Impact of Sarcopenia on the Risk of Erosive Esophagitis

• Main Authors: Chan Mi Heo, Tae Jun Kim, Hyuk Lee, Jeung Hui Pyo, Yang Won Min, Byung-Hoon Min, Jun Haeng Lee, Hee Jung Son, Sun-Young Baek, Kyunga Kim, Seungho Ryu, Poong-Lyul Rhee, Jae J. Kim
• Format: Article
• Language: English
• Published: Jin Publishing & Printing Co. 2020-03-01
• Series: The Korean Journal of Gastroenterology
• Subjects: sarcopenia; obesity; esophagitis
• Online Access: http://www.kjg.or.kr/journal/view.html?uid=5555&vmd=Full&
• ISSN: 1598-9992; 2233-6869

Background/Aims: An association between obesity and erosive esophagitis has been reported, but the effects of sarcopenia and obesity on erosive esophagitis are unknown. This study examined the relationship between obesity, sarcopenia, sarcopenic obesity, and erosive esophagitis in a large population of asymptomatic men and women. Methods: This study analyzed 32,762 subjects who underwent a comprehensive health check-up, which included upper gastrointestinal endoscopy, from August 2006 to December 2011 by a cross-sectional study. Sarcopenia was defined as a decrease in the appendicular skeletal muscle mass (ASM)/body weight value of two SD or more below the normal means for a younger reference group. Results: The study was carried out on four groups according to obesity and sarcopenic status: normal, obesity, sarcopenic, and sarcopenic obese group. In a multivariable model, the risk of erosive esophagitis was higher in the obese (adjusted OR [aOR] 1.35, 95% CI 1.22-1.49), sarcopenic (aOR 2.12, 95% CI 1.40-3.19), and sarcopenic obese groups (aOR 1.54, 95% CI 1.27-1.87) than in the normal group. The risk of erosive esophagitis was higher in the sarcopenic and sarcopenic obese groups than the obese group; the ORs were 1.63 (95% CI 1.08-2.47) and 1.22 (95% CI 1.01-1.46), respectively. In dose-response analysis, increasing sarcopenia severity showed a positive and graded relationship with the overall, Los Angeles (LA)-B or higher grade, and LA-C erosive esophagitis. Conclusions: This study suggests that sarcopenia is strongly and progressively associated with erosive esophagitis.