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Chong Il Sohn - One of the best experts on this subject based on the ideXlab platform.
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Nonalcoholic Fatty Liver Disease Is Associated with Increased Risk of Reflux Esophagitis
Digestive Diseases and Sciences, 2017Co-Authors: Hyo-joon Yang, Yoosoo Chang, Soo-kyung Park, Yoon Suk Jung, Jung Ho Park, Dong Il Park, Yong Kyun Cho, Seungho Ryu, Chong Il SohnAbstract:Background Reflux Esophagitis is associated with obesity and metabolic syndrome; however, the relationship between nonalcoholic fatty liver disease (NAFLD) and Reflux Esophagitis is unclear. Aim We examined the association between NAFLD and the development of Reflux Esophagitis. Methods Our cohort consisted of 117,377 Korean adults without Reflux Esophagitis at baseline who underwent a health checkup program including upper endoscopy between 2002 and 2014 and were followed annually or biennially until December 2014. NAFLD was defined as hepatic steatosis on ultrasonography in the absence of excessive alcohol use or any other identifiable cause. Results Over 520,843.2 person-years of follow-up, 22,500 participants developed Reflux Esophagitis (incidence density, 43.2 per 1000 person-years). In models adjusted for age and sex, the adjusted hazard ratio (aHR) (95% confidence interval [CI]) for incident Reflux Esophagitis in subjects with NAFLD compared to those without was 1.16 (1.13–1.20). After further adjustment for confounders of center, year of visit, smoking status, alcohol intake, regular exercise, education level, and body mass index, the association between NAFLD and incident Reflux Esophagitis was attenuated, but remained significant (aHR 1.06; 95% CI 1.02–1.10). Conclusions In this large cohort of Korean men and women, participants with NAFLD exhibited increased incidence of Reflux Esophagitis independent of possible confounders, suggesting that NAFLD contributes to the development of Reflux Esophagitis.
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Nonalcoholic Fatty Liver Disease Is Associated with Increased Risk of Reflux Esophagitis.
Digestive diseases and sciences, 2017Co-Authors: Hyo-joon Yang, Yoosoo Chang, Soo-kyung Park, Yoon Suk Jung, Jung Ho Park, Dong Il Park, Yong Kyun Cho, Seungho Ryu, Chong Il SohnAbstract:Reflux Esophagitis is associated with obesity and metabolic syndrome; however, the relationship between nonalcoholic fatty liver disease (NAFLD) and Reflux Esophagitis is unclear. We examined the association between NAFLD and the development of Reflux Esophagitis. Our cohort consisted of 117,377 Korean adults without Reflux Esophagitis at baseline who underwent a health checkup program including upper endoscopy between 2002 and 2014 and were followed annually or biennially until December 2014. NAFLD was defined as hepatic steatosis on ultrasonography in the absence of excessive alcohol use or any other identifiable cause. Over 520,843.2 person-years of follow-up, 22,500 participants developed Reflux Esophagitis (incidence density, 43.2 per 1000 person-years). In models adjusted for age and sex, the adjusted hazard ratio (aHR) (95% confidence interval [CI]) for incident Reflux Esophagitis in subjects with NAFLD compared to those without was 1.16 (1.13–1.20). After further adjustment for confounders of center, year of visit, smoking status, alcohol intake, regular exercise, education level, and body mass index, the association between NAFLD and incident Reflux Esophagitis was attenuated, but remained significant (aHR 1.06; 95% CI 1.02–1.10). In this large cohort of Korean men and women, participants with NAFLD exhibited increased incidence of Reflux Esophagitis independent of possible confounders, suggesting that NAFLD contributes to the development of Reflux Esophagitis.
Yoshikazu Kinoshita - One of the best experts on this subject based on the ideXlab platform.
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Gender differences in the time-course changes of Reflux Esophagitis in Japanese patients.
