The prevalence of reflux esophagitis is increasing in Korea. (OR 1.46, 95% CI 1.20-1.76), and fasting glucose 110 mg/dL (OR 1.45, 95% CI 1.13-1.86) were 865479-71-6 significantly associated with reflux esophagitis (all infection were not associated with reflux esophagitis. In conclusiosn, significant relationships of reflux esophagitis with obesity, low high-density lipoprotein (HDL) cholesterol, high triglyceride, high BP, and elevated fasting glucose suggested that reflux esophagitis might represent the disease spectrum of the metabolic syndrome. (test, Asan pharm.co., LTD., Seoul, Korea) or histologic findings from the biopsy specimens. The esophagogastroduodenoscopy (EGD) was a component of a complete medical examination that includes routine studies of blood, urine, stool, and an ultrasound of the abdomen. The body mass index (BMI) was calculated using the following formula: BMI=weight (kg)/height2 (m2). Data for blood pressure (BP), total cholesterol, low-density lipoprotein (LDL) cholesterol, high-density lipoprotein (HDL) cholesterol, triglyceride, and fasting glucose were also collected. High BP was defined as 130/85 mmHg or documented use of antihypertensive therapy according to National Cholesterol Education Program (NCEP) criteria (7). Metabolic syndrome was defined based on the World Health Organization (WHO) criteria and NCEP criteria. Under the WHO criteria, the diagnosis of metabolic syndrome can be made in subjects with type 2 DM, impaired glucose tolerance, or insulin resistance, and also requires at least two of the following four components: 1) hypertension, either treated with medication or 160/90 mmHg untreated; 2) dyslipidemia with elevated plasma triglyceride (150 mg/dL) and/or low HDL (<35 mg/dL in men, <39 mg/dL in women); 3) obesity with BMI 30 kg/m2 or central adiposity (waist-hip ratio >0.90 in men or >0.85 in women); and 4) microalbuminuria (urinary average excretion rate 20 g/min or albumin-creatinine ratio 20 mg/g). The NCEP criteria for metabolic syndrome require at least three of the following: waist circumference >40 inch in men or >35 inch in women, plasma triglyceride 150 mg/dL, HDL cholesterol <40 mg/dL in men or <50 mg/dL in women, blood pressure 130/85 mmHg, and fasting plasma glucose 110 mg/dL (7). Endoscopic findings The severities of RE were defined by the Los Angeles classification (1). The criteria for the diagnosis of esophagitis were: grade A, one or more mucosal breaks confined to the mucosal folds, each no longer than 5 mm; grade B, at least one mucosal break more than 5 mm long confined to the mucosal folds; grade C, at least one mucosal break continuing between the tops of two or more mucosal folds but not circumferential; grade D, 865479-71-6 circumferential mucosal break. Minimal change esophagitis was excluded because of low interobserver agreement (8). Statistical analysis The differences of mean value in age, BMI, total cholesterol, LDL cholesterol, HDL cholesterol, triglyceride, and fasting glucose were evaluated 865479-71-6 using Student's t test. Categorical variables such as sex, smoking, alcohol drinking and infection were evaluated using Pearson chi-square test. The risk of reflux esophagitis was calculated by logistic regression analysis with regards to several variables, including age, sex, smoking, alcohol drinking and infection, BMI, high BP, total cholesterol, LDL cholesterol, HDL cholesterol, triglyceride, and fasting glucose. A value below 0.05 was considered to be statistically significant. The software package used for analysis was SPSS version 13.0 (SPSS Inc., Chicago, IL, U.S.A.). RESULTS Prevalence and age distribution Among a total of 6,082 subjects (3,590 male and 2,492 female, mean age 4410 yr, 17-83 yr) (Fig. 1), 639 subjects were found to have RE, and the overall prevalence was 10.5%. The prevalence of RE in male was 14.6% (523 of 3,590), the prevalence of RE in female was only 4.7% (116 of 2,376) (infection (2.7% vs. 4.1%) were not significantly different between the two groups. And BMI was also found to be significantly higher in subjects with RE than in those Vav1 without (24.72.8 kg/m2 vs. 23.62.9 kg/m2, infection (OR 1.59, 95% CI 0.85-2.98) were not shown to be significant risk factors of RE. Low HDL cholesterol (male <40 mg/dL, female <50 mg/dL) was not a significant risk factor in males (OR 1.04, 95% CI 0.81-1.34) and females (OR 0.95, 95% CI 0.62-1.45) (Table 3). Table 3 Logistic regression analysis of covariables for reflux esophagitis DISCUSSION GERD is one of the most prevalent digestive diseases experienced in Western countries. In the United States, the prevalence is about 1,900,000 cases/yr and the annual.