Presence of columnar-lined esophagus is negatively associated with the presence of esophageal varices in Japanese alcoholic men

Table 1 Background of the Japanese alcoholic men with and without esophageal varices n (%)

	Esophageal varices
	Absent	Present	P value
n	1434	180
Age (yr)
mean ± SE	55.8 ± 0.3	54.4 ± 0.7	0.079
Alcohol consumption (g ethanol/d)
mean ± SE	121 ± 2	133 ± 7	0.066
Ever smoker	1310 (91.4)	159 (88.3)	0.21
Liver cirrhosis
Absent	1282 (89.4)	6 (3.3)
Present	152 (10.6)	174 (96.7)	< 0.0001
Gastric Varices
Absent	1418 (98.9)	147 (81.7)
Cardia, cardia/fornix	2 (0.1)	23 (12.8)
Fornix	14 (1.0)	10 (5.6)	< 0.0001
Portal hypertensive gastropathy	1432	179
Absence	1172 (81.8)	59 (33.0)
Grade 1	191 (13.3)	80 (44.7)
Grade 2	53 (3.7)	25 (14.0)
Grade 3	16 (1.1)	15 (8.4)	< 0.0001
Anti-HCV antibody positive	69 (4.8)	13 (7.2)	0.20
HBs antigen positive	17 (1.2)	4 (2.2)	0.28
ALDH2 genotype
*1/*1	1216 (84.8)	161 (89.4)
*1/*2	218 (15.2)	19 (10.6)
*2/*2	0 (0.0)	0 (0.0)	0.12
ADH1B genotype
*1/*1	406 (28.3)	41 (22.8)
*1/*2	470 (32.8)	69 (38.3)
*2/*2	558 (38.9)	70 (38.9)	0.20

ADH1B: Alcohol dehydrogenase-1B; ALDH2: Aldehyde dehydrogenase-2; P values were calculated by Student's t-test for mean values, and Fisher's exact test for percent data.

Table 2 Columnar-lined esophagus and hiatal hernia and the degree of esophageal varices n (%)

Esophageal varices	Absent	F1 varices	Advanced varices	P value
n	1434	92	88
Columnar-lined esophagus
0-4 mm	1100 (76.7)	76 (82.6)	83 (94.3)
≥ 5 mm	334 (23.3)	16 (17.4)	5 (5.7)	< 0.0001
5-9 mm	208 (14.5)	8 (8.7)	3 (3.4)
10-29 mm	120 (8.4)	8 (8.7)	2 (2.3)
≥ 30 mm	6 (0.4)	0 (0.0)	0 (0.0)
Hiatal hernia ≥ 10 mm
Absent	1084 (75.6)	73 (79.3)	76 (86.4)
Present	350 (24.4)	19 (20.7)	12 (13.6)	0.017
Number of patients with liver cirrhosis	152	86	88
Columnar-lined esophagus
0-4 mm	117 (77.0)	73 (84.9)	83 (94.3)
≥ 5 mm	35 (23.0)	13 (15.1)	5 (5.7)	0.0004
5-9 mm	22 (14.5)	8 (9.3)	3 (3.4)
10-29 mm	12 (7.9)	5 (5.8)	2 (2.3)
≥ 30 mm	1 (0.7)	0 (0.0)	0 (0.0)
Hiatal hernia ≥ 10 mm
Absent	124 (81.6)	71 (82.6)	76 (86.4)
Present	28 (18.4)	15 (17.4)	12 (13.6)	0.36

Advanced varices: F2-F3 varices, red-color-sign positive varices, or post-treatment varices. P values are for trend calculated by the Cochran-Mantel-Haenszel test.

