Wolf W Asher, Piazza Nicholas A, Gebhart Jessica H, Rusin Spencer, Covey Shannon, Higgins Leana L, Beitia RoseMary, Speck Olga, Woodward Kimberly, Cotton Cary C, Runge Thomas M, Eluri Swathi, Woosley John T, Shaheen Nicholas J, Dellon Evan S
Division of Gastroenterology and Hepatology, Center for Esophageal Diseases and Swallowing, University of North Carolina at Chapel Hill, CB#7080 Bioinformatics Building, 130 Mason Farm Rd., Chapel Hill, NC, 27599-7080, USA.
Department of Pathology and Laboratory Medicine, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA.
Dig Dis Sci. 2017 Jan;62(1):143-149. doi: 10.1007/s10620-016-4357-1. Epub 2016 Oct 24.
Because eosinophilic esophagitis (EoE) causes dysphagia, esophageal narrowing, and strictures, it could result in low body mass index (BMI), but there are few data assessing this.
To determine whether EoE is associated with decreased BMI.
We conducted a prospective study at the University of North Carolina from 2009 to 2013 enrolling consecutive adults undergoing outpatient EGD. BMI and endoscopic findings were recorded. Incident cases of EoE were diagnosed per consensus guidelines. Controls had either reflux or dysphagia, but not EoE. BMI was compared between cases and controls and by endoscopic features.
Of 120 EoE cases and 297 controls analyzed, the median BMI was lower in EoE cases (25 vs. 28 kg/m, p = 0.002). BMI did not differ by stricture presence (26 vs. 26 kg/m, p = 0.05) or by performance of dilation (26 vs. 27 kg/m for undilated; p = 0.16). However, BMI was lower in patients with narrow caliber esophagus (24 vs. 27 kg/m, p < 0.001). EoE patients with narrow caliber esophagus also had decreased BMI compared to controls with narrow caliber esophagi (24 vs. 27 kg/m, p = 0.001). On linear regression after adjustment for age, race, and gender, narrowing decreased BMI by 2.3 kg/m [95% CI -4.1, -0.6].
BMI is lower in EoE cases compared to controls, and esophageal narrowing, but not focal stricture, is associated with a lower BMI in patients with EoE. Weight loss or low BMI in a patient suspected of having EoE should raise concern for esophageal remodeling causing narrow caliber esophagus.
由于嗜酸性粒细胞性食管炎（EoE）可导致吞咽困难、食管狭窄，进而可能导致体重指数（BMI）降低，但评估这一情况的数据较少。
确定EoE是否与BMI降低有关。
我们于2009年至2013年在北卡罗来纳大学进行了一项前瞻性研究，纳入连续接受门诊内镜检查的成年患者。记录BMI和内镜检查结果。根据共识指南诊断EoE的新发病例。对照组有反流或吞咽困难，但无EoE。比较病例组和对照组之间以及根据内镜特征的BMI。
在分析的120例EoE病例和297例对照中，EoE病例的BMI中位数较低（25 vs. 28kg/m²，p = 0.002）。BMI在有无狭窄（26 vs. 26kg/m²，p = 0.05）或是否进行扩张方面无差异（未扩张者为26 vs. 27kg/m²；p = 0.16）。然而，食管管径狭窄的患者BMI较低（24 vs. 27kg/m²，p < 0.001）。与食管管径狭窄的对照组相比，食管管径狭窄的EoE患者BMI也降低（24 vs. 27kg/m²，p = 0.001）。在对年龄、种族和性别进行调整后的线性回归分析中，狭窄使BMI降低2.3kg/m² [95%可信区间 -4.1，-0.6]。
与对照组相比，EoE病例的BMI较低，并且食管狭窄而非局灶性狭窄与EoE患者的低BMI有关。怀疑患有EoE的患者体重减轻或BMI较低应引起对食管重塑导致食管管径狭窄的关注。
