Objective: To investigate the relationship between overweight and erosive esophagitis (EE) in a non-obese Taiwanese population. Design and Methods: A total of 7,352 subjects (non-obese, 5,826; obese, 1,526) from a health examination center at National Cheng Kung University Hospital were enrolled. Central obesity was defined by a waist circumference (WC) ≥90 cm in male and 80 cm in female. Overweight was defined as body mass index (BMI) of 24-26.9 kg/m2, and general obesity as BMI ≥27 kg/m2. The Los Angeles classification was adopted to determine the presence of EE. Results: There were significant differences in the prevalence of central obesity and different BMI status between subjects with and without EE in total and non-obese population. In total population, multivariate analyses revealed central obesity (OR, 1.17, 95% CI, 1.02-1.34, p = 0.021) and being obese (OR, 1.28, 95% CI, 1.07-1.52, p = 0.007)/overweight (OR, 1.25, 95% CI, 1.08-1.45, p = 0.003) had positive associations with EE in different model, respectively. When considering the joint effect of central obesity and BMI status, overweight (OR, 1.22; 95% CI, 1.04-1.44; p = 0.016) remained as an independent associated factor of EE but central obesity (OR, 1.06; 95% CI, 0.89-1.26; p = 0.549)/being obese (OR, 1.22; 95% CI, 0.98-1.53; p = 0.082) did not. As for non-obese group, separate model showed central obesity (OR, 1.19, 95% CI, 1.00-1.40, p = 0.046) and overweight (OR, 1.24; 95% CI, 1.07-1.44, p = 0.005) was positively associated with EE, respectively. However, being overweight (OR, 1.20; 95% CI, 1.02-1.42, p = 0.030) but not central obesity (OR, 1.08; 95% CI, 0.90-1.31; p = 0.398) was positively related to EE with considering the effect of overweight and central obesity simultaneously. Conclusion: Overweight effect on EE was more detrimental than central obesity in non-obese subjects. In addition, male gender, hiatus hernia and alcohol use were also associated with increased risk of EE.
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