Association Between Body Mass Index and Clinical and Endoscopic Features of Eosinophilic Esophagitis

W. Asher Wolf, Nicholas A. Piazza, Jessica H. Gebhart, Spencer Rusin, Shannon Covey, Leana L. Higgins, Rose Mary Beitia, Olga Speck, Kimberly Woodward, Cary C. Cotton, Thomas M. Runge, Swathi Eluri, John T. Woosley, Nicholas J. Shaheen, Evan S. Dellon

Research output: Research - peer-reviewArticle

Abstract

Background: Because eosinophilic esophagitis (EoE) causes dysphagia, esophageal narrowing, and strictures, it could result in low body mass index (BMI), but there are few data assessing this. Aim: To determine whether EoE is associated with decreased BMI. Methods: We conducted a prospective study at the University of North Carolina from 2009 to 2013 enrolling consecutive adults undergoing outpatient EGD. BMI and endoscopic findings were recorded. Incident cases of EoE were diagnosed per consensus guidelines. Controls had either reflux or dysphagia, but not EoE. BMI was compared between cases and controls and by endoscopic features. Results: Of 120 EoE cases and 297 controls analyzed, the median BMI was lower in EoE cases (25 vs. 28 kg/m2, p = 0.002). BMI did not differ by stricture presence (26 vs. 26 kg/m2, p = 0.05) or by performance of dilation (26 vs. 27 kg/m2 for undilated; p = 0.16). However, BMI was lower in patients with narrow caliber esophagus (24 vs. 27 kg/m2, p < 0.001). EoE patients with narrow caliber esophagus also had decreased BMI compared to controls with narrow caliber esophagi (24 vs. 27 kg/m2, p = 0.001). On linear regression after adjustment for age, race, and gender, narrowing decreased BMI by 2.3 kg/m2 [95% CI −4.1, −0.6]. Conclusions: BMI is lower in EoE cases compared to controls, and esophageal narrowing, but not focal stricture, is associated with a lower BMI in patients with EoE. Weight loss or low BMI in a patient suspected of having EoE should raise concern for esophageal remodeling causing narrow caliber esophagus.

LanguageEnglish (US)
Pages143-149
Number of pages7
JournalDigestive Diseases and Sciences
Volume62
Issue number1
DOIs
StatePublished - Jan 1 2017

Fingerprint

Eosinophilic Esophagitis
Body Mass Index
Esophagus
Deglutition Disorders
Pathologic Constriction
Esophageal Stenosis
Weight Loss
Dilatation
Linear Models
Outpatients
Prospective Studies
Guidelines

Keywords

  • Body mass index
  • Dilation
  • Eosinophilic esophagitis
  • Narrowing
  • Stricture

ASJC Scopus subject areas

  • Physiology
  • Gastroenterology

Cite this

Wolf, W. A., Piazza, N. A., Gebhart, J. H., Rusin, S., Covey, S., Higgins, L. L., ... Dellon, E. S. (2017). Association Between Body Mass Index and Clinical and Endoscopic Features of Eosinophilic Esophagitis. Digestive Diseases and Sciences, 62(1), 143-149. DOI: 10.1007/s10620-016-4357-1

Association Between Body Mass Index and Clinical and Endoscopic Features of Eosinophilic Esophagitis. / Wolf, W. Asher; Piazza, Nicholas A.; Gebhart, Jessica H.; Rusin, Spencer; Covey, Shannon; Higgins, Leana L.; Beitia, Rose Mary; Speck, Olga; Woodward, Kimberly; Cotton, Cary C.; Runge, Thomas M.; Eluri, Swathi; Woosley, John T.; Shaheen, Nicholas J.; Dellon, Evan S.

In: Digestive Diseases and Sciences, Vol. 62, No. 1, 01.01.2017, p. 143-149.

