Central adiposity is associated with increased risk of esophageal inflammation, metaplasia, and adenocarcinoma: a systematic review and meta-analysis.
Central adiposity is associated with increased risk of esophageal inflammation, metaplasia, and adenocarcinoma: a systematic review and meta-analysis.
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DOI：
10.1016/j.cgh.2013.05.009
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发表时间：
2013-11
影响因子：
12.6
通讯作者：
Iyer, Prasad G.
中科院分区：
文献类型：
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作者：
Singh, Siddharth;Sharma, Anamay N.;Murad, Mohammad Hassan;Buttar, Navtej S.;El-Serag, Hashem B.;Katzka, David A.;Iyer, Prasad G.
中心性肥胖已被认为是Barrett‘s食道(BE)和食管腺癌(EAC)的危险因素，可能促进从炎症到化生和肿瘤的进展。我们对中心性肥胖与糜烂性食管炎(EE)、BE和EAC之间的相关性进行了系统的综述和荟萃分析，特别是探索中心性肥胖对这些结果的风险的非体重指数(BMI)和胃食道反流(GERD)无关的影响。到2013年3月，我们对多个数据库进行了系统搜索。如果他们报告中心性肥胖(内脏脂肪组织面积、腰臀比和/或腰围)对EE、BE和EAC风险的影响，研究就包括在内。采用随机效应模型计算了以95%可信区间(CI)比较最高肥胖类别和最低肥胖类别的汇总调整优势比(AOR)。确定了40篇相关文章。与身体正常的患者相比，中心性肥胖患者发生EE(19项研究；AOR，1.87；95%CI，1.51-2.31)和BE(17项研究；AOR，1.98；95%CI，1.52-2.57)的风险更高。在调整BMI后，中心性肥胖与BMI之间的关联持续存在(5项研究；AOR，1.88；95%CI，1.20-2.95)。在以GERD患者为对照或调整了GERD症状的研究中，观察到中心性肥胖和BE的非返流相关性(11项研究；AOR，2.04；95%CI，1.44-2.90)。在6项研究中，中心性肥胖与EAC的风险相关(AOR，2.51；95%CI，1.54-4.06)，与正常身体习惯相比。在荟萃分析的基础上，中心性肥胖与食管炎(EE)、化生(BE)和肿瘤(EAC)相关，与BMI无关。其作用是通过回流依赖和回流非依赖机制来实现的。
Central adiposity has been implicated as a risk factor for Barrett’s esophagus (BE) and esophageal adenocarcinoma (EAC), possibly promoting the progression from inflammation to metaplasia and neoplasia. We performed a systematic review and meta-analysis of studies to evaluate the association between central adiposity and erosive esophagitis (EE), BE, and EAC, specifically exploring body mass index (BMI)–independent and gastroesophageal reflux (GERD)–independent effects of central adiposity on the risk of these outcomes. We performed a systematic search of multiple databases through March 2013. Studies were included if they reported effect of central adiposity (visceral adipose tissue area, waist-hip ratio, and/or waist circumference) on the risk of EE, BE, and EAC. Summary adjusted odds ratio (aOR) estimates with 95% confidence intervals (CIs), comparing highest category of adiposity with the lowest category of adiposity, were calculated by using randomeffects model. Forty relevant articles were identified. Compared with patients with normal body habitus, patients with central adiposity had a higher risk of EE (19 studies; aOR, 1.87; 95% CI, 1.51–2.31) and BE (17 studies; aOR, 1.98; 95% CI, 1.52–2.57). The association between central adiposity and BE persisted after adjusting for BMI (5 studies; aOR, 1.88; 95% CI, 1.20–2.95). Refluxindependent association of central adiposity and BE was observed in studies that used GERD patients as controls or adjusted for GERD symptoms (11 studies; aOR, 2.04; 95% CI, 1.44–2.90). In 6 studies, central adiposity was associated with higher risk of EAC (aOR, 2.51; 95% CI, 1.54–4.06), compared with normal body habitus. On the basis of a meta-analysis, central adiposity, independent of BMI, is associated with esophageal inflammation (EE), metaplasia (BE), and neoplasia (EAC). Its effects are mediated by reflux-dependent and reflux-independent mechanisms.
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影响因子：
4.5
作者：
Ha NR;Lee HL;Lee OY;Yoon BC;Choi HS;Hahm JS;Ahn YH;Koh DH
通讯作者：
Koh DH
影响因子：
9.6
作者：
Beddy, P.;Howard, J.;Keogan, M. T.
通讯作者：
Keogan, M. T.
影响因子：
9.8
作者：
El-Serag, HB;Kvapil, P;Kramer, JR
通讯作者：
Kramer, JR
影响因子：
1.9
作者：
Duval, S;Tweedie, R
通讯作者：
Tweedie, R
DOI：
10.1016/0197-2456(86)90046-2
发表时间：
1986-09-01
期刊：
CONTROLLED CLINICAL TRIALS
影响因子：
--
作者：
DERSIMONIAN, R;LAIRD, N
通讯作者：
LAIRD, N