Internal medicine (Tokyo Japan), 2015Co-Authors: Kyoichi Adachi, Shino Tanaka, Tomoko Mishiro, Kozue Hanada, Yoshikazu KinoshitaAbstract:OBJECTIVE Obesity is related to an increased prevalence of Reflux Esophagitis and gastroesophageal Reflux disease symptoms. This study was performed to clarify the influence of gender on time-course changes in the rate of a high BMI and incidence of Reflux Esophagitis in Japanese subjects. METHODS The subjects included individuals who visited a medical center for medical checkups between April 2000 and March 2001, April 2005 and March 2006 and April 2010 and March 2011. At each examination, the subjects underwent upper gastrointestinal endoscopy to determine the presence of Reflux Esophagitis, size of the diaphragmatic hiatus and degree of gastric mucosal atrophy. A body mass index (BMI) of ≥ 25 kg/m(2) was defined as a high BMI. RESULTS A multiple logistic regression analysis showed that a high BMI, milder degree of gastric mucosal atrophy and larger size of diaphragmatic hiatus were significant predictive factors for the presence of Reflux Esophagitis in both men and women. The number of male subjects with Reflux Esophagitis and a high BMI increased during the 10-year examination period. In contrast, the number of individuals with Reflux Esophagitis and a high BMI was not increased among women. For both men and women, the proportions of patients with a large diaphragmatic hiatus and mild gastric mucosal atrophy increased during the 10-year period. CONCLUSION The prevalence of Reflux Esophagitis in the female subjects remained constant over 10 years, different from that observed in the men. A lack of change in BMI may be an important factor accounting for the constant prevalence of Reflux Esophagitis in women.
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Characteristics of gastritis in patients with Helicobacter pylori-positive Reflux Esophagitis.
Journal of gastroenterology and hepatology, 2005Co-Authors: Takafumi Mihara, Kyoichi Adachi, Kenji Furuta, Yoshinori Komazawa, Manabu Yoshida, Asuka Araki, Riruke Maruyama, Shunji Ishihara, Yuji Amano, Yoshikazu KinoshitaAbstract:Background and Aim: The influence of Helicobacter pylori on gastric acid secretion differs with the status of gastritis. The histological characteristics of gastritis in H. pylori-positive patients with Reflux Esophagitis have not been fully investigated. We therefore studied the pattern of endoscopic gastric mucosal atrophy and degree of histological gastritis in such patients. Methods: Subjects comprised 41 H. pylori-positive patients with Reflux Esophagitis, 41 age- and sex-matched patients with duodenal ulcer, and 41 patients with early gastric cancer. The endoscopic pattern of gastric mucosal atrophy was reviewed, and the degree of histological gastritis in biopsy specimens from the antrum and corpus was assessed in accordance with the updated Sydney system. Results: The grade of endoscopic and histological gastric mucosal atrophy in patients with Reflux Esophagitis was significantly lower than that in patients with gastric cancer, and the histological scores for antral atrophy and metaplasia in patients with Reflux Esophagitis tended to be lower than those in patients with duodenal ulcer. In patients with Reflux Esophagitis and duodenal ulcer, the scores for antral inflammation and activity tended to be higher than those for the corpus. Conversely, the inflammation and activity score in patients with early gastric cancer showed a corpus-predominant gastritis pattern. Conclusion: In H. pylori-positive patients with Reflux Esophagitis, the degree of endoscopic gastric mucosal atrophy is low and histologically there is an antral-predominant gastritis pattern. Therefore, gastric acid secretion in H. pylori-positive patients with Reflux Esophagitis may be augmented by H. pylori infection.
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Influence of Helicobacter pylori infection on the prevalence of Reflux Esophagitis in Japanese patients.
Journal of gastroenterology and hepatology, 2001Co-Authors: Hirofumi Fujishiro, Kyoichi Adachi, Shunji Ishihara, Akira Kawamura, Tomoko Katsube, Masahiro Ono, Mika Yuki, Kazutoshi Amano, Yoshikazu KinoshitaAbstract:Abstract Background and Aim: Reflux Esophagitis is caused by esophageal motor dysfunction in patients with sufficient gastric acid secretion. Helicobacter pylori causes atrophic gastritis and influences gastric acid secretion. Hiatus hernia (HH) of the esophagus causes motor dysfunction in the lower esophagus. Therefore, this study aimed to test whether H. pylori infection, gastric mucosal atrophy and HH are predictive factors for Reflux Esophagitis. Methods: Helicobacter pylori infection was examined in 781 patients by the measurement of serum immunoglobulin (Ig)G antibody, bacteriological culture and histological examination of biopsy specimens. The prevalence of HH, endoscopically identified gastric mucosal atrophy (closed- or open-type) and Reflux Esophagitis were investigated by reviewing endoscopic films. Investigated patients were divided into three age groups, under 49, 50–69, and over 70 years. The prevalence of Esophagitis, H. pylori infection, gastric mucosal atrophy, and HH were compared to identify the possible predictive factors for Reflux Esophagitis by using logistic regression analysis. Results: Sixty-nine patients with Reflux Esophagitis were found among the 781 investigated cases. The odds ratios of negative H. pylori infection, endoscopically identified closed-type gastric mucosal atrophy, and HH for the prevalence of Reflux Esophagitis were 1.342, 1.751 and 5.527, respectively. These results indicated that the presence of H. pylori infection was only a weak negative risk factor, and that HH was the most reliable endoscopic predictive factor for Reflux Esophagitis. Conclusion: Helicobacter pylori infection is a weak negative risk factor for the prevalence of Reflux Esophagitis, while HH is the most reliable predictive factor.
