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

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Abstract

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/m2, 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.

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Acknowledgements

We thank Ms. Akane Utsunomiya for technical support of data collection at MedCity21 and Dr. Takashi Sugawa for clinical advice on EoE.

Funding

No funding was allocated for this study.

Author information

Authors and Affiliations

  1. Department of Gastroenterology, Graduate School of Medicine, Osaka City University, 1-4-3 Asahimachi, Abeno-ku, Osaka, 545-8585, Japan

    Fumio Tanaka, Koji Otani, Shuhei Hosomi, Yasuaki Nagami, Noriko Kamata, Koichi Taira, Hirokazu Yamagami, Tetsuya Tanigawa, Toshio Watanabe & Yasuhiro Fujiwara

  2. Department of Premier Preventive Medicine, Graduate School of Medicine, Osaka City University, Osaka, Japan

    Fumio Tanaka, Shinya Fukumoto, Tamami Morisaki, Koji Otani, Akemi Nakano, Tatsuo Kimura, Hiroyasu Morikawa, Norifumi Kawada & Kazuto Hirata

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  1. Fumio Tanaka
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Contributions

FT: study design, data collection, data analysis, and manuscript writing; SF, TM, KO, SH, YN, Noriko Kamata, KT, AN, TK, HY, TT, HM, TW, Norifumi Kawada, KH, and YF: critical revision of the manuscript for important intellectual content. All authors read and approved of the final manuscript.

Corresponding author

Correspondence to Fumio Tanaka.

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Ethical Statement

The study protocol was in accordance with the Declaration of Helsinki and was approved by the institutional review board of the Osaka City University Graduate School of Medicine (September 2016, Protocol number 3564). The need for informed consent has been waived by the institutional review board of the Osaka City University Graduate School of Medicine. We have disclosed the information about this study on our home page on the Internet and the patients had the opportunity to opt out.

Conflict of interest

The authors declare no conflict of interests for this article.

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Tanaka, F., Fukumoto, S., Morisaki, T. et al. Obesity and hiatal hernia may be non-allergic risk factors for esophageal eosinophilia in Japanese adults. Esophagus 16, 309–315 (2019). https://doi.org/10.1007/s10388-019-00662-3

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  • DOI: https://doi.org/10.1007/s10388-019-00662-3

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