Risk Factors for Barrett's Esophagus

巴雷特食管的危险因素

• 批准号: 7950047
• 负责人: BRIAN C JACOBSON
• 金额: $ 24.86万
• 依托单位: BOSTON MEDICAL CENTER
• 依托单位国家: 美国
• 财政年份: 2010
• 资助国家: 美国
• 起止时间: 2010-07-01 至 2015-06-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/7950047
• 关键词: ABO blood group system; Address; Anti-Inflammatory Agents; Anti-inflammatory; Archives; Aspirin; Barrett Esophagus; Blood specimen; Body mass index; C-Peptide; C-reactive protein; Cell Line; Characteristics; Chronic; Cohort Studies; Collection; Columnar Epithelium; Data; Development; Diagnosis; Diet; Dietary Practices; Drug usage; Endoscopy; Epidemic; Esophageal Adenocarcinoma; Esophagus; Excision; Fatty acid glycerol esters; Follow-Up Studies; Frequencies; Functional disorder; Funding; Gastroesophageal reflux disease; Gender; General Population; Genes; Genetic Variation; Genotype; Goals; Grant; Growth Factor; Health Professional; Histologic; Hyperinsulinism; Incidence; Individual; Inflammation; Inflammation Mediators; Insulin; Insulin Resistance; Insulin-Like Growth Factor I; Insulin-Like Growth-Factor-Binding Proteins; Intake; Intercellular adhesion molecule 1; Interleukin-6; Intestines; K-Series Research Career Programs; Lead; Leptin; Life Style; Malignant Neoplasms; Measures; Meat; Mediating; Modification; Nurses' Health Study; Obesity; Overweight; Pathogenesis; Persons; Plasma; Polyunsaturated Fatty Acids; Premalignant; Prospective Studies; Proteins; Records; Reflux; Reporting; Research; Research Personnel; Resources; Retrospective Studies; Risk; Risk Factors; Role; Serum; Squamous Cell; Squamous Epithelium; Stomach; Symptoms; TNF gene; Time; Tumor Necrosis Factor-alpha; Tumor Necrosis Factors; United States; Western Europe; Woman; adiponectin; cancer type; cohort; disease diagnosis; energy balance; fruits and vegetables; indexing; men; novel; prospective; public health relevance; receptor; sedentary

DESCRIPTION (provided by applicant): The incidence of esophageal adenocarcinoma has been rising rapidly over the past two decades for unclear reasons. The most important risk factor for this cancer is Barrett's esophagus, a condition resulting from the reflux of gastric contents into the esophagus. In Barrett's esophagus the normal squamous cell lining of the esophagus is replaced by a specialized cell lining containing intestinal features. Risk factors associated with the development of Barrett's esophagus are not well defined. Furthermore, while men and women report symptoms of gastroesophageal reflux with equal frequency, men are twice as likely to develop Barrett's esophagus, suggesting gender-associated modifications of underlying risk factors. We propose to utilize the resources of three large, ongoing cohort studies, the Nurses' Health Study I, the Nurses' Health Study II, and the Health Professionals' Follow-up Study, to investigate inter-related mechanisms among both men and women that may contribute to Barrett's esophagus, including the roles of energy balance, insulin resistance, and chronic inflammation. All three cohorts provide prospectively collected data on potential risk factors for Barrett's esophagus, archived pre-diagnosis blood samples, and detailed endoscopy records and validated data on histologically-documented Barrett's esophagus. This unique investigative opportunity will allow us to examine, in detail, the associations between diet; gender; circulating levels of insulin, insulin derived growth factor, leptin, adiponectin, interleukin 6, tumor necrosis factor alpha, c-reactive protein, and other markers of insulin resistance and systemic inflammation; and other novel influences on the pathogenesis of Barrett's esophagus. PUBLIC HEALTH RELEVANCE: The goals of the project are to better understand reasons why people develop Barrett's esophagus, a condition that can lead to esophageal adenocarcinoma (a type of cancer whose frequency is rising faster than most other cancers). The project combines the resources of three large, ongoing cohort studies of both men and women to answer questions about why obesity is associated with Barrett's esophagus. These questions are especially relevant given our nation's current obesity epidemic.

描述（由申请人提供）：在过去的二十年中，食道腺癌的发生率一直在迅速上升。该癌症的最重要危险因素是巴雷特的食管，这是胃含量转化为食道导致的。在巴雷特的食道中，食管的正常鳞状细胞衬里被含有肠道特征的专门细胞衬里取代。与巴雷特食道发展相关的危险因素尚未很好地定义。此外，尽管男性和女性报告了胃食管反流的症状，但男性的可能发展是巴雷特食管的两倍，这表明与性别相关的基本危险因素的修饰。我们建议利用三项大型，正在进行的队列研究的资源，护士健康研究I，护士健康研究II和卫生专业人员的后续研究，调查男性和女性相互关联的机制，这些机制可能会促进巴雷特食道的，包括能量平衡的作用，胰岛素抵抗，胰岛素抵抗和慢性炎症。这三个队列都提供了有关巴雷特食管的潜在危险因素的前瞻性收集数据，存档的诊断前血液样本以及详细的内窥镜记录以及验证了有关组织学证明的巴雷特食管的验证数据。这个独特的调查机会将使我们能够详细研究饮食之间的关联。性别;胰岛素，胰岛素衍生因子，瘦素，脂联素，白介素6，肿瘤坏死因子α，C反应蛋白以及其他胰岛素抵抗和全身性炎症的标志物的循环水平；以及对巴雷特食管发病机理的其他新型影响。 公共卫生相关性：该项目的目标是更好地理解人们发展Barrett食管的原因，这种疾病可以导致食管腺癌（一种癌症的频率比大多数其他癌症的频率更快）。该项目结合了三个大型，正在进行的男女研究的资源，以回答有关为什么肥胖与巴雷特食管有关的问题。考虑到我们国家目前的肥胖流行，这些问题尤其重要。