Hyo-joon Yang - One of the best experts on this subject based on the ideXlab platform.
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Nonalcoholic Fatty Liver Disease Is Associated with Increased Risk of Reflux Esophagitis
Digestive Diseases and Sciences, 2017Co-Authors: Hyo-joon Yang, Yoosoo Chang, Soo-kyung Park, Yoon Suk Jung, Jung Ho Park, Dong Il Park, Yong Kyun Cho, Seungho Ryu, Chong Il SohnAbstract:Background Reflux Esophagitis is associated with obesity and metabolic syndrome; however, the relationship between nonalcoholic fatty liver disease (NAFLD) and Reflux Esophagitis is unclear. Aim We examined the association between NAFLD and the development of Reflux Esophagitis. Methods Our cohort consisted of 117,377 Korean adults without Reflux Esophagitis at baseline who underwent a health checkup program including upper endoscopy between 2002 and 2014 and were followed annually or biennially until December 2014. NAFLD was defined as hepatic steatosis on ultrasonography in the absence of excessive alcohol use or any other identifiable cause. Results Over 520,843.2 person-years of follow-up, 22,500 participants developed Reflux Esophagitis (incidence density, 43.2 per 1000 person-years). In models adjusted for age and sex, the adjusted hazard ratio (aHR) (95% confidence interval [CI]) for incident Reflux Esophagitis in subjects with NAFLD compared to those without was 1.16 (1.13–1.20). After further adjustment for confounders of center, year of visit, smoking status, alcohol intake, regular exercise, education level, and body mass index, the association between NAFLD and incident Reflux Esophagitis was attenuated, but remained significant (aHR 1.06; 95% CI 1.02–1.10). Conclusions In this large cohort of Korean men and women, participants with NAFLD exhibited increased incidence of Reflux Esophagitis independent of possible confounders, suggesting that NAFLD contributes to the development of Reflux Esophagitis.
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Nonalcoholic Fatty Liver Disease Is Associated with Increased Risk of Reflux Esophagitis.
Digestive diseases and sciences, 2017Co-Authors: Hyo-joon Yang, Yoosoo Chang, Soo-kyung Park, Yoon Suk Jung, Jung Ho Park, Dong Il Park, Yong Kyun Cho, Seungho Ryu, Chong Il SohnAbstract:Reflux Esophagitis is associated with obesity and metabolic syndrome; however, the relationship between nonalcoholic fatty liver disease (NAFLD) and Reflux Esophagitis is unclear. We examined the association between NAFLD and the development of Reflux Esophagitis. Our cohort consisted of 117,377 Korean adults without Reflux Esophagitis at baseline who underwent a health checkup program including upper endoscopy between 2002 and 2014 and were followed annually or biennially until December 2014. NAFLD was defined as hepatic steatosis on ultrasonography in the absence of excessive alcohol use or any other identifiable cause. Over 520,843.2 person-years of follow-up, 22,500 participants developed Reflux Esophagitis (incidence density, 43.2 per 1000 person-years). In models adjusted for age and sex, the adjusted hazard ratio (aHR) (95% confidence interval [CI]) for incident Reflux Esophagitis in subjects with NAFLD compared to those without was 1.16 (1.13–1.20). After further adjustment for confounders of center, year of visit, smoking status, alcohol intake, regular exercise, education level, and body mass index, the association between NAFLD and incident Reflux Esophagitis was attenuated, but remained significant (aHR 1.06; 95% CI 1.02–1.10). In this large cohort of Korean men and women, participants with NAFLD exhibited increased incidence of Reflux Esophagitis independent of possible confounders, suggesting that NAFLD contributes to the development of Reflux Esophagitis.
Kyoichi Adachi - One of the best experts on this subject based on the ideXlab platform.
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Gender differences in the time-course changes of Reflux Esophagitis in Japanese patients.
