Obesity and hiatal hernia may be non-allergic risk factors for esophageal eosinophilia in Japanese adults

• Published in: Esophagus : official journal of the Japan Esophageal Society Vol. 16; no. 3; pp. 309 - 315
• Main Authors: Tanaka, Fumio, Fukumoto, Shinya, Morisaki, Tamami, Otani, Koji, Hosomi, Shuhei, Nagami, Yasuaki, Kamata, Noriko, Taira, Koichi, Nakano, Akemi, Kimura, Tatsuo, Yamagami, Hirokazu, Tanigawa, Tetsuya, Morikawa, Hiroyasu, Watanabe, Toshio, Kawada, Norifumi, Hirata, Kazuto, Fujiwara, Yasuhiro
• Format: Journal Article
• Language: English
• Published: Singapore Springer Singapore 01.07.2019; Springer Nature B.V
• Subjects: Adult; Aged; Allergies; Asymptomatic; Blood diseases; Body Mass Index; Case-Control Studies; Cross-Sectional Studies; Endoscopy; Endoscopy, Digestive System - methods; Eosinophilic Esophagitis - diagnostic imaging; Eosinophilic Esophagitis - epidemiology; Eosinophilic Esophagitis - physiopathology; Esophageal diseases; Esophagus; Female; Gastroenterology; Gastroesophageal reflux; Gastroesophageal Reflux - diagnostic imaging; Gastroesophageal Reflux - epidemiology; Gastroesophageal Reflux - physiopathology; Gastrointestinal diseases; Health risks; Hernia, Hiatal - complications; Hiatal hernias; Humans; Inflammatory diseases; Japan - epidemiology; Leukocytes; Male; Medicine; Medicine & Public Health; Middle Aged; Obesity; Obesity - complications; Original Article; Prevalence; Risk Factors; Surgical Oncology; Thoracic Surgery; Japan; Gastroesophageal reflux; Obesity; Body mass index; Hiatal hernia; Eosinophilic esophagitis
• ISSN: 1612-9059; 1612-9067; 1612-9067
• DOI: 10.1007/s10388-019-00662-3

Background Esophageal eosinophilia (EE) is a basal condition of eosinophilic esophageal disorders including eosinophilic esophagitis (EoE) and asymptomatic EE. EoE is considered as an allergic disorder, while it is unclear whether other non-allergic conditions are involved in the pathophysiology of EE. The aim of this study is to investigate the non-allergic risk factors for EE. Methods This cross-sectional study included subjects who underwent esophagogastroduodenoscopy on a medical health check-up. We compared clinical characteristics between subjects with EE ( n  = 27) and those without EE ( n  = 5937). Results The detection rate of EE was 0.45% (27/5964 persons). Of 27 subjects with EE, 20 subjects were symptomatic and 7 were asymptomatic. On univariate analysis, subjects with EE significantly had higher body mass index (BMI) compared to those without EE; 23.4 (4.4) vs 22.3 (4.5) kg/m 2 , median (interquartile range), p  = 0.005. Endoscopic findings revealed that subjects with EE had significantly higher proportion of hiatal hernia (29.6% vs 14.7%; p  = 0.049). Subjects with EE were significantly younger and had higher proportion of bronchial asthma; 45 (11.5) vs 51 (18) years, p  = 0.013; 25.9% vs 5.2%, p  < 0.001, respectively. Multivariate analysis showed that subjects with EE were positively associated with BMI [odds ratio (OR) 1.11; 95% confidence interval (CI) 1.03–1.20; p  = 0.010) and hiatal hernia (OR 2.63; 95% CI 1.12–6.18; p  = 0.026) compared to those without EE. On trend test, advanced BMI classification had significant trend for increased prevalence of EE ( p  = 0.002). Conclusions Obesity and hiatal hernia may be non-allergic risk factors for EE in Japanese adults.