High visceral-to-subcutaneous fat ratio increases risk of reflux symptoms and erosive esophagitis in non-obese adults.

Gastroesophageal reflux disease (GERD) and computed tomography (CT)-measured belly fat area were the two variables that the study sought to correlate.

Logistic regression models were used to examine the impact of abdominal fat area on symptoms of GERD and erosive esophagitis in 5,338 subjects who were scheduled to undergo abdominal fat measurment CT and screening esophagogastroduodenoscopy.

Erosive esophagitis and reflux symptoms were identified in 1,168 (21.9%) and 671 (12.5%) volunteers, respectively. As per the multivariate analysis, subcutaneous and visceral fat areas were linked with erosive esophagitis and reflux symptoms. Reflux symptoms and erosive esophagitis had adjusted odds ratios (OR) of 1.98 and 2.33, respectively, in the fourth quartile of visceral fat area contrasted to the lowest quartile.

The younger age group was more affected by the visceral fat area. The adjusted OR in the fourth quartile of visceral fat area for those under 50 years of age was 3.59 for erosive esophagitis and 2.70 for reflux symptoms. Volunteers with a body mass index of less than 25 kg/m2 and a normal waist circumference were more likely to experience erosive esophagitis and reflux symptoms when their visceral-to-subcutaneous fat ratio (VSR) was high.

The likelihood of erosive esophagitis and reflux symptoms was higher in regions of subcutaneous and visceral fat.