Internal medicine (Tokyo Japan), 2015Co-Authors: Kyoichi Adachi, Shino Tanaka, Tomoko Mishiro, Kozue Hanada, Yoshikazu KinoshitaAbstract:OBJECTIVE Obesity is related to an increased prevalence of Reflux Esophagitis and gastroesophageal Reflux disease symptoms. This study was performed to clarify the influence of gender on time-course changes in the rate of a high BMI and incidence of Reflux Esophagitis in Japanese subjects. METHODS The subjects included individuals who visited a medical center for medical checkups between April 2000 and March 2001, April 2005 and March 2006 and April 2010 and March 2011. At each examination, the subjects underwent upper gastrointestinal endoscopy to determine the presence of Reflux Esophagitis, size of the diaphragmatic hiatus and degree of gastric mucosal atrophy. A body mass index (BMI) of ≥ 25 kg/m(2) was defined as a high BMI. RESULTS A multiple logistic regression analysis showed that a high BMI, milder degree of gastric mucosal atrophy and larger size of diaphragmatic hiatus were significant predictive factors for the presence of Reflux Esophagitis in both men and women. The number of male subjects with Reflux Esophagitis and a high BMI increased during the 10-year examination period. In contrast, the number of individuals with Reflux Esophagitis and a high BMI was not increased among women. For both men and women, the proportions of patients with a large diaphragmatic hiatus and mild gastric mucosal atrophy increased during the 10-year period. CONCLUSION The prevalence of Reflux Esophagitis in the female subjects remained constant over 10 years, different from that observed in the men. A lack of change in BMI may be an important factor accounting for the constant prevalence of Reflux Esophagitis in women.
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Different sex‐related influences of eating habits on the prevalence of Reflux Esophagitis in Japanese
Journal of gastroenterology and hepatology, 2011Co-Authors: Atsushi Mizuta, Kyoichi Adachi, Kenji Furuta, Shunji Ohara, Terumi Morita, Kenji Koshino, Shino Tanaka, Mika Moriyama, Masuko Sumikawa, Mari SanpeiAbstract:Background and Aim: Many types of food have been shown to affect lower esophageal sphincter pressure and esophageal motor function, and thus, the prevalence of Reflux Esophagitis. The present study was performed to clarify the different eating habits that predominantly affect the prevalence of Reflux Esophagitis in Japanese. Methods: The study included 2303 individuals (males: 1599, females: 704, mean age: 49.9 years) who underwent upper gastrointestinal endoscopy for gastric cancer screening. The daily dietary contents of the patients were analyzed using a self-administered questionnaire. Results: A total of 201 patients had endoscopically-proven Reflux Esophagitis, and the percentage of males with Reflux Esophagitis was significantly higher than their female counterparts (11.3% vs 2.8%). The body mass indexes of individuals with Reflux Esophagitis were significantly higher than those without, both for males and females. Total energy intake was the most important risk factor for the occurrence of Reflux Esophagitis in males, but the food content was not a significant risk factor. Dietary habit did not affect the prevalence of Reflux Esophagitis in the female patients. The age and height of females with Reflux Esophagitis significantly exceeded those of females without Reflux Esophagitis, and were independent risk factors for the occurrence of Reflux Esophagitis only in the female patients. Conclusion: There is a sex-related difference in the influence of eating habits on the prevalence of Reflux Esophagitis in Japanese.
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Characteristics of gastritis in patients with Helicobacter pylori-positive Reflux Esophagitis.
Journal of gastroenterology and hepatology, 2005Co-Authors: Takafumi Mihara, Kyoichi Adachi, Kenji Furuta, Yoshinori Komazawa, Manabu Yoshida, Asuka Araki, Riruke Maruyama, Shunji Ishihara, Yuji Amano, Yoshikazu KinoshitaAbstract:Background and Aim: The influence of Helicobacter pylori on gastric acid secretion differs with the status of gastritis. The histological characteristics of gastritis in H. pylori-positive patients with Reflux Esophagitis have not been fully investigated. We therefore studied the pattern of endoscopic gastric mucosal atrophy and degree of histological gastritis in such patients. Methods: Subjects comprised 41 H. pylori-positive patients with Reflux Esophagitis, 41 age- and sex-matched patients with duodenal ulcer, and 41 patients with early gastric cancer. The endoscopic pattern of gastric mucosal atrophy was reviewed, and the degree of histological gastritis in biopsy specimens from the antrum and corpus was assessed in accordance with the updated Sydney system. Results: The grade of endoscopic and histological gastric mucosal atrophy in patients with Reflux Esophagitis was significantly lower than that in patients with gastric cancer, and the histological scores for antral atrophy and metaplasia in patients with Reflux Esophagitis tended to be lower than those in patients with duodenal ulcer. In patients with Reflux Esophagitis and duodenal ulcer, the scores for antral inflammation and activity tended to be higher than those for the corpus. Conversely, the inflammation and activity score in patients with early gastric cancer showed a corpus-predominant gastritis pattern. Conclusion: In H. pylori-positive patients with Reflux Esophagitis, the degree of endoscopic gastric mucosal atrophy is low and histologically there is an antral-predominant gastritis pattern. Therefore, gastric acid secretion in H. pylori-positive patients with Reflux Esophagitis may be augmented by H. pylori infection.
