Abdominal Obesity and Body Mass Index as Risk Factors for Barrett’s Esophagus

Corley, Douglas A.; Kubo, Ai; Levin, Theodore R.; Block, Gladys; Habel, Laurel A.; Zhao, Wei; Leighton, Pat; Quesenberry, Charles P.; Rumore, Greg; Buffler, Patricia A.

doi:10.1053/j.gastro.2007.04.046

Cited by 315 publications

(288 citation statements)

References 31 publications

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“…26 Recent studies also showed that waist circumference was associated with esophageal acid exposure 18 and Barrett's esophagus. 27 Our data also showed that waist circumference was less important than BMI in the progression of symptomatic GER. Few data have been available in evaluating the initiation and progression of symptomatic GER separately.…”

Section: Discussionsupporting

confidence: 63%

“…Body mass index (BMI; in kg/m 2 ) was calculated and was categorized as underweight (<21, equivalent to below the 5th percentile of our study participants) and, according to the World Health Organization classification, normal (21 to <25), overweight (25)(26)(27)(28)(29)(30), class 1 obesity (>30-35), class 2 obesity (>35-40), and class 3 obesity (>40, equivalent to above the 95th percentile of our study participants). Waist circumference and waist-to-hip ratio were categorized into 6 categories, based on their distribution percentiles among our study participants with equivalent to <5th (referred to as lowest), 5th-25th (referred to as normal and used as reference), 26th-50th, 51st-75th, 76th-95th, and >95th (referred to as highest) percentiles.…”

Section: Statistical Analysesmentioning

confidence: 99%

“…118 (4.2) 107 (3.9) 369 (7.8) 380 (7.6) Normal (21 to <25) 581 (20.9) 621 (22.8) 1362 (28.6) 1424 (28.3) Overweight ( [25][26][27][28][29][30] 987 ( 294 (10.6) 293 (10.8) 354 (7.4) 381 (7.6) Class 3 obesity (>40) 155 (5.6) 171 (6.3) .28…”

Section: Abbreviations Used In This Papermentioning

confidence: 99%

See 2 more Smart Citations

Effects of Estrogen With and Without Progestin and Obesity on Symptomatic Gastroesophageal Reflux

Zheng

Margolis

Liu³

et al. 2008

Gastroenterology

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Section: Discussionsupporting

confidence: 63%

Section: Statistical Analysesmentioning

confidence: 99%

See 1 more Smart Citation

Effects of Estrogen With and Without Progestin and Obesity on Symptomatic Gastroesophageal Reflux

Zheng

Margolis

Liu³

et al. 2008

Gastroenterology

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“…In contrast, waist circumference (WC) rather than BMI is associated with esophageal acid exposure, with larger WCs leading to a risk of GERD and BE [97]. Recent epidemiological studies showed that WC and the waist-to-hip ratio (WHR), both of which are associated with increased abdominal fat, are risk factors for BE independent of the BMI, with the association between BMI and BE no longer observed after adjustment for WC or WHR [98,99].…”

Section: Obesity and Carcinogenesismentioning

confidence: 99%

Carcinogenesis of Barrett’s esophagus: a review of the clinical literature

Watari

Oshima

Fukui

et al. 2013

Clin J Gastroenterol

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Barrett's esophagus (BE) is a premalignant condition of esophageal adenocarcinoma (EAC). Although the incidence of BE has risen rapidly in the West, it is rare in Asia despite a recent increase in the prevalence of gastroesophageal reflux disease. Controversies over the definition of BE are presented because most cases show shortsegment BE, especially ultra-short BE, in Asia. Here we review possible risk factors for the development of EAC, particularly possible roles of ethnicity, specialized intestinal metaplasia (SIM), BE length, and environmental factors, such as Helicobacter pylori infection and obesity. Additionally, we summarize recent studies on the effect of chemoprevention including proton pump inhibitors, nonsteroidal anti-inflammatory drugs or aspirin in order to reduce the risk of neoplastic progression in BE patients. Although substantial knowledge of risk factors of dysplasia/EAC in BE is shown, the risk for neoplastic development may be influenced by geographic variation, study population, the presence or absence of SIM or dysplasia at baseline, and the small number of BE patients investigated. Recently, the efficiency of surveillance for BE patients has been discussed from the standpoint of cost-effectiveness. It may be too difficult to draw conclusions because no randomized clinical trials of BE surveillance have been performed.

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“…Elevation of the intraabdominal pressure by obesity is a factor contributing to GERD, suggesting that obesity is a risk factor for BE [7][8][9][10] . GERD and BE appear to be metabolic syndrome (MS)-related complications, given that waist circumference, obesity, and body mass index (BMI) are associated with GERD [11][12][13][14][15][16] . Moreover, Helicobacter pylori (H. pylori) infection may play a key role in suppression of BE.…”

Section: Introductionmentioning

confidence: 99%

Risk factors associated with Barrett’s epithelial dysplasia

Fujita

Nakamura

Kasashima

et al. 2014

WJG

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AIM:To elucidate risk factors associated with dysplasia of short-segment Barrett's esophagus (BE). METHODS:A total of 151 BE patients who underwent endoscopic examination from 2004 to 2008 in Aoyama Hospital, Tokyo Women's Medical University, Japan and whose diagnosis was confirmed from biopsy specimens were enrolled in the study. BE was diagnosed based on endoscopic findings of gastric-appearing mucosa or apparent columnar-lined esophagus proximal to the esophagogastric junction. Dysplasia was classified into three grades -mild, moderate and severe -according to the guidelines of the Vienna Classification System for gastrointestinal epithelial neoplasia. Anthropometric and biochemical data were analyzed to identify risk factors for BE dysplasia. The prevalence of Helicobacter pylori (H. pylori ) infection and the expression of p53 by immunohistological staining were also investigated. RESULTS:Histological examination classified patients into three types: specialized columnar epithelium (SCE) (n = 65); junctional (n = 38); and gastric fundic (n = 48). The incidence of dysplasia or adenocarcinoma from BE of the SCE type was significantly higher than that of the other two types (P < 0.01). The univariate analysis revealed that sex, H. pylori infection, body weight, p53 overexpression, and low diastolic blood pressure (BP) were associated with BE dysplasia. In contrast, body mass index, waist circumference, metabolic syndrome complications, and variables related to glucose or lipid metabolism were not associated with dysplasia. Multivariate logistic analysis showed that overexpression of p53 [odds ratio (OR) = 13.1, P = 0.004], H. pylori infection (OR = 0.19, P = 0.066), and diastolic BP (OR = 0.87, P = 0.021) were independent risk factors for epithelial dysplasia in BE patients with the SCE type. CONCLUSION:Overexpression of p53 is a risk factor for dysplasia of BE, however, H. pylori infection and diastolic BP inversely associated with BE dysplasia might be protective.

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Abdominal Obesity and Body Mass Index as Risk Factors for Barrett’s Esophagus

Cited by 315 publications

References 31 publications

Effects of Estrogen With and Without Progestin and Obesity on Symptomatic Gastroesophageal Reflux

Effects of Estrogen With and Without Progestin and Obesity on Symptomatic Gastroesophageal Reflux

Carcinogenesis of Barrett’s esophagus: a review of the clinical literature

Risk factors associated with Barrett’s epithelial dysplasia

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