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

Lee, Shou-Wu; Lien, Han‐Chung; Lee, Teng‐Yu; Tung, C. J.; Yeh, Hong‐Zen; Chang, Chi-Sen

doi:10.5009/gnl16211

Cited by 9 publications

(4 citation statements)

References 22 publications

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“…AO is determined as WC of above 102 cm for men and above 88 cm for women [35]. The WC of the obese population showed a higher risk of BE than that of a healthy population, which was consistent with other studies [36,37]. Interestingly, we observed that the WC of the healthy population also had 1.22 times of BE risk, while we originally supposed that the healthy population with normal WC were not easy to suffer from BE.…”

Section: Discussionsupporting

confidence: 90%

A Meta-Analysis of the Impact of Obesity, Metabolic Syndrome, Insulin Resistance, and Microbiome on the Diagnosis of Barrett’s Esophagus

Jia

Cheng

Chang

et al. 2019

Dig Dis

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Background and Aim: The etiology and pathogenesis of Barrett's esophagus (BE) have been widely studied during recent decades. However, the association between BE and possible risk factors, including abdominal obesity (AO), metabolic syndrome (MetS), insulin resistance (IR), and the microbiome has not reached a consensus and lacks a systematic assessment. The purpose of our study is to evaluate, quantify, and summarize the association between these factors and BE risk. Methods: A systematic search of Pubmed, Embase, and Cochrane Library databases was performed to identify relevant studies before September 2018. Studies were estimated with the OR, the weighted mean difference (WMD), and the 95% CI by using a random effects model. Subgroup analysis and publication bias were also performed. Results: A total of 46 citations were included in the analysis, and 119,273 subjects were analyzed (AO 13, MetS 15, IR 9, and microbiome: 9). The pooled results showed that AO (p < 0.01, OR 1.30, 95% CI 1.11-1.52, I 2 = 31.9%), MetS (p < 0.01, OR 1.68, 95% CI 1.40-2.01, I 2 = 87.6%), and IR (p < 0.01, WMD 0.23, 95% CI 0.11-0.35, I 2 = 55.8%) were all significantly associated with an increased risk of BE, but except for the mi-crobiome (p > 0.05, OR 1.27, 95% CI 0.66-2.43, I 2 = 46.7%). In addition, subgroup analyses were stratified by waist-to-hip ratio, waist circumference, body mass index, diagnosis criteria, strain type, geographical region, and study design, respectively. Moreover, we observed no evidence of publication bias in Egger's and Begg's tests. Conclusions: Our study reveals that AO, MetS, and IR are significantly associated with BE risk, except for the microbiome. The mechanism of BE induced by 3 risk factors should be further explored.

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Section: Discussionsupporting

confidence: 90%

A Meta-Analysis of the Impact of Obesity, Metabolic Syndrome, Insulin Resistance, and Microbiome on the Diagnosis of Barrett’s Esophagus

Jia

Cheng

Chang

et al. 2019

Dig Dis

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“…2 Hence, as shown in the additional studies performed in Japan and Taiwan, central obesity might be not a risk factor for BE. 19,20,39 Overall, these findings suggest the need to investigate the associations and mechanisms of BE, particularly in different races and types of BE, that are caused by central adiposity. On the other hand, similar to other studies, we also observed that alcohol consumption was not associated with BE.…”

Section: Discussionmentioning

confidence: 94%

Risk factors for Barrett’s esophagus in young adults who underwent upper gastrointestinal endoscopy in a health examination center

Chen

et al. 2019

Therap Adv Gastroenterol

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Background: Barrett’s esophagus (BE) is a premalignant condition with increased incidence worldwide both in old and young individuals. However, the role of certain potential risk factors remains unclear in young adults (< 50 years). We aimed to determine the risk factors of BE in young adults. Methods: A total of 4943 young adults who underwent upper gastrointestinal endoscopy at our health check-up center were enrolled. The diagnosis of BE was based on histological confirmation. We analyzed demographic factors, laboratory data, potential risk factors such as smoking, alcohol consumption, presence of gastroesophageal reflux disease (GERD) symptoms, and metabolic syndrome for the risk of BE by using binary logistic regression analysis. Results: The prevalence of BE was 1.8% (88/4943). Male sex, the presence of GERD symptoms, and smoking were three significant risk factors related to BE. Furthermore, participants who had smoked for 10 pack-years or more had increased risk of BE with dose-dependent phenomenon ( p trend < 0.001). The proportion of BE in male participants with both GERD symptoms and a smoking history of 10 pack-years or more was as high as 10.3% (16/155). Conclusions: Significant risk factors of BE in young adults are male sex, the presence of GERD symptoms, and smoking. The risk also increases with an increase in cumulative exposure to smoking.

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“…A meta-analysis of twenty-one studies demonstrated a strong association with increasing BMI and erosive esophagitis in males, but not females [ 9 ], while the converse was found in a case–control study [ 11 ]. Finally, a retrospective study in a Chinese population demonstrated a positive association between obesity and erosive esophagitis [ 13 ].…”

Section: Discussionmentioning

confidence: 99%

Gender-Specific Risk Factors for Reflux Esophagitis in a Predominantly Hispanic Population of a Large Safety-Net Hospital

et al. 2020

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Background Defining factors associated with severe reflux esophagitis allows for identification of subgroups most at risk for complications of strictures and esophageal malignancy. We hypothesized there might be unique clinical features in patients with reflux esophagitis in a predominantly Hispanic population of a large, safety-net hospital. Aim Define clinical and endoscopic features of reflux esophagitis in a predominantly Hispanic population of a large, safetynet hospital. Methods This is retrospective comparative study of outpatients and hospitalized patients identified with mild (Los Angeles Grade A/B) and severe (Los Angeles Grade C/D) esophagitis through an endoscopy database review. The electronic medical record was reviewed for demographic and clinical data. Results Reflux esophagitis was identified in 382/5925 individuals: 56.5% males and 79.8% Hispanic. Multivariable logistic regression model adjusted for age, gender, race, body mass index (BMI), tobacco and alcohol use, and hospitalization status with severity as the outcome showed an interaction between gender and BMI (p ≤ 0.01). Stratification by gender showed that obese females had decreased odds of severe esophagitis compared to normal BMI females (OR = 0.18, 95% CI = 0.07-0.47; p < 0.01). In males, the odds of esophagitis were higher in inpatient status (OR = 2.84, 95% CI = 1.52 − 5.28; p < 0.01) and as age increased (OR = 1.37, 95% CI = 1.03 − 1.83; p = 0.03). Conclusions We identify gender-specific associations with severe esophagitis in a predominantly Hispanic cohort. In females, obese BMI appears to be protective against severe esophagitis compared to normal BMI, while in men inpatient status and increasing age were associated with increased odds of severe esophagitis.

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

Cited by 9 publications

References 22 publications

A Meta-Analysis of the Impact of Obesity, Metabolic Syndrome, Insulin Resistance, and Microbiome on the Diagnosis of Barrett’s Esophagus

A Meta-Analysis of the Impact of Obesity, Metabolic Syndrome, Insulin Resistance, and Microbiome on the Diagnosis of Barrett’s Esophagus

Risk factors for Barrett’s esophagus in young adults who underwent upper gastrointestinal endoscopy in a health examination center

Gender-Specific Risk Factors for Reflux Esophagitis in a Predominantly Hispanic Population of a Large Safety-Net Hospital

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