Table 3 Background of the Japanese alcoholic men with and without a columnar-lined esophagus n (%)

	Columnar-lined esophagus ≥ 5 mm
	Absent	Present	P value
n	1259	355
Age (yr), mean ± SE	55.6 ± 0.3	55.8 ± 0.5	0.75
Usual alcohol consumption (g ethanol), mean ± SE	123 ± 2	121 ± 4	0.69
Ever smoker	1151 (91.4)	318 (89.6)	0.29
Hiatal hernia ≥ 10 mm	218 (17.3)	163 (45.9)	< 0.0001
No liver cirrhosis and no EVs	983 (78.1)	299 (84.2)
Liver cirrhosis and no EVs	117 (9.3)	35 (9.9)
EVs	159 (12.6)	21 (5.9)	0.001
Gastric varices
Absent	1215 (96.5)	350 (98.6)
Cardia, cardia and fornix	23 (1.8)	2 (0.6)
Fornix	21 (1.7)	3 (0.8)	0.13
Portal hypertensive gastropathy	1256	355
Absent	947 (75.4)	284 (80.0)
Grade 1	218 (17.4)	53 (14.9)
Grade 2,3	91 (7.2)	18 (5.1)	0.17
ALDH2 genotype,
*1/*1	1077 (85.5)	300 (84.5)
*1/*2	182 (14.5)	55 (15.5)
*2/*2	0 (0.0)	0 (0.0)	0.61
ADH1B genotype,
*1/*1	348 (27.6)	99 (27.9)
*1/*2	407 (32.3)	132 (37.2)
*2/*2	504 (40.0)	124 (34.9)	0.15

ADH1B: Alcohol dehydrogenase-1B; ALDH2: Aldehyde dehydrogenase-2; EVs: Esophageal varices; P values are according to the results of Student’s t-test for age; the Mann-Whitney U-test for alcohol consumption; and Fisher's exact test for the other variables.

Table 4 Multivariate analyses to predict the presence of columnar-lined esophagus in Japanese alcoholic men

	CLE, ≥ 5 mm vs 0-4 mm
Independent variables	OR	95%CI	P value
Age, per +10 yr	1.15	(1.00-1.32)	0.043
Usual alcohol consumption, per +22 g ethanol	0.99	(0.96-1.03)	0.75
Ever smoker vs never smoker	0.75	(0.49-1.14)	0.17
Hiatal hernia ≥ 10 mm, presence vs absence	4.33	(3.31-5.67)	< 0.0001
Liver cirrhosis, presence vs absence	1.04	(0.68-1.60)	0.86
Esophageal varices, presence vs absence	0.47	(0.26-0.87)	0.015
Gastric varices, presence vs absence	0.59	(0.21-1.64)	0.31
Portal hypertensive gastropathy
Absent	1.00	Referent
Grade 1	1.23	(0.86-1.78)	0.26
Grade 2,3	0.91	(0.52-1.60)	0.74
Anti-HCV antibody, positive vs, negative	0.93	(0.53-1.66)	0.81
HBs antigen, positive vs, negative	0.56	(0.13-2.47)	0.44
ALDH2 genotype, *1/*1 vs *1/*2	0.94	(0.67-1.33)	0.73
ADH1B genotype, *2 carrier vs *1/*1	0.97	(0.73-1.28)	0.81

ADH1B: Alcohol dehydrogenase-1B; ALDH2: Aldehyde dehydrogenase-2; OR: Multivariate odds ratio; CI: Confidence interval; CLE: Columnar-lined esophagus. ORs and CIs were calculated by using a multiple logistic regression model.

Table 5 Background of the Japanese alcoholic men with liver cirrhosis according to whether they had esophageal varices n (%)

