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Association between visceral abdominal obesity and long-segment Barrett’s esophagus in a Japanese population

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Abstract

Background

Visceral abdominal obesity is associated with Barrett’s esophagus (BE), especially long-segment BE (≥ 3 cm) (LSBE), in white individuals. However, the association between central obesity and LSBE has not been well investigated in Asia. The aim of this study was to investigate the association between central obesity and LSBE in the Japanese population.

Methods

A total of 38,298 healthy subjects who took medical surveys between April 2006 and November 2018 were enrolled. We investigated the association between LSBE and central obesity indices [visceral adipose tissue (VAT), subcutaneous adipose tissue (SAT), and the VAT to SAT ratio (VAT/SAT)] using a multivariable logistic regression model.

Results

A total of 37,686 subjects were eligible for the analysis. LSBE rates in the middle and high VAT/SAT groups were higher than those in the low VAT/SAT group [odds ratio (OR) 1.70, 95% confidence interval (CI) 1.07–2.69 for middle vs low; OR 2.02, 95% CI 1.17–3.49 for high vs low). These associational trends between VAT/SAT and LSBE remained in subgroups with and without reflux esophagitis. From subgroup analyses by SAT, we found that the OR between VAT and LSBE is higher in the low SAT subgroup (OR 2.43, 95% CI 1.34–4.40 for middle vs low; OR 2.55, 95% CI 1.01–6.40 for high vs low); but not large or imprecise due to limited event numbers in the middle and high SAT subgroups.

Conclusions

VAT was associated with LSBE, especially among subjects with low SAT accumulation, who are seemingly not obese. VAT/SAT was associated with LSBE regardless of the presence of reflux esophagitis in a Japanese population.

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References

  1. de Jonge PJ, van Blankenstein M, Grady WM, et al. Barrett's oesophagus: epidemiology, cancer risk and implications for management. Gut. 2014;63:191–202.

    Article  Google Scholar 

  2. Spechler SJ. Barrett esophagus and risk of esophageal cancer: a clinical review. JAMA. 2013;310:627–36.

    Article  CAS  Google Scholar 

  3. Spechler SJ, Souza RF. Barrett's esophagus. N Engl J Med. 2014;371:836–45.

    Article  CAS  Google Scholar 

  4. El-Serag H. Role of obesity in GORD-related disorders. Gut. 2008;57:281–4.

    Article  Google Scholar 

  5. Corley DA, Kubo A, Zhao W. Abdominal obesity, ethnicity and gastro-oesophageal reflux symptoms. Gut. 2007;56:756–62.

    Article  Google Scholar 

  6. Hampel H, Abraham NS, El-Serag HB. Meta-analysis: obesity and the risk for gastroesophageal reflux disease and its complications. Ann Intern Med. 2005;143:199–21111.

    Article  Google Scholar 

  7. Cook MB, Greenwood DC, Hardie LJ, et al. A systematic review and meta-analysis of the risk of increasing adiposity on Barrett's esophagus. Am J Gastroenterol. 2008;103:292–300.

    Article  Google Scholar 

  8. Kamat P, Wen S, Morris J, et al. Exploring the association between elevated body mass index and Barrett's esophagus: a systematic review and meta-analysis. Ann Thorac Surg. 2009;87:655–62.

    Article  Google Scholar 

  9. Edelstein ZR, Farrow DC, Bronner MP, et al. Central adiposity and risk of Barrett's esophagus. Gastroenterology. 2007;133:403–11.

    Article  Google Scholar 

  10. Pou KM, Massaro JM, Hoffmann U, et al. Patterns of abdominal fat distribution: the Framingham Heart Study. Diabetes Care. 2009;32:481–5.

    Article  Google Scholar 

  11. Pouliot MC, Despres JP, Lemieux S, et al. Waist circumference and abdominal sagittal diameter: best simple anthropometric indexes of abdominal visceral adipose tissue accumulation and related cardiovascular risk in men and women. Am J Cardiol. 1994;73:460–8.

    Article  CAS  Google Scholar 

  12. El-Serag HB, Hashmi A, Garcia J, et al. Visceral abdominal obesity measured by CT scan is associated with an increased risk of Barrett's oesophagus: a case-control study. Gut. 2014;63:220–9.

    PubMed  Google Scholar 

  13. Akiyama T, Yoneda M, Inamori M, et al. Visceral obesity and the risk of Barrett's esophagus in Japanese patients with non-alcoholic fatty liver disease. BMC Gastroenterol. 2009;9:56.

    Article  Google Scholar 

  14. Maeda N, Matsuzaki J, Suzuki H, et al. Association of visceral fat area, smoking, and alcohol consumption with reflux esophagitis and Barrett's esophagus in Japan. PLoS ONE. 2015;10:e0133865.

