Metabolic syndrome is associated with erosive esophagitis

Aim: To clarify whether insulin resistance and metabolic syndrome are risk factors for erosive esophagitis. Methods: A case-control study was performed using the database of the Kangbuk Samsung Hospital Medical Screening Center. Results: A total of 1679 cases of erosive esophagitis and 3358 randomly selected controls were included. Metabolic syndrome was diagnosed in 21% of the cases and 12% of the controls (P < 0.001). Multiple logistic regressions confirmed the association between erosive esophagitis and metabolic syndrome (Odds ratio, 1.25; 95% CI, 1.04-1.49). Among the components of metabolic syndrome, increased waist circumference, elevated serum triglyceride levels and hypertension were significant risk factors for erosive esophagitis (all P < 0.01). Furthermore, increased insulin resistance (Odds ratio, 0.91; 95% CI, 0.85-0.98) and fatty liver, as diagnosed by ultrasonography (Odds ratio, 1.39; 95% CI, 1.20-1.60), were also related to erosive esophagitis even after adjustment for a series of confounding factors. Conclusion: Metabolic syndrome and increased insulin resistance are associated with an increased risk of developing erosive esophagitis.