Central obesity could increase the risk for Barrett's esophagus and esophageal adenocarcinoma by mechanical and/or metabolic mechanisms, such as hyperinsulinemia.
Dr Prasad Iyer and colleagues from Minnesota, USA performed an epidemiologic study to determine whether prior type 2 diabetes mellitus is associated with Barrett's esophagus.
The team performed a population-based case-control study using the General Practice Research Database, a UK primary care database that contains information on more than 8 million subjects, to identify cases of Barrett's esophagus and matched controls without Barrett's esophagus.
|Diabetes mellitus 2 was associated with a 49% increase in the risk of Barrett's|
|Clinical Gastroenterology and Hepatology|
The researchers assessed the association of a prior diagnosis of diabetes mellitus 2 with Barrett's esophagus using conditional univariate and multivariable regression analysis.
Confounders assessed smoking, obesity measured by body mass index, and gastroesophageal reflux disease.
Barrett's esophagus cases were more likely than controls to have smoked, have a higher mean body mass index, and a higher prevalence of diabetes mellitus 2 than controls.
The team noted that diabetes mellitus 2 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.
Results remained stable with sensitivity analyses.
Dr Iyer's team concludes, "In a large population-based case-control study, diabetes mellitus 2 was a risk factor for Barrett's esophagus, independent of obesity and other risk factors."
"These data suggest that metabolic pathways related to diabetes mellitus 2 should be explored in Barrett's esophagus pathogenesis and esophageal carcinogenesis."