Obesity and weight gain as risk factors for erosive oesophagitis in men

Background  Although obesity and weight gain increase the risk for symptoms of gastro-oesophageal reflux disease, their association with erosive oesophagitis is still unclear in the male population.
Aim  To evaluate, in men, the association of body mass index (BMI) and weight gain with endoscopically proven erosive oesophagitis.
Methods  A total of 8571 Korean men in a comprehensive screening cohort were enrolled. Effects of BMI and abdominal obesity on erosive oesophagitis were estimated with odds ratios (ORs) and 95% confidence intervals (CIs) using logistic regression analysis. We also evaluated the association between erosive oesophagitis and BMI change after 1–3 years.
Results  The prevalence of erosive oesophagitis was 6.4% (552/8571). In univariate analysis, the ORs for erosive oesophagitis increased as BMI or waist circumference increased ( P for trend <0.001, both). In multivariate analysis, OR for erosive oesophagitis increased as BMI increased ( P for trend = 0.002), while the significance of waist circumference was attenuated ( P for trend = 0.13). Increase in BMI (≥1 kg/m²) was associated with persistence of erosive oesophagitis (OR = 2.83, 95% CI: 1.01–7.92, P  = 0.04) and new development of the disease (OR = 2.13, 95% CI: 1.38–3.28, P  = 0.001) compared with BMI change less than 1 kg/m².
Conclusions  Elevated BMI and weight gain have a significant association with erosive oesophagitis.