Waist to hip ratio is a better predictor of esophageal acid exposure than body mass index.

Ringhofer, C; Lenglinger, Johannes; Riegler, M; Kristo, I; Kainz, A; Schoppmann, S F (2017). Waist to hip ratio is a better predictor of esophageal acid exposure than body mass index. Neurogastroenterology and motility, 29(7) Blackwell Science 10.1111/nmo.13033

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BACKGROUND

Obesity and gastroesophageal reflux disease (GERD) are major health problems showing an inconstant relationship in the literature. Therefore, anthropometric parameters which are predictive and can simply be assessed at first patient presentation may lead to a better patient selection for ambulatory reflux monitoring. We aimed to examine the association of body mass index (BMI) and waist to hip ratio (WHR) with gastroesophageal reflux activity during 24 hour-pH-impedance monitoring.

METHODS

Seven hundred and seventy-one patients with GERD symptoms underwent 24 hour-pH-impedance monitoring and high resolution manometry off proton pump inhibitors. Patients with known primary motility disorders of the esophagus and pre-existing endoscopic or operative procedure on esophagus or stomach were excluded from the study. Reflux parameters and anthropometric and demographic data from our prospectively gathered database were analyzed. We performed univariate and multivariate regression analysis to evaluate the associations of BMI and WHR with reflux parameters measured with 24 hour-pH-impedance monitoring.

KEY RESULTS

WHR showed a significantly stronger association with esophageal acid exposure than BMI (P<.001). Our data show that 6.9% of the percentage of endoluminal pH<4 in the distal esophagus is attributable to WHR. Furthermore, an association of WHR with impaired esophageal acid clearance was observed. Additionally, we observed an inverse relationship between lower esophageal sphincter integrity (P=.05) and esophageal acid exposure.

CONCLUSIONS AND INFERENCES

WHR is a better predictor for esophageal acid exposure than BMI. Biomechanical and metabolic mechanisms of central fat distribution may influence reflux parameters in 24 hour pH impedance monitoring, which may affect patient selection for ambulatory reflux monitoring.

Item Type:

Journal Article (Original Article)

Division/Institute:

04 Faculty of Medicine > Department of Gastro-intestinal, Liver and Lung Disorders (DMLL) > Clinic of Visceral Surgery and Medicine
04 Faculty of Medicine > Department of Gastro-intestinal, Liver and Lung Disorders (DMLL) > Clinic of Visceral Surgery and Medicine > Gastroenterology

UniBE Contributor:

Lenglinger, Johannes

Subjects:

600 Technology > 610 Medicine & health

ISSN:

1350-1925

Publisher:

Blackwell Science

Language:

English

Submitter:

Thi Thao Anh Pham

Date Deposited:

01 Feb 2018 12:33

Last Modified:

05 Dec 2022 15:10

Publisher DOI:

10.1111/nmo.13033

PubMed ID:

28133854

Uncontrolled Keywords:

body mass index gastroesophageal reflux disease reflux monitoring waist to hip ratio

BORIS DOI:

10.7892/boris.110324

URI:

https://boris.unibe.ch/id/eprint/110324

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