    Article  Google Scholar 

  15. Hamade N, Vennelaganti S, Parasa S, et al. Lower annual rate of progression of short-segment vs long-segment Barrett's esophagus to esophageal adenocarcinoma. Clin Gastroenterol Hepatol. 2019;17:864–8.

    Article  Google Scholar 

  16. Gunji T, Sato H, Iijima K, et al. Risk factors for erosive esophagitis: a cross-sectional study of a large number of Japanese males. J Gastroenterol. 2011;46:448–55.

    Article  Google Scholar 

  17. Gunji T, Matsuhashi N, Sato H, et al. Helicobacter pylori infection is significantly associated with metabolic syndrome in the Japanese population. Am J Gastroenterol. 2008;103:3005–100.

    Article  CAS  Google Scholar 

  18. Gunji T, Matsuhashi N, Sato H, et al. Light and moderate alcohol consumption significantly reduces the prevalence of fatty liver in the Japanese male population. Am J Gastroenterol. 2009;104:2189–95.

    Article  Google Scholar 

  19. Usui G, Sato H, Shinozaki T, et al. Association between Helicobacter pylori infection and short-segment/long-segment Barrett's esophagus in a Japanese population: a large cross-sectional study. J Clin Gastroenterol. 2019. https://doi.org/10.1097/MCG.0000000000001264.

    Article  PubMed  Google Scholar 

  20. Woodward M, Morrison C, McColl K. An investigation into factors associated with Helicobacter pylori infection. J Clin Epidemiol. 2000;53:175–81.

    Article  CAS  Google Scholar 

  21. Longo-Mbenza B, Nkondi Nsenga J, Vangu ND. Prevention of the metabolic syndrome insulin resistance and the atherosclerotic diseases in Africans infected by Helicobacter pylori infection and treated by antibiotics. Int J Cardiol. 2007;121:229–38.

    Article  CAS  Google Scholar 

  22. Lundell LR, Dent J, Bennett JR, et al. Endoscopic assessment of oesophagitis: clinical and functional correlates and further validation of the Los Angeles classification. Gut. 1999;45:172–80.

    Article  CAS  Google Scholar 

  23. Dent J. Endoscopic grading of reflux oesophagitis: the past, present and future. Best Pract Res Clin Gastroenterol. 2008;22:585–99.

    Article  Google Scholar 

  24. Sharma P, Dent J, Armstrong D, et al. The development and validation of an endoscopic grading system for Barrett’s esophagus: the Prague C & M Criteria. Gastroenterology. 2006;131:1392–9.

    Article  Google Scholar 

  25. Kanda Y. Investigation of the freely available easy-to-use software 'EZR' for medical statistics. Bone Marrow Transplant. 2013;48:452–8.

    Article  CAS  Google Scholar 

  26. Rubenstein JH, Kao JY, Madanick RD, et al. Association of adiponectin multimers with Barrett's oesophagus. Gut. 2009;58:1583–9.

    Article  CAS  Google Scholar 

  27. Kendall BJ, Macdonald GA, Hayward NK, et al. Leptin and the risk of Barrett's oesophagus. Gut. 2007;57:448–54.

    Article  Google Scholar 

  28. Ryan AM, Duong M, Healy L, et al. Obesity, metabolic syndrome and esophageal adenocarcinoma: epidemiology, etiology and new targets. Cancer Epidemiol. 2011;35:309–19.

    Article  Google Scholar 

  29. Lee YC, Cook MB, Bhatia S, et al. Interobserver reliability in the endoscopic diagnosis and grading of Barrett's esophagus: an Asian multinational study. Endoscopy. 2010;42:699–704.

    Article  CAS  Google Scholar 

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Acknowledgements

We thank the clinical technologists and radiological technologists of NTT Medical Center Tokyo for their excellent technical assistance.

Funding

The authors received no financial support for the research, authorship, and/or publications of this article.

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Authors and Affiliations

  1. Department of Diagnostic Pathology, NTT Medical Center Tokyo, 5-9-22 Higashi-gotanda, Shinagawa-ku, Tokyo, 141-8625, Japan

    Genki Usui & Teppei Morikawa

  2. Department of Information and Computer Technology, Faculty of Engineering, Tokyo University of Science, Tokyo, Japan

    Tomohiro Shinozaki

  3. Center for Preventive Medicine, NTT Medical Center Tokyo, Tokyo, Japan

    Toyohisa Jinno & Toshiaki Gunji

  4. Department of General Medicine, Juntendo University Hospital, Tokyo, Japan

    Kazutoshi Fujibayashi

  5. Department of Gastroenterology, NTT Medical Center Tokyo, Tokyo, Japan

    Nobuyuki Matsuhashi

Authors
  1. Genki Usui
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  2. Tomohiro Shinozaki
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  3. Toyohisa Jinno
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  4. Kazutoshi Fujibayashi
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  5. Teppei Morikawa
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  