Decreased levels of adiponectin in obese patients with gastroesophageal reflux evaluated by videoesophagography: Possible relationship between gastroesophageal reflux and metabolic syndrome

Background: Body mass index (BMI) and obesity are reportedly associated with symptoms of gastroesophageal reflux disease (GERD). The present study was designed to investigate the effect of metabolic disorders including obesity on the levels of functional gastroesophageal reflux by videoesophagography. Methods: Twenty-one patients with GERD-associated symptoms were examined by videoesophagography. On their initial visit, all patients completed the Japanese version of the Carlsson-Dent self-administered questionnaire (QUEST). The findings of videoesophagography were evaluated by the X-ray severity scores for gastroesophageal reflux (XRSS), which were defined for the total diagnosis of functional gastroesophageal reflux. Correlation between XRSS scores and physical or metabolic markers was evaluated. Results: The mean XRSS in the QUEST-positive group (4.7 ± 0.6) was significantly higher than that in the QUEST-negative group (3.3 ± 0.5, P < 0.05). XRSS correlated positively with BMI (P < 0.05) and waist circumference (P < 0.05), but negatively with high-density lipoprotein-cholesterol (P < 0.05), serum adiponectin (P < 0.05) and active ghrelin (P < 0.05). In the multivariate analysis, serum adiponectin level, BMI and triglyceride independently affected the XRSS. Conclusion: Videoesophagography is a useful diagnostic modality for the evaluation of patients with GERD symptoms. Functional gastroesophageal reflux is seen in obese patients, especially with decreased levels of adiponectin.