Abdominal obesity and the risk of Barrett's esophagus
Abdominal obesity and the risk of Barrett's esophagus
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DOI：
10.1111/j.1572-0241.2005.00251.x
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发表时间：
2005-10-01
影响因子：
9.8
通讯作者：
Kramer, JR
中科院分区：
文献类型：
--
作者：
El-Serag, HB;Kvapil, P;Kramer, JR
背景：超重/肥胖与巴雷特食管（BE）风险之间的关系尚不清楚。此外，身体脂肪分布与 BE 风险之间的关联尚不清楚。 方法：我们对 2000 年至 2003 年间在一家大型 VA 医疗中心接受内窥镜检查的患者进行了一项回顾性病例对照研究。病例是记录有 BE 且在内窥镜检查后 1 年内接受腹部 CT 扫描的患者，而对照是没有 BE（有或没有糜烂性食管炎）但也接受了腹部 CT 扫描的患者。根据L4和L5之间椎间盘水平的CT扫描图像计算内脏脂肪组织（VAT）和皮下脂肪组织（SAT）的表面积，并记录内窥镜检查时的体重指数（BMI）（以kg/m（2）为单位）。在单变量和多变量分析中对病例和对照进行比较。结果：我们确定了 36 名病例和 93 名对照。病例和对照之间在年龄（平均 63 岁）、性别（98% 男性）或种族（71% 白种人）方面没有显着差异。病例组的 BMI 显着高于对照组（27 vs 24；p = 0.006）。 BMI > 30 kg/m(2) 与较低 BMI 相比，BE 风险更高（比值比 4.0；95% CI：1.4-11.1，p= 0.008）。病例中的 VAT 大约是对照组的 1.5 倍（183 vs 115 cm(2)；p < 0.0001），而 SAT 差异较小（248 vs 200 cm(2)；p = 0.03）。我们估计，增值税每增加 10 厘米(2)，BE 风险就会增加 9%。有趣的是，在调整 BMI 的模型中，增值税仍然与 BE 独立相关，并且在该模型中，BMI 与 BE 没有显着相关性。结论：肥胖似乎与 BE 风险增加相关。腹部内脏肥胖可能会介导大部分这种风险。
BACKGROUND: The association between overweight/obesity and the risk of Barrett's esophagus (BE) is unclear. Further, the association between body fat distribution and the risk of BE is unknown.METHODS: We conducted a retrospective case-control study in patients who underwent endoscopy at a single large VA Medical Center between 2000 and 2003. Cases were patients with documented BE who had an abdominal CT scan within 1 yr of the endoscopy, whereas controls were patients without BE (with or without erosive esophagitis) who also had an abdominal CT scan. The surface areas of visceral adipose tissue (VAT) and subcutaneous adipose tissue (SAT) were calculated from CT scan images at level of intervertebral disc between L4 and L5, and body mass index (BMI) in kg/m(2) at the time of endoscopy was also recorded. Cases and controls were compared in univariate and multivariable analyses.RESULTS: We identified 36 cases and 93 controls. There were no significant differences between cases and controls in age (mean 63 yr), gender (98% men), or race (71% white Caucasian). BMI was significantly greater in cases than controls (27 vs 24; p= 0.006). BMI > 30 kg/m(2) was associated with a greater risk of BE than lower BMI (odds ratio 4.0; 95% CI: 1.4-11.1, p= 0.008). VAT was approximately 1.5-fold greater in cases than controls (183 vs 115 cm(2); p < 0.0001), whereas SAT was less different (248 vs 200 cm(2); p= 0.03). We estimated that each 10-cm(2) increase in VAT was associated with 9% increase in risk of BE. Interestingly, VAT remained independently associated with BE in the model that adjusted for BMI, and in that model, BMI was not significantly associated with BE.CONCLUSIONS: Obesity seems to be associated with an increased risk of BE. Abdominal visceral adiposity might mediate most of this risk.