Research output: Research - peer-reviewArticle

Wolf, WA, Piazza, NA, Gebhart, JH, Rusin, S, Covey, S, Higgins, LL, Beitia, RM, Speck, O, Woodward, K, Cotton, CC, Runge, TM, Eluri, S, Woosley, JT, Shaheen, NJ & Dellon, ES 2017, 'Association Between Body Mass Index and Clinical and Endoscopic Features of Eosinophilic Esophagitis' Digestive Diseases and Sciences, vol 62, no. 1, pp. 143-149. DOI: 10.1007/s10620-016-4357-1
Wolf WA, Piazza NA, Gebhart JH, Rusin S, Covey S, Higgins LL et al. Association Between Body Mass Index and Clinical and Endoscopic Features of Eosinophilic Esophagitis. Digestive Diseases and Sciences. 2017 Jan 1;62(1):143-149. Available from, DOI: 10.1007/s10620-016-4357-1
Wolf, W. Asher ; Piazza, Nicholas A. ; Gebhart, Jessica H. ; Rusin, Spencer ; Covey, Shannon ; Higgins, Leana L. ; Beitia, Rose Mary ; Speck, Olga ; Woodward, Kimberly ; Cotton, Cary C. ; Runge, Thomas M. ; Eluri, Swathi ; Woosley, John T. ; Shaheen, Nicholas J. ; Dellon, Evan S./ Association Between Body Mass Index and Clinical and Endoscopic Features of Eosinophilic Esophagitis. In: Digestive Diseases and Sciences. 2017 ; Vol. 62, No. 1. pp. 143-149
@article{2dd545d3730841549c2cdd023f4a08ab,
title = "Association Between Body Mass Index and Clinical and Endoscopic Features of Eosinophilic Esophagitis",
abstract = "Background: Because eosinophilic esophagitis (EoE) causes dysphagia, esophageal narrowing, and strictures, it could result in low body mass index (BMI), but there are few data assessing this. Aim: To determine whether EoE is associated with decreased BMI. Methods: We conducted a prospective study at the University of North Carolina from 2009 to 2013 enrolling consecutive adults undergoing outpatient EGD. BMI and endoscopic findings were recorded. Incident cases of EoE were diagnosed per consensus guidelines. Controls had either reflux or dysphagia, but not EoE. BMI was compared between cases and controls and by endoscopic features. Results: Of 120 EoE cases and 297 controls analyzed, the median BMI was lower in EoE cases (25 vs. 28 kg/m2, p = 0.002). BMI did not differ by stricture presence (26 vs. 26 kg/m2, p = 0.05) or by performance of dilation (26 vs. 27 kg/m2 for undilated; p = 0.16). However, BMI was lower in patients with narrow caliber esophagus (24 vs. 27 kg/m2, p < 0.001). EoE patients with narrow caliber esophagus also had decreased BMI compared to controls with narrow caliber esophagi (24 vs. 27 kg/m2, p = 0.001). On linear regression after adjustment for age, race, and gender, narrowing decreased BMI by 2.3 kg/m2 [95% CI −4.1, −0.6]. Conclusions: BMI is lower in EoE cases compared to controls, and esophageal narrowing, but not focal stricture, is associated with a lower BMI in patients with EoE. Weight loss or low BMI in a patient suspected of having EoE should raise concern for esophageal remodeling causing narrow caliber esophagus.",
keywords = "Body mass index, Dilation, Eosinophilic esophagitis, Narrowing, Stricture",
author = "Wolf, {W. Asher} and Piazza, {Nicholas A.} and Gebhart, {Jessica H.} and Spencer Rusin and Shannon Covey and Higgins, {Leana L.} and Beitia, {Rose Mary} and Olga Speck and Kimberly Woodward and Cotton, {Cary C.} and Runge, {Thomas M.} and Swathi Eluri and Woosley, {John T.} and Shaheen, {Nicholas J.} and Dellon, {Evan S.}",
year = "2017",
month = "1",
doi = "10.1007/s10620-016-4357-1",
volume = "62",
pages = "143--149",
journal = "Digestive Diseases and Sciences",
issn = "0163-2116",
publisher = "Springer New York",
number = "1",

}

TY - JOUR

T1 - Association Between Body Mass Index and Clinical and Endoscopic Features of Eosinophilic Esophagitis

AU - Wolf,W. Asher

AU - Piazza,Nicholas A.

AU - Gebhart,Jessica H.

AU - Rusin,Spencer

AU - Covey,Shannon

AU - Higgins,Leana L.

