{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,5]],"date-time":"2026-09-05T23:03:10Z","timestamp":1788649390663,"version":"build-2803163510"},"reference-count":36,"publisher":"Wiley","issue":"7","license":[{"start":{"date-parts":[[2017,1,29]],"date-time":"2017-01-29T00:00:00Z","timestamp":1485648000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Neurogastroenterology Motil"],"published-print":{"date-parts":[[2017,7]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Obesity and gastroesophageal reflux disease (GERD) are major health problems showing an inconstant relationship in the literature. Therefore, anthropometric parameters which are predictive and can simply be assessed at first patient presentation may lead to a better patient selection for ambulatory reflux monitoring. We aimed to examine the association of body mass index (BMI) and waist to hip ratio (WHR) with gastroesophageal reflux activity during 24\u00a0hour\u2010pH\u2010impedance monitoring.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Seven hundred and seventy\u2010one patients with GERD symptoms underwent 24\u00a0hour\u2010pH\u2010impedance monitoring and high resolution manometry off proton pump inhibitors. Patients with known primary motility disorders of the esophagus and pre\u2010existing endoscopic or operative procedure on esophagus or stomach were excluded from the study. Reflux parameters and anthropometric and demographic data from our prospectively gathered database were analyzed. We performed univariate and multivariate regression analysis to evaluate the associations of BMI and WHR with reflux parameters measured with 24\u00a0hour\u2010pH\u2010impedance monitoring.<\/jats:p><\/jats:sec><jats:sec><jats:title>Key Results<\/jats:title><jats:p>WHR showed a significantly stronger association with esophageal acid exposure than BMI (<jats:italic>P<\/jats:italic>&lt;.001). Our data show that 6.9% of the percentage of endoluminal pH&lt;4 in the distal esophagus is attributable to WHR. Furthermore, an association of WHR with impaired esophageal acid clearance was observed. Additionally, we observed an inverse relationship between lower esophageal sphincter integrity (<jats:italic>P<\/jats:italic>=.05) and esophageal acid exposure.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions and Inferences<\/jats:title><jats:p>WHR is a better predictor for esophageal acid exposure than BMI. Biomechanical and metabolic mechanisms of central fat distribution may influence reflux parameters in 24\u00a0hour pH impedance monitoring, which may affect patient selection for ambulatory reflux monitoring.<\/jats:p><\/jats:sec>","DOI":"10.1111\/nmo.13033","type":"journal-article","created":{"date-parts":[[2017,1,30]],"date-time":"2017-01-30T02:52:48Z","timestamp":1485744768000},"source":"Crossref","is-referenced-by-count":20,"title":["Waist to hip ratio is a better predictor of esophageal acid exposure than body mass index"],"prefix":"10.1111","volume":"29","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-5192-8330","authenticated-orcid":false,"given":"C.","family":"Ringhofer","sequence":"first","affiliation":[{"name":"Department of Surgery Medical University of Vienna Vienna Austria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"J.","family":"Lenglinger","sequence":"additional","affiliation":[{"name":"Department of Visceral Medicine and Surgery University of Bern Bern Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"M.","family":"Riegler","sequence":"additional","affiliation":[{"name":"Department of Surgery Medical University of Vienna Vienna Austria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"I.","family":"Kristo","sequence":"additional","affiliation":[{"name":"Department of Surgery Medical University of Vienna Vienna Austria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"A.","family":"Kainz","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine III Medical University of Vienna Vienna Austria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"S. 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