Relationship between body mass index, waist circumference, waist hip ratio and erosive gastroesophageal reflux disease in a tertiary centre in Nigeria: A case control study

Abstract

Background: Gastro-oesophageal reflux disease (GERD) is a condition that develops when the reflux of stomach content causes troublesome symptoms with or without mucosa damage and or complications. GERD is believed to be evolving among blacks.

Objectives: The objective of this study was to look at the relationship of GERD to body mass index (BMI), waist circumference (WC), hip circumference (HC) and waist hip ratio (WHR) among patients with distal oesophageal erosive GERD and controls.

Methods: A case control study among patients with dyspepsia that had diagnostic upper gastrointestinal endoscopy. Patients with erosive GERD were grouped into cases while those without GERD were controls. GERD was graded using the Los Angeles classification. BMI, WC, HC and WHR were measured among cases and controls. Obesity was defined as BMI ≥ 30 kg/m² or WC ≥ 88 cm or ≥WHR 0.85 in females and BMI ≥ 30 kg/m² or WHR ≥ 0.9 or WC ≥102 cm for males. Data were analysed using descriptive and inferential statistics.

Results: A total of 160 subjects (80 cases and 80 controls) were analysed. Mean (SD) age for cases was 51.1 (±12.4) years and 50.1 (±13.7) years for controls. When cases with GERD were compared with controls; males were less likely to be obese, BMI < 30 kg/m², have normal WC, HC and WHR while females were more likely to be obese, BMI ≥ 30 kg/m² and have increased WC, and HC, (p < 0.05).

Conclusion: Central obesity is a risk factor for distal oesophageal erosive GERD among female Nigerians but not among males.

Keywords: Gastro esophageal reflux, Central obesity, Dyspepsia, Nigeria