AU - Beitia,Rose Mary

AU - Speck,Olga

AU - Woodward,Kimberly

AU - Cotton,Cary C.

AU - Runge,Thomas M.

AU - Eluri,Swathi

AU - Woosley,John T.

AU - Shaheen,Nicholas J.

AU - Dellon,Evan S.

PY - 2017/1/1

Y1 - 2017/1/1

N2 - Background: Because eosinophilic esophagitis (EoE) causes dysphagia, esophageal narrowing, and strictures, it could result in low body mass index (BMI), but there are few data assessing this. Aim: To determine whether EoE is associated with decreased BMI. Methods: We conducted a prospective study at the University of North Carolina from 2009 to 2013 enrolling consecutive adults undergoing outpatient EGD. BMI and endoscopic findings were recorded. Incident cases of EoE were diagnosed per consensus guidelines. Controls had either reflux or dysphagia, but not EoE. BMI was compared between cases and controls and by endoscopic features. Results: Of 120 EoE cases and 297 controls analyzed, the median BMI was lower in EoE cases (25 vs. 28 kg/m2, p = 0.002). BMI did not differ by stricture presence (26 vs. 26 kg/m2, p = 0.05) or by performance of dilation (26 vs. 27 kg/m2 for undilated; p = 0.16). However, BMI was lower in patients with narrow caliber esophagus (24 vs. 27 kg/m2, p < 0.001). EoE patients with narrow caliber esophagus also had decreased BMI compared to controls with narrow caliber esophagi (24 vs. 27 kg/m2, p = 0.001). On linear regression after adjustment for age, race, and gender, narrowing decreased BMI by 2.3 kg/m2 [95% CI −4.1, −0.6]. Conclusions: BMI is lower in EoE cases compared to controls, and esophageal narrowing, but not focal stricture, is associated with a lower BMI in patients with EoE. Weight loss or low BMI in a patient suspected of having EoE should raise concern for esophageal remodeling causing narrow caliber esophagus.

AB - Background: Because eosinophilic esophagitis (EoE) causes dysphagia, esophageal narrowing, and strictures, it could result in low body mass index (BMI), but there are few data assessing this. Aim: To determine whether EoE is associated with decreased BMI. Methods: We conducted a prospective study at the University of North Carolina from 2009 to 2013 enrolling consecutive adults undergoing outpatient EGD. BMI and endoscopic findings were recorded. Incident cases of EoE were diagnosed per consensus guidelines. Controls had either reflux or dysphagia, but not EoE. BMI was compared between cases and controls and by endoscopic features. Results: Of 120 EoE cases and 297 controls analyzed, the median BMI was lower in EoE cases (25 vs. 28 kg/m2, p = 0.002). BMI did not differ by stricture presence (26 vs. 26 kg/m2, p = 0.05) or by performance of dilation (26 vs. 27 kg/m2 for undilated; p = 0.16). However, BMI was lower in patients with narrow caliber esophagus (24 vs. 27 kg/m2, p < 0.001). EoE patients with narrow caliber esophagus also had decreased BMI compared to controls with narrow caliber esophagi (24 vs. 27 kg/m2, p = 0.001). On linear regression after adjustment for age, race, and gender, narrowing decreased BMI by 2.3 kg/m2 [95% CI −4.1, −0.6]. Conclusions: BMI is lower in EoE cases compared to controls, and esophageal narrowing, but not focal stricture, is associated with a lower BMI in patients with EoE. Weight loss or low BMI in a patient suspected of having EoE should raise concern for esophageal remodeling causing narrow caliber esophagus.

KW - Body mass index

KW - Dilation

KW - Eosinophilic esophagitis

KW - Narrowing

KW - Stricture

UR - http://www.scopus.com/inward/record.url?scp=84992205932&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84992205932&partnerID=8YFLogxK

U2 - 10.1007/s10620-016-4357-1

DO - 10.1007/s10620-016-4357-1

M3 - Article

VL - 62

SP - 143

EP - 149

JO - Digestive Diseases and Sciences

T2 - Digestive Diseases and Sciences

JF - Digestive Diseases and Sciences

SN - 0163-2116

IS - 1

ER -