Association between obesity and Barrett’s esophagus in a Japanese population: a hospital-based, cross-sectional study

Abstract

BackgroundThe association between obesity and Barrett’s esophagus (BE) in the Japanese population remains unclear. The prevalence of BE and its associated risk factors was examined.MethodsA cross-sectional study of 1581 consecutive individuals who underwent upper gastrointestinal endoscopy was conducted. The prevalence of endoscopically suspected BE (ESBE) was evaluated. Obesity was evaluated by body mass index (BMI, ≥ 25 kg/m2) and waist circumference (WC) (males, ≥ 85 cm; females, ≥ 90 cm). Because endoscopic diagnosis of ultra-short ESBE (<1 cm in extent) is difficult and highly unreliable, this type of ESBE was excluded from the study.ResultsIn proton pump inhibitor (PPI) non-users, the prevalence of ESBE ≥ 1 cm was 5.6%. In univariate analysis, male sex and reflux esophagitis (RE) were significantly associated with BE, but BMI, WC, and reflux symptoms were not. In multivariate logistic regression analysis, only RE (odds ratio [OR] = 3.48, 95% confidence interval [CI] 1.89-6.41, p < 0.0001) was an independent risk factor for BE; obesity and the other factors were not. In contrast, RE (OR 5.67, p = 0.0004) and large WC (OR 5.09, p = 0.0005) were significant risk factors for ESBE ≥ 1 cm in PPI users. Only male sex, but not obesity or the other risk factors, was associated with an increased risk of RE in patients not taking PPIs.ConclusionsRE, but not obesity, may have an independent association with the risk of ESBE in the Japanese population. Furthermore, obesity measures were not independent risks for RE. Interestingly, PPI-refractory RE and large WC were risk factors for ESBE ≥1 cm in patients taking PPIs.

Asia-Pacific consensus on the management of gastro-oesophageal reflux disease: an update focusing on refractory reflux disease and Barrett's oesophagus

“…As highlighted earlier, Japanese studies on the epidemiology of BO have reported high prevalence rates 139 140. When the entity of USSBO is removed, the prevalence rate of BO in Japan is low, similar to other Asian countries.…”

“…If USSBO is excluded, the prevalence rates from Japan are actually similar to other Asian countries. For instance, recent papers by Okita et al 139 and Watari et al 140 reported overall BO prevalence rates of 37.6% and 36.4%, respectively. However, in the paper by Okita et al , SSBO occurred in 37.4% and LSBO in 0.2%.…”

Impact of Obesity on a Chinese Population with Erosive Esophagitis and Barrett's Esophagus

“…In contrast, it remains controversial whether obesity is actually an independent risk factor for BE. Furthermore, there are race and gender differences in the distribution of BE 5. The aim of the study was to investigate the associations between obesity and EE, or BE, in a Chinese population in Taiwan.…”

Central Obesity and H. pylori Infection Influence Risk of Barrett’s Esophagus in an Asian Population

“…[3] Intriguingly, they found no association with obesity or Helicobacter pylori infection, but heterogeneous methodology across studies precluded a firm conclusion. We can see from 4 studies in Asia[10–13], elevated waist circumference, rather than BMI (defined as > 25kg/m 2 ), was more associated with histologic BE.…”