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Waist-to-hip ratio is associated with an increased risk of Barrett's esophagus

Waist-to-hip ratio, but not body mass index, is associated with an increased risk of Barrett's esophagus in white men, reports the latest issue of the Clinical Gastroenterology & Hepatology.

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Abdominal obesity increases the risk of gastroesophageal reflux disease (GERD), and also might contribute to the development of Barrett's esophagus, although results are inconsistent.

Dr Jennifer Kramer and colleagues from Houston Texas examined the effects of waist-to-hip ratio and body mass index on the risk of Barrett's esophagus and investigated whether race, gastroesophageal reflux disease symptoms, or hiatus hernia were involved.

The team conducted a case-control study using data from eligible patients who underwent elective esophagogastroduodenoscopy.

The researchers noted that 237 patients had Barrett's esophagus, and the other 1021 patients served as endoscopy controls.

The team also analyzed data and tissue samples from enrolled patients who were eligible for screening colonoscopies at a primary care clinic.

The research team reported that all patients underwent esophagogastroduodenoscopy, completed a survey, and had anthropometric measurements taken.

Waist-to-hip ratio was categorized as high if it was 0.9 or greater for men or 0.85 or greater for women.

Patients with Barrett's were 2-fold more likely to have a high waist-to-hip ratio
Clinical Gastroenterology and Hepatology

There was no association between body mass index, and Barrett's esophagus.

The doctors noted that more patients with Barrett's esophagus had a high waist-to-hip ratio than endoscopy controls or colonoscopy controls.

In adjusted analysis, patients with Barrett's esophagus were 2-fold more likely to have a high waist-to-hip ratio than endoscopy controls, this association was stronger for patients with long-segment Barrett's esophagus.

The research team found that a high waist-to-hip ratio was associated significantly with Barrett's esophagus only in whites, but not in blacks or Hispanics.

Gastroesophageal reflux disease symptoms, hiatus hernia, or gastroesophageal valve flap grade could not account for the association.

Dr Kramer's team concludes, "High waist-to-hip ratio, but not body mass index , is associated with a significant increase in the risk of Barrett's esophagus, especially long-segment Barrett's esophagus and in whites."

"The association is not caused by gastroesophageal reflux disease symptoms or hiatus hernia."

Clin Gastroenterol Hepatol 2013: 11(4): 373-381
26 March 2013

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