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Influence of Helicobacter pylori infection on the prevalence of Reflux Esophagitis in Japanese patients.
Journal of gastroenterology and hepatology, 2001Co-Authors: Hirofumi Fujishiro, Kyoichi Adachi, Shunji Ishihara, Akira Kawamura, Tomoko Katsube, Masahiro Ono, Mika Yuki, Kazutoshi Amano, Yoshikazu KinoshitaAbstract:Abstract Background and Aim: Reflux Esophagitis is caused by esophageal motor dysfunction in patients with sufficient gastric acid secretion. Helicobacter pylori causes atrophic gastritis and influences gastric acid secretion. Hiatus hernia (HH) of the esophagus causes motor dysfunction in the lower esophagus. Therefore, this study aimed to test whether H. pylori infection, gastric mucosal atrophy and HH are predictive factors for Reflux Esophagitis. Methods: Helicobacter pylori infection was examined in 781 patients by the measurement of serum immunoglobulin (Ig)G antibody, bacteriological culture and histological examination of biopsy specimens. The prevalence of HH, endoscopically identified gastric mucosal atrophy (closed- or open-type) and Reflux Esophagitis were investigated by reviewing endoscopic films. Investigated patients were divided into three age groups, under 49, 50–69, and over 70 years. The prevalence of Esophagitis, H. pylori infection, gastric mucosal atrophy, and HH were compared to identify the possible predictive factors for Reflux Esophagitis by using logistic regression analysis. Results: Sixty-nine patients with Reflux Esophagitis were found among the 781 investigated cases. The odds ratios of negative H. pylori infection, endoscopically identified closed-type gastric mucosal atrophy, and HH for the prevalence of Reflux Esophagitis were 1.342, 1.751 and 5.527, respectively. These results indicated that the presence of H. pylori infection was only a weak negative risk factor, and that HH was the most reliable endoscopic predictive factor for Reflux Esophagitis. Conclusion: Helicobacter pylori infection is a weak negative risk factor for the prevalence of Reflux Esophagitis, while HH is the most reliable predictive factor.
Juhee Cho - One of the best experts on this subject based on the ideXlab platform.
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non alcoholic fatty liver disease and the development of Reflux Esophagitis a cohort study
Journal of Gastroenterology and Hepatology, 2018Co-Authors: Yang Won Min, Youngha Kim, Geumyoun Gwak, Danbee Kang, Soo Jin Cho, Eliseo Guallar, Juhee ChoAbstract:BACKGROUND AND AIM Non-alcoholic fatty liver disease (NAFLD), a hepatic manifestation of the metabolic syndrome, is associated with gastroesophageal Reflux disease in cross-sectional studies, but a prospective association has not been evaluated. The current study aimed to determine whether NAFLD increases the risk of incident Reflux Esophagitis in a large cohort study. METHODS We conducted a cohort study of 34 063 men and women without Reflux Esophagitis or other upper gastrointestinal disease at baseline who underwent health checkup examinations between January 2003 and December 2013. Fatty liver was diagnosed by ultrasound based on standard criteria. Reflux Esophagitis was defined by the presence of at least grade A mucosal break on esophagogastroduodenoscopy. RESULTS The prevalence of NAFLD at baseline was 33.2%. During 153 520.2 person-years of follow-up, the cumulative incidences of Reflux Esophagitis for participants without and with NAFLD were 9.6% and 13.8%, respectively (P < 0.001). The age-adjusted and sex-adjusted hazard ratio for the risk of Reflux Esophagitis development in participants with NAFLD compared with those without NAFLD was 1.15 (95% confidence interval 1.07-1.23; P < 0.001). However, this association disappeared after adjusting for body mass index and other metabolic factors (hazard ratio 1.01, 95% confidence interval 0.94-1.09; P = 0.79). Similarly, in multivariable-adjusted models, there was no significant association between NAFLD severity and the risk of developing Reflux Esophagitis. CONCLUSIONS Non-alcoholic fatty liver disease is not independently associated with the risk of the development of Reflux Esophagitis, but rather, Reflux Esophagitis is primarily the consequence of increased body mass index commonly associated with NAFLD.