Association between obesity and Barrett’s esophagus in a Japanese population: a hospital-based, cross-sectional study

BMC Gastroenterology

Hiroto Miwa¹  Hirokazu Fukui¹  Tadayuki Oshima¹  Toshihiko Tomita¹  Jun Sakurai¹  Hisatomo Ikehara¹  Takashi Kondo¹  Zhao Liang Li¹  Haruki Asano¹  Takuya Okugawa¹  Takahisa Yamasaki¹  Noriko Kamiya¹  Fumihiko Toyoshima¹  Kazutoshi Hori¹  Jiro Watari¹ 

[1] Division of Upper Gastroenterology, Department of Internal Medicine, Hyogo College of Medicine, 1-1, Mukogawa-cho, Nishinomiya 663-8501, Japan

关键词: Reflux esophagitis;    Visceral obesity;    Waist circumference;    Body mass index;    Barrett’s esophagus;   

Others  :  857575
DOI  :  10.1186/1471-230X-13-143

 received in 2013-03-17, accepted in 2013-09-20,  发布年份 2013

【 摘 要 】

Background

The association between obesity and Barrett’s esophagus (BE) in the Japanese population remains unclear. The prevalence of BE and its associated risk factors was examined.

Methods

A cross-sectional study of 1581 consecutive individuals who underwent upper gastrointestinal endoscopy was conducted. The prevalence of endoscopically suspected BE (ESBE) was evaluated. Obesity was evaluated by body mass index (BMI, ≥ 25 kg/m²) and waist circumference (WC) (males, ≥ 85 cm; females, ≥ 90 cm). Because endoscopic diagnosis of ultra-short ESBE (<1 cm in extent) is difficult and highly unreliable, this type of ESBE was excluded from the study.

Results

In proton pump inhibitor (PPI) non-users, the prevalence of ESBE ≥ 1 cm was 5.6%. In univariate analysis, male sex and reflux esophagitis (RE) were significantly associated with BE, but BMI, WC, and reflux symptoms were not. In multivariate logistic regression analysis, only RE (odds ratio [OR] = 3.48, 95% confidence interval [CI] 1.89-6.41, p < 0.0001) was an independent risk factor for BE; obesity and the other factors were not. In contrast, RE (OR 5.67, p = 0.0004) and large WC (OR 5.09, p = 0.0005) were significant risk factors for ESBE ≥ 1 cm in PPI users. Only male sex, but not obesity or the other risk factors, was associated with an increased risk of RE in patients not taking PPIs.

Conclusions

RE, but not obesity, may have an independent association with the risk of ESBE in the Japanese population. Furthermore, obesity measures were not independent risks for RE. Interestingly, PPI-refractory RE and large WC were risk factors for ESBE ≥1 cm in patients taking PPIs.

【 授权许可】

   
2013 Watari et al.; licensee BioMed Central Ltd.

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