Heo Chan Mi, Kim Tae Jun, Lee Hyuk, Pyo Jeung Hui, Min Yang Won, Min Byung-Hoon, Lee Jun Haeng, Son Hee Jung, Baek Sun-Young, Kim Kyunga, Ryu Seungho, Rhee Poong-Lyul, Kim Jae J
Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.
Center for Health Promotion, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.
Korean J Gastroenterol. 2020 Mar 25;75(3):132-140. doi: 10.4166/kjg.2020.75.3.132.
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.
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.
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.
This study suggests that sarcopenia is strongly and progressively associated with erosive esophagitis.
背景/目的：已有报道称肥胖与糜烂性食管炎之间存在关联，但肌肉减少症和肥胖对糜烂性食管炎的影响尚不清楚。本研究在大量无症状男性和女性人群中探讨了肥胖、肌肉减少症、肌肉减少性肥胖与糜烂性食管炎之间的关系。
本研究通过横断面研究分析了2006年8月至2011年12月期间接受包括上消化道内镜检查在内的全面健康检查的32762名受试者。肌肉减少症的定义为四肢骨骼肌质量（ASM）/体重值比年轻参照组的正常均值低两个标准差或更多。
根据肥胖和肌肉减少症状态将研究对象分为四组：正常组、肥胖组、肌肉减少症组和肌肉减少性肥胖组。在多变量模型中，肥胖组（校正比值比[aOR] 1.35，95%置信区间[CI] 1.22 - 1.49）、肌肉减少症组（aOR 2.12，95% CI 1.40 - 3.19）和肌肉减少性肥胖组（aOR 1.54，95% CI 1.27 - 1.87）糜烂性食管炎的风险高于正常组。肌肉减少症组和肌肉减少性肥胖组糜烂性食管炎的风险高于肥胖组；比值比分别为1.63（95% CI 1.08 - 2.47）和1.22（95% CI 1.01 - 1.46）。在剂量反应分析中，肌肉减少症严重程度增加与总体、洛杉矶（LA）-B级或更高等级以及LA-C级糜烂性食管炎呈正相关且具有分级关系。
本研究表明，肌肉减少症与糜烂性食管炎密切相关且呈渐进性关联。
