The association between overweight/obesity and the risk of Barrett's esophagus is unclear.
Further, the association between body fat distribution and the risk of Barrett's esophagus is unknown.
Dr El-Serag and colleagues from Texas conducted a retrospective case-control study in patients who underwent endoscopy.
The patients were treated at a single large VA Medical Center between 2000 and 2003.
The patients included in the study had documented Barrett's esophagus who had an abdominal CT scan within 1 yr of the endoscopy.
The controls were patients without Barrett's esophagus, with or without erosive esophagitis, who also had an abdominal CT scan.
The surface areas of visceral adipose tissue and subcutaneous adipose tissue were calculated from CT scan images at level of intervertebral disc between L4 and L5.
The research team recorded body mass index in kg/m2 at the time of endoscopy.
Cases and controls were compared in univariate and multivariable analyses.
The researchers identified 36 cases and 93 controls.
|Visceral adipose tissue was approximately 2-fold greater in cases than controls|
|American Journal of Gastroenterology|
The team found no significant differences between cases and controls in age, gender, or race.
The mean age of the cases and controls was 63 years, of which 98% were men and 71% were white Caucasian.
The researchers observed that body mass index was significantly greater in cases than controls.
Body mass index greater than 30 kg/m2 was associated with a greater risk of Barrett's esophagus than lower body mass index.
Visceral adipose tissue was approximately 2-fold greater in cases than controls, whereas subcutaneous adipose was less different.
The research team estimated that each 10-cm2 increase in visceral adipose tissue was associated with 9% increase in risk of Barrett's esophagus.
Interestingly, visceral adipose tissue remained independently associated with Barrett's esophagus in the model that adjusted for body mass index.
In that model, the team noted that body mass index was not significantly associated with Barrett's esophagus.
Dr El-Serag's team concluded, “Obesity seems to be associated with an increased risk of Barrett's esophagus.”
“Abdominal visceral adiposity might mediate most of this risk.”