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Korean J Gastroenterol  <  Volume 75(3); 2020 <  Articles

Korean J Gastroenterol 2020; 75(3): 132-140  https://doi.org/10.4166/kjg.2020.75.3.132
Impact of Sarcopenia on the Risk of Erosive Esophagitis
Chan Mi Heo1,*, Tae Jun Kim1,*, Hyuk Lee1 , Jeung Hui Pyo2, Yang Won Min1, Byung-Hoon Min1, Jun Haeng Lee1, Hee Jung Son1,2, Sun-Young Baek3, Kyunga Kim3, Seungho Ryu4, Poong-Lyul Rhee1 and Jae J. Kim1
Department of Medicine1, Center for Health Promotion2, Statistics and Data Center3, Samsung Medical Center; Department of Occupational and Environmental Medicine, Kangbuk Samsung Hospital4, Sungkyunkwan University School of Medicine, Seoul, Korea
Correspondence to: Hyuk Lee, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, 81 Irwon-ro, Gangnam-gu, Seoul 06351, Korea. Tel: +82-2-3410-3409, Fax: +82-2-3410-6983, E-mail: leehyuk@skku.edu, ORCID: https://orcid.org/0000-0003-4271-7205

*The first two authors contributed equally to this work as co-first authors of this paper.
Received: August 31, 2018; Revised: January 12, 2020; Accepted: January 13, 2020; Published online: March 25, 2020.
© The Korean Journal of Gastroenterology. All rights reserved.

This is an open access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
Abstract
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.
Keywords: Sarcopenia; Obesity; Esophagitis


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