Central obesity could increase risk for Barrett’s esophagus and esophageal adenocarcinoma by mechanical and/or metabolic mechanisms, such as hyperinsulinemia.
We performed an epidemiologic study to determine if there whether prior type 2 diabetes mellitus is associated with Barrett’s esophagus.
Dr Prasad G. Iyer reported that they performed a population-based case-control study using the General Practice Research Database, a United Kingdom primary care database that contains information from more than 8 million subjects, to identify cases of Barrett’s esophagus and matched controls without Barrett’s esophagus.
We assessed the association of a prior diagnosis of type 2 diabetes mellitus with Barrett’s esophagus, using conditional univariate and multivariable regression analysis.
The team of doctors assessed that confounders assessed included smoking, obesity measured by BMI, and gastroesophageal reflux disease.
|The calculated pooled gastric cancer incidence-rate was about 0.3% per person-years|
|Clinical Gastroenterology and Hepatology |
Barrett’s esophagus cases were more likely than controls to have smoked, have a higher mean BMI, and a higher prevalence of type 2 diabetes mellitus than controls.
The researchers examined that on multivariable analysis, type 2 diabetes mellitus was associated with a 49% increase in the risk of Barrett’s esophagus, independent of other known risk factors.
This association was stronger in women than men.
The doctors noted that results remained stable with sensitivity analyses.
Dr Iyer's team concluded "In a large population based case-control study, type 2 diabetes mellitus was a risk factor for Barrett’s esophagus, independent of obesity and other risk factors."
"These data suggest that metabolic pathways related to type 2 diabetes mellitus should be explored in Barrett’s esophagus pathogenesis and esophageal carcinogenesis."