	Esophageal varices
	Absent	All forms	P value	Advanced forms	P1 value
n	152	174		88
Age (yr)
mean ± SE	55.9 ± 0.7	54.5 ± 0.7	0.16	54.3 ± 1.0	0.21
Alcohol consumption (g ethanol/d)
mean ± SE	124 ± 7	133 ± 7	0.37	142 ± 11	0.18
Ever smoker	132 (86.8)	155 (89.1)	0.61	83 (94.3)	0.081
Columnar-lined esophagus ≥ 5 mm	35 (23.0)	18 (10.3)	0.003	5 (5.7)	0.0005
Hiatal hernia ≥ 10 mm	28 (18.4)	27 (15.5)	0.55	12 (13.6)	0.37
Child-Pugh class
A	93 (61.2)	88 (50.6)		41 (46.6)
B	50 (32.9)	64 (36.8)		32 (36.4)
C	9 (5.9)	22 (12.6)	0.053	15 (17.0)	0.011
Gastric varices
Absent	137 (90.1)	141 (81.0)		65 (73.9)
Cardia, cardia and fornix	2 (1.3)	23 (13.2)		17 (19.3)
Fornix	13 (8.6)	10 (5.7)	< 0.0001	6 (6.8%)	< 0.0001
Portal hypertensive gastropathy	151	173
Absent	88 (58.3)	55 (31.8)		27 (30.7)
Grade 1	50 (33.1)	78 (45.1)		39 (44.3)
Grade 2	10 (6.6)	25 (14.5)		12 (11.4)
Grade 3	3 (2.0)	15 (8.7)	< 0.0001	15 (8.4)	< 0.0001
Anti-HCV antibody positive	8 (5.3)	13 (7.5)	0.50	8 (9.1)	0.29
HBs antigen positive	4 (2.6)	4 (2.3)	1.00	1 (1.1)	0.65
ALDH2 genotype
*1/*1	134 (88.2)	156 (89.7)		77 (87.5)
*1/*2	18 (11.8)	18 (10.3)		11 (12.5)
*2/*2	0 (0.0)	0 (0.0)	0.72	0 (0.0)	1.00
ADH1B genotype
*1/*1	32 (21.1)	36 (20.7)		15 (17.0)
*1/*2	51 (33.6)	68 (39.1)		37 (42.0)
*2/*2	69 (45.4)	70 (40.2)	0.55	36 (40.9)	0.41

¹Advanced forms of EVs vs no EVs. ADH1B: Alcohol dehydrogenase-1B; ALDH2: Aldehyde dehydrogenase-2; EVs: Esophageal varices; P values were calculated by Student's t-test for mean values, and Fisher's exact test for percent data.

Table 6 Multivariate analyses to predict the presence of esophageal varices in Japanese alcoholic men with liver cirrhosis

	Cirrhosis with EVs vs cirrhosis without EVs
	All forms of EVs		Advanced forms of EVs
Independent variables	OR (95%CI)	P value	OR (95%CI)	P1 value
Age, per +10 yr	0.88 (0.67-1.16)	0.35	0.90 (0.64-1.26)	0.55
Usual alcohol consumption, per +22 g ethanol	1.00 (0.94-1.06)	0.97	1.02 (0.95-1.10)	0.52
Ever smoker vs never smoker	1.04 (0.50-2.16)	0.93	2.13 (0.69-6.57)	0.19
Columnar-lined esophagus, ≥ 5 mm vs 0-4 mm	0.46 (0.23-0.93)	0.030	0.24 (0.08-0.74)	0.013
Hiatal hernia ≥ 10 mm, presence vs absence	1.10 (0.54-2.21)	0.80	0.97 (0.38-2.49)	0.95
Child-Pugh class
A	1.00 Referent		1.00 Referent
B	1.18 (0.70-1.98)	0.53	1.06 (0.55-2.05)	0.87
C	1.56 (0.64-3.82)	0.33	1.85 (0.67-5.16)	0.24
Gastric varices, presence vs absence	1.94 (0.96-3.91)	0.065	2.89 (1.29-6.47)	0.010
Portal hypertensive gastropathy
Absent	1.00 Referent		1.00 Referent
Grade 1	2.24 (1.32-3.80)	0.003	1.92 (0.97-3.77)	0.060
Grade 2,3	4.40 (2.11-9.15)	< 0.0001	5.29 (2.18-12.81)	0.0002
Anti-HCV antibody, positive vs negative	1.09 (0.41-2.93)	0.87	1.54 (0.49-4.88)	0.46
HBs antigen, positive vs, negative	1.16 (0.26-5.16)	0.85	0.61 (0.06-6.36)	0.68
ALDH2 genotype, *1/*1 vs *1/*2	1.02 (0.47-2.20)	0.96	1.00 (0.38-2.60)	1.00
ADH1B genotype, *2 carrier vs *1/*1	1.10 (0.61-1.99)	0.76	1.59 (0.72-3.51)	0.25

¹Advanced forms of EVs vs no EVs, EVs: Esophageal varices; ADH1B: Alcohol dehydrogenase-1B; ALDH2: Aldehyde dehydrogenase-2; OR: Multivariate odds ratio; ORs and CIs were calculated by using a multiple logistic regression model; Advanced forms of EVs were F2-F3 varices, red-color-sign positive varices, or post-treatment varices.