/m2 (n=646)BMI ≥25 kg/m2 (n=480)Overall (n=1,126)
Decrease in BMI
 01.00 (reference)1.00 (reference)1.00 (reference)
 ≤11.38 (0.91–2.10)0.99 (0.60–1.62)1.19 (0.87–1.63)
 1–21.65 (0.88–3.09)1.86 (1.01–3.44)1.76 (1.14–2.71)
 >22.53 (0.63–10.22)2.89 (1.25–6.70)2.86 (1.41–5.81)
Sex0.42 (0.22–0.81)0.55 (0.14–2.14)0.44 (0.25–0.78)
Age1.02 (0.99–1.04)1.01 (0.97–1.04)1.01 (0.99–1.03)
Smoking status0.93 (0.61–1.40)0.95 (0.61–1.48)0.94 (0.69–1.27)
Alcohol intake1.00 (0.99–1.02)1.00 (0.99–1.02)1.00 (0.99–1.01)
Education1.39 (0.84–2.28)1.17 (0.64–2.15)1.30 (0.89–1.90)
Regular exercise0.94 (0.57–1.54)1.33 (0.71–2.47)1.06 (0.73–1.56)
Fatty liver0.99 (0.63–1.55)0.89 (0.56–1.42)0.93 (0.69–1.26)
Metabolic syndrome0.79 (0.30–2.09)0.66 (0.40–1.10)0.64 (0.42–0.98)

OR, odds ratio; CI, confidence interval; BMI, body mass index.


Table 4 Resolution of Erosive Esophagitis According to Change in BMI

VariableHR (95% CI)

UnadjustedAdjusted 1Adjusted 2
Decrease in BMI
 01.00 (reference)1.00 (reference)1.00 (reference)
 ≤11.10 (0.92–1.31)1.10 (0.92–1.32)1.09 (0.89–1.35)
 1–21.23 (0.98–1.54)1.23 (0.98–1.56)1.31 (1.01–1.72)
 >21.81 (1.30–2.51)2.07 (1.48–2.91)2.12 (1.44–3.12)

Adjusted 1 was adjusted for sex, age, body mass index (BMI), smoking status, and alcohol intake. Adjusted 2 was adjusted for all variables in adjusted 1 plus fatty liver, education status, regular exercise, total cholesterol, triglycerides, low-density lipoprotein cholesterol, homeostatic model assessment for insulin resistance.

HR, hazard ratio; CI, confidence interval.


Gut and Liver

Vol.15 No.6
November, 2021

pISSN 1976-2283
eISSN 2005-1212

qrcode
qrcode

Share this article on :

  • line

Popular Keywords

Gut and LiverQR code Download
qr-code

Editorial Office