ORIGINAL ARTICLE Erosive Esophagitis in Asymptomatic Subjects: Risk Factors Fu-Wei Wang Æ Ming-Shium Tu Æ Hung-Yi Chuang Æ Hsien-Chung Yu Æ Lung-Chih Cheng Æ Ping-I Hsu Received: 5 March 2009 / Accepted: 19 June 2009 / Published online: 14 August 2009 Ó Springer Science+Business Media, LLC 2009 Abstract Introduction Asymptomatic erosive esophagitis is a common yet rarely reported disease. The purpose of this study is to investigate the prevalence of asymptomatic erosive esophagitis and to identify the risk factors for this disease. Materials and Methods In this study, we investigated 572 asymptomatic subjects undergoing health check-ups after upper gastrointestinal endoscopy. The severity of esopha- gitis was evaluated by the Los Angeles classification, and the independent risk factors for asymptomatic esophagitis were analyzed by the logistic regression method. Results The results showed the prevalence of erosive esophagitis in asymptomatic subjects was 12% (70/572). In all asymptomatic subjects, erosive esophagitis was grade A (71%) or B (29%). Univariate analysis revealed that male gender, high body mass index (BMI), and consumption of tobacco, alcohol, tea, spicy foods, and betel nut were associated with the development of erosive esophagitis. Multivariate analysis revealed that male gender (OR, 3.8, 95% CI, 1.5–9.3) and high BMI (BMI 25–30: OR, 2.3, 95% CI, 1.3–4.2; BMI [ 30: OR, 3.8, 95% CI, 1.3–10.9) were independent predictors of erosive esophagitis. Conclusion Our data revealed male gender and high BMI are independent risk factors for asymptomatic erosive esophagitis. Keywords Erosive esophagitis Á Asymptomatic Á Endoscopy Á Health check-up Introduction Silent gastroesophageal reflux disease (GERD) is a com- mon disorder that manifests with erosive esophagitis, Barrett’s esophagus, and esophageal adenocarcinoma in asymptomatic subjects undergoing screening endoscopy [1]. The causes of GERD in the absence of clearly inden- tifiable symptoms are poorly understood. A US study revealed that 14% of GERD patients had no remarkable symptoms [2]. Additionally, the first nationwide Japanese survey for GERD reported that 210 of 600 (35%) patients with erosive esophagitis were asymptomatic [3], indicating that a significant proportion of GERD patients are asymptomatic. The prevalence of asymptomatic erosive esophagitis in eastern and western countries is unknown. According to a population survey, symptoms of heartburn or acid regur- gitation occur monthly or more frequently in 9.3% of Chinese subjects [4]. The prevalence of GERD is consid- erably higher in the Western population at approximately 20% for weekly reflux symptoms [5, 6]. However, it remains unknown whether Chinese populations also have a F.-W. Wang Á M.-S. Tu Department of Family Medicine, Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan e-mail: wfwvghks@yahoo.com.tw H.-Y. Chuang Department of Community Medicine, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan H.-Y. Chuang Faculty of Public Health, Kaohsiung Medical University, Kaohsiung, Taiwan H.-C. Yu Á L.-C. Cheng Á P.-I. Hsu (&) Division of Gastroenterology, Department of Internal Medicine, Kaohsiung Veterans General Hospital, 386 Ta-Chung 1 st Road, Kaohsiung 80424, Taiwan e-mail: williamhsup@yahoo.com.tw 123 Dig Dis Sci (2010) 55:1320–1324 DOI 10.1007/s10620-009-0888-z