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Visceral obesity is associated with an increased risk of developing esophago-gastric junctional adenocarcinoma in Japan: a population-based case–control study in Akita Prefecture

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Abstract

Background

While an association between esophago-gastric junctional adenocarcinomas (EGJACs) and obesity, especially visceral obesity, has been suggested in Western countries, the association remains unclear in Asia, including Japan. In this population-based case–control study, we investigated the association between EGJACs and obesity.

Methods

To perform near-population-based data collection for all early-stage EGJACs occurring in Akita Prefecture from 2014 to 2019, clinical data, including endoscopic and computed tomography (CT) findings, were collected from 11 cancer treatment base hospitals in the area. Age- and gender-matched controls were extracted at a case-to-control ratio of 1:2 from healthy subjects who received health checkups in the same area. The visceral fat area (VFA) was calculated using CT images. Logistic regression analyses were performed to investigate the associations between EGJACs and obesity-related parameters.

Results

In total, 74 EGJAC cases (62 males, median age of 70 years old) and 148 controls were extracted. Multivariable analyses showed a significantly negative association between the BMI and EGJACs and a significantly positive association between the VFA and EGJACs with odds ratios (ORs) (95% confidence intervals [CIs]) of 0.65 (0.53–0.80) and 1.01 (1.01–1.02), respectively. These findings were confirmed in another dataset (40 EGJACs and 80 controls). In addition, as a categorical variable, VFA ≥ 100 cm2 showed a significantly positive association with EGJACs (OR [95% CI] 1.96 [1.02–3.76]).

Conclusions

We found paradoxical associations between EGJACs and obesity-related parameters (BMI vs. VFA) in a Japanese population, suggesting a potentially pivotal role of the VFA rather than the BMI as a risk factor for EGJACs.

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Authors and Affiliations

  1. Department of Gastroenterology, Akita University Graduate School of Medicine, 1-1-1 Hondo, Akita, 010-8543, Japan

    Kenta Watanabe, Shigeto Koizumi, Yosuke Shimodaira, Tamotsu Matsuhashi & Katsunori Iijima

  2. Shirane Hospital, Akita, Japan

    Kenji Shirane

  3. Department of Gastroenterology, Akita Kousei Medical Center, Akita, Japan

    Hidehiko Tsuda & Hiroyuki Watanabe

  4. Department of Gastroenterology, Akita City Hospital, Akita, Japan

    Tsuyotoshi Tsuji

  5. Department of Gastroenterology, Omagari Kosei Medical Center, Akita, Japan

    Kengo Onochi

  6. Department of Gastroenterology, Odate Municipal General Hospital, Akita, Japan

    Kiyonori Yamai

  7. Department of Gastroenterology, Yuri Kumiai General Hospital, Akita, Japan

    Chika Kusano & Takahiro Dohmen

  8. Department of Gastroenterology, Kitasato University School of Medicine, Kanagawa, Japan

    Chika Kusano

  9. Department of Gastroenterology, Hiraka General Hospital, Akita, Japan

    Yohei Horikawa

  10. Department of Gastroenterology, Northern Akita Municipal Hospital, Akita, Japan

    Takuma Ajimine

  11. Division of Gastroenterology, Tohoku University Graduate School of Medicine, Miyagi, Japan

    Masahiro Saito, Tomoyuki Koike & Atsushi Masamune

Authors
  1. Kenta Watanabe
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  2. Shigeto Koizumi
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  17. Tamotsu Matsuhashi
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  18. Katsunori Iijima
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Corresponding author

Correspondence to Kenta Watanabe.

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Ethical statement

This study was approved by the Ethics Committee of Akita University Graduate School of Medicine (2294) and other cooperating institutions.

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Watanabe, K., Koizumi, S., Shirane, K. et al. Visceral obesity is associated with an increased risk of developing esophago-gastric junctional adenocarcinoma in Japan: a population-based case–control study in Akita Prefecture. Esophagus 19, 477–485 (2022). https://doi.org/10.1007/s10388-021-00906-1

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