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Vol. 83, No. 3, 2011
Issue release date: January 2011

Visceral Obesity and the Risk of Barrett’s Esophagus

Akiyama T. · Yoneda M. · Maeda S. · Nakajima A. · Koyama S. · Inamori M.
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Abstract

It still remains controversial whether simple obesity, as measured by the body mass index (BMI), is an independent risk factor for Barrett’s esophagus (BE). Recent studies have shown abdominal obesity, as defined by the waist circumference (WC) and the waist-to-hip ratio (WHR), to be a risk factor for BE, independent of the BMI, with the association between BMI and BE being no longer observed after adjustment for the WC and WHR. Moreover, visceral obesity, as directly measured by the surface area of the visceral adipose tissue (VAT) on abdominal CT images, has also been reported to have an association with the risk of BE. In addition to the mechanical effects of abdominal obesity, that is, increase of the intra- abdominal pressure by the large amount of adipose tissue, circulating factors secreted from the VAT, such as tumor necrosis factor-α, interleukin-6, leptin, and adiponectin, have also been proposed to be pathogenetically linked to BE and esophageal adenocarcinoma. Obesity is associated with the risk of BE, and this risk appeared to be mediated for the most part by abdominal obesity, especially visceral obesity. This raises several questions regarding the pathogenesis of obesity-related BE. Larger studies with prospective enrollment of patients are required for further examination of this issue.



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References

  1. Dent J, El-Serag HB, Wallander MA, Johansson S: Epidemiology of gastro-oesophageal reflux disease: a systematic review. Gut 2005;54:710–717.
  2. Van Soest EM, Dieleman JP, Siersema PD, Sturkenboom MC, Kuipers EJ: Increasing incidence of Barrett’s oesophagus in the general population. Gut 2005;54:1062–1066.
  3. Bollschweiler E, Wolfgarten E, Gutschow C, Holscher AH: Demographic variations in the rising incidence of esophageal adenocarcinoma in white males. Cancer 2001;92:549–555.
  4. Flegal KM, Carroll MD, Ogden CL, Johnson CL: Prevalence and trends in obesity among US adults, 1999–2000. JAMA 2002;288:1723–1727.
  5. Ogden CL, Carroll MD, Curtin LR, McDowell MA, Tabak CJ, Flegal KM: Prevalence of overweight and obesity in the United States, 1999–2004. JAMA 2006;295:1549–1555.
  6. Locke GR 3rd, Talley NJ, Fett SL, Zinsmeister AR, Melton LJ 3rd: Risk factors associated with symptoms of gastroesophageal reflux. Am J Med 1999;106:642–649.
  7. Ruhl CE, Everhart JE: Overweight, but not high dietary fat intake, increases risk of gastroesophageal reflux disease hospitalization: the NHANES I Epidemiologic Follow-Up Study. First National Health and Nutrition Examination Survey. Ann Epidemiol 1999;9:424–435.
  8. El-Serag HB, Graham DY, Satia JA, Rabeneck L: Obesity is an independent risk factor for GERD symptoms and erosive esophagitis. Am J Gastroenterol 2005;100:1243–1250.
  9. Nandurkar S, Locke GR 3rd, Fett S, Zinsmeister AR, Cameron AJ, Talley NJ: Relationship between body mass index, diet, exercise and gastro-oesophageal reflux symptoms in a community. Aliment Pharmacol Ther 2004;20:497–505.
  10. Kubo A, Corley DA: Body mass index and adenocarcinomas of the esophagus or gastric cardia: a systematic review and meta-analysis. Cancer Epidemiol Biomarkers Prev 2006;15:872–878.
  11. El-Serag HB, Kvapil P, Hacken-Bitar J, Kramer JR: Abdominal obesity and the risk of Barrett’s esophagus. Am J Gastroenterol 2005;100:2151–2156.
  12. Stein DJ, El-Serag HB, Kuczynski J, Kramer JR, Sampliner RE: The association of body mass index with Barrett’s oesophagus. Aliment Pharmacol Ther 2005;22:1005–1010.
  13. Smith KJ, O’Brien SM, Smithers BM, Gotley DC, Webb PM, Green AC, Whiteman DC: Interactions among smoking, obesity, and symptoms of acid reflux in Barrett’s esophagus. Cancer Epidemiol Biomarkers Prev 2005;14:2481–2486.
  14. Gerson LB, Ullah N, Fass R, Green C, Shetler K, Singh G: Does body mass index differ between patients with Barrett’s esophagus and patients with chronic gastroesophageal reflux disease? Aliment Pharmacol Ther 2007;25:1079–1086.
  15. Akiyama T, Inamori M, Akimoto K, Iida H, Mawatari H, Endo H, Ikeda T, Nozaki Y, Yoneda K, Sakamoto Y, Fujita K, Yoneda M, Takahashi H, Hirokawa S, Goto A, Abe Y, Kirikoshi H, Kobayashi N, Kubota K, Saito S, Nakajima A: Risk factors for the progression of endoscopic Barrett’s epithelium in Japan: a multivariate analysis based on the Prague C&M Criteria. Dig Dis Sci 2009;54:1702–1707.
  16. Corley DA, Kubo A, Levin TR, Block G, Habel L, Zhao W, Leighton P, Quesenberry C, Rumore GJ, Buffler PA: Abdominal obesity and body mass index as risk factors for Barrett’s esophagus. Gastroenterology 2007;133:34–41.
  17. Edelstein ZR, Farrow DC, Bronner MP, Rosen SN, Vaughan TL: Central adiposity and risk of Barrett’s esophagus. Gastroenterology 2007;133:403–411.
  18. Akiyama T, Yoneda M, Inamori M, Iida H, Endo H, Hosono K, Yoneda K, Fujita K, Koide T, Tokoro C, Takahashi H, Goto A, Abe Y, Kirikoshi H, Kobayashi N, Kubota K, Saito S, Nakajima A: Visceral obesity and the risk of Barrett’s esophagus in Japanese patients with non-alcoholic fatty liver disease. BMC Gastroenterol 2009;9:56.
  19. Seidell JC, Oosterlee A, Deurenberg P, Hautvast JG, Ruijs JH: Abdominal fat depots measured with computed tomography: effects of degree of obesity, sex, and age. Eur J Clin Nutr 1988;42:805–815.
  20. Beasley LE, Koster A, Newman AB, Javaid MK, Ferrucci L, Kritchevsky SB, Kuller LH, Pahor M, Schaap LA, Visser M, Rubin SM, Goodpaster BH, Harris TB: Health ABC Study. Abdominal composition quantified by computed tomography. Am J Clin Nutr 1988;48:936–945.

    External Resources

  21. Weinsier RL, Hunter GR, Gower BA, Schutz Y, Darnell BE, Zuckerman PA: Body fat distribution in white and black women: different patterns of intraabdominal and subcutaneous abdominal adipose tissue utilization with weight loss. Am J Clin Nutr 2001;74:631–636.
  22. El-Serag HB, Mason AC, Petersen N, Key CR: Epidemiological differences between adenocarcinoma of the oesophagus and adenocarcinoma of the gastric cardia in the USA. Gut 2002;50:368–372.
  23. Calle EE, Rodriguez C, Walker-Thurmond K, Thun MJ: Overweight, obesity, and mortality from cancer in a prospectively studied cohort of US adults. N Engl J Med 2003;348:1625–1638.
  24. Calle EE, Kaaks R: Overweight, obesity, and cancer: epidemiological evidence and proposed mechanisms. Nat Rev Cancer 2004;4:579–591.
  25. El-Serag HB, Ergun GA, Pandolfino J, Fitzgerald S, Tran T, Kramer JR: Obesity increases esophageal acid exposure. Gut 2007;56:749–755.
  26. John BJ, Irukulla S, Abulafi AM, Kumar D, Mendall MA: Systematic review: adipose tissue, obesity and gastrointestinal diseases. Aliment Pharmacol Ther 2006;23:1511–1523.
  27. Considine RV, Sinha MK, Heiman ML, Kriauciunas A, Stephens TW, Nyce MR, Ohannesian JP, Marco CC, McKee LJ, Bauer TL, Caro JF: Serum-immunoreactive leptin concentrations in normal-weight and obese humans. N Engl J Med 1996;334:292–295.
  28. Ogunwobi O, Mutungi G, Beales IL: Leptin stimulates proliferation and inhibits apoptosis in Barrett’s esophageal adenocarcinoma cells by cyclooxygenase-2-dependent, prostaglandin-E2-mediated transactivation of the epidermal growth factor receptor and c-Jun NH2-terminal kinase activation. Endocrinology 2006;147:4505–4516.
  29. Kendall BJ, Macdonald GA, Hayward NK, Prins JB, Brown I, Walker N, Pandeya N, Green AC, Webb PM, Whiteman DC: Study of digestive health. Leptin and the risk of Barrett’s oesophagus. Gut 2008;57:448–454.
  30. Kelesidis I, Kelesidis T, Mantzoros CS: Adiponectin and cancer: a systematic review. Br J Cancer 2006;94:1221–1225.
  31. Rubenstein JH, Dahlkemper A, Kao JY, Zhang M, Morgenstern H, McMahon L, Inadomi JM: A pilot study of the association of low plasma adiponectin and Barrett’s esophagus. Am J Gastroenterol 2008;103:1358–1364.


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