Obesity and Risk of Peptic Ulcer Disease: A Large-Scale Health Check-Up Cohort Study

• Published in: Nutrients Vol. 11; no. 6; p. 1288
• Main Authors: Pyo, Jeung Hui, Lee, Hyuk, Kim, Jee Eun, Choi, Yoon Ho, Kim, Tae Jun, Min, Yang Won, Min, Byung Hoon, Lee, Jun Haeng, Rhee, Poong Lyul, Yoo, Heejin, Kim, Kyunga, Kim, Jae J.
• Format: Journal Article
• Language: English
• Published: Switzerland MDPI AG 06.06.2019; MDPI
• Subjects: Adult; Body Mass Index; Cohort analysis; cohort studies; confidence interval; Duodenal Ulcer - epidemiology; Duodenal Ulcer - etiology; Duodenal Ulcer - microbiology; duodenal ulcers; Female; Health risk assessment; Helicobacter pylori; Helicobacter pylori - growth & development; Humans; Incidence; Insulin resistance; lifestyle; Male; Middle Aged; nutrition risk assessment; Obesity; Obesity - complications; Obesity - metabolism; Obesity, Metabolically Benign - complications; Obesity, Metabolically Benign - metabolism; Peptic Ulcer - epidemiology; Peptic Ulcer - etiology; Peptic Ulcer - microbiology; Proportional Hazards Models; Retrospective Studies; Risk Assessment; Stomach Ulcer - epidemiology; Stomach Ulcer - etiology; Stomach Ulcer - microbiology; stomach ulcers; Studies; Japan; Taiwan; Obesity; Duodenal ulcer; Peptic ulcer disease; Gastric ulcer; Metabolically healthy obesity
• ISSN: 2072-6643; 2072-6643
• DOI: 10.3390/nu11061288

The association between obesity and peptic ulcer disease (PUD) is inconclusive. To evaluate the association of obesity and metabolically healthy obesity (MHO) with PUD risk, we performed a retrospective cohort study of 32,472 subjects without PUD at baseline who underwent repeated health examinations. Participants were stratified by body mass index (BMI) and metabolically healthy state. Hazard ratios (HRs) and 95% confidence intervals (CIs) were calculated using Cox proportional hazard modelling. During the follow-up period, 1940 PUD cases occurred. PUD, particularly gastric ulcer (GU), had significantly higher cumulative incidence in obese subjects compared to non-obese subjects (p value < 0.001). The HR for developing GU was 1.32 (95% CI, 1.16–1.49; p value <0.001); after adjusting for confounding factors (lifestyle, metabolic, and Helicobacter pylori status), the association was no more significant (p value = 0.789). For duodenal ulcer (DU), cumulative incidence between obese and non-obese groups was not significantly different (p value = 0.464). The risk of developing DU in the obese group was not significantly different from the non-obese group (HR 0.95; 95% CI, 0.83–1.09; p value = 0.469) and consistently showed no association after adjusting for metabolic parameters (p value = 0.199). Furthermore, MHO subjects had no increase in GU or DU risks. In this large cohort study, PUD risk was not associated with obesity or MHO.