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

Abstract

Background and AimThe prevalence rates of Barrett’s esophagus (BE) in western countries are higher than Asian ones, but little is known about their difference among risk factors of BE. The aim of this study is to investigate the associations of various risk factors including central obesity, body mass index (BMI), metabolic syndrome and H. pylori infection, with BE.MethodsA total of 161 subjects with BE were enrolled and compared to age- and gender-matched controls randomly sampled (1:4) from check-up center in same hospital. Central obesity was defined by waist circumference (female>80cm; male>90cm), metabolic syndrome by the modified National Cholesterol Education Program Adult Treatment Panel III criteria in Taiwan. Independent risk factors for BE were identified by multiple logistic regression analyses.ResultsThe mean age for BE was 53.8±13.7 years and 75.8% was male. H. pylori infection status was detected by the rapid urease test with the prevalence of 28.4% and 44.4% in the BE patients and controls, respectively. The univariate logistic regression analyses showed the risk was associated with higher waist circumference (odds ratio [OR], 2.53; 95% confidence interval [CI], 1.78–3.60), metabolic syndrome (OR, 2.02; 95% CI, 1.38–2.96) and negative H. pylori infection (OR, 0.50; 95% CI, 0.34–0.74). However, multivariate logistic regression analyses revealed that BE associated with higher waist circumference (adjusted OR, 2.79; 95% CI, 1.89–4.12) and negative H. pylori infection (adjusted OR, 0.46; 95% CI, 0.30–0.70).ConclusionsCentral obesity is associated with a higher risk of BE whereas H. pylori infection with a lower risk in an ethnic Chinese population.

Helicobacter pylori infection reduces the risk of Barrett's esophagus: A meta‐analysis and systematic review

“…Thirteen studies were excluded, as they did not provide sufficient data (reasons for exclusion detailed in Appendix ). Data were extracted from 83 studies; however, 11 of these studies had to be excluded from the statistical analysis as they contained data from same populations already described in other articles . Our final statistical analysis included 72 studies.…”

“…Our new findings prove that the risk reduction in case of HPI seems to be independent of the geographical location and it is directly associated with the length of the BE segment and the presence of dysplasia in BE. 23 • • • • • • • Abouda (2003) 13 • • • • • • • Ackermack (2003) 23 • • • • • • • Ahmed (2004) 25 • • • • • • • Anderson (2008) 26 • • • • • • • Blaser (1991) 27 • 14 • • • • • • • Chang (2010) 29 • • • • • • • Chen (2016) 30 • • • • • • • Cooper (1991) 31 • • • • • • • Corley (2008) 32 • • • • • • • Csendes (1997) 33 • • • • • • • Dore (2016) 34 • • • • • • • El Serag (1999) 15 • • • • • • • Fassan (2009) 36 • 61 • • • • • • • Meng (2008) 17 • • • • • • • Monkemuller (2008) 62 • • • • • • • Nandurkar (1997) b 63 • • • • • • • Newton (1997) 64 • • • • • • • Pascareno (2014) 66 • • • • • • • Paull (1988) 67 • • • • • • • Peng (2009) 69 • • • • • • • Rajendra (2004) 18 • 76 • • • • • • • Schenk (1999) 76 • • • • • • • Sonnenberg (2010) 77 • • • • • • • Sonnenberg (2016) 78 • • • • • • • Thrift (2012) 79 • • • • • • • Toruner (2004) 20 • • • • • • • Uno (2011) 83 • • • • • • • Vaezi (2000) a 84 • • • • • • • Veldhuyzen (2006) 85 • • • • • • • Vicari (1998) 86 • • • • • • • Vieth (2000) 87 • • • • • • • Watari (2009) 88 • • • • • • • Werdmuller (1997) 89 •…”

Helicobacter pylori infection is associated with reduced risk of Barrett’s esophagus: a meta-analysis and systematic review

“…The 36 included studies comprised a total of 90,895 BE patients and 430,846 controls [ 11 – 13 , 35 – 67 ]. A summary of the characteristics of these studies is shown in Table 1 .…”

“…Multiple studies have highlighted the relationship between Hp and BE [ 11 – 13 ]. Recently, Wang used individual-level data from six case–control studies to conduct analysis.…”

Risk factors associated with Barrett's esophagus in hospitalized patients

“…Con respecto a la presentación y datos clínicos, según Shou-wu Lee et al y Cadman L. Leggett et al, el síndrome metabólico es un factor de riesgo de esófago de Barrett (16,17) . Otros autores han encontrado otros componentes de la triada del síndrome metabólico como factores de riesgo como es el caso de Chih -Cheng Chen et al, que nos menciona que la obesidad central es un factor de riesgo de esófago de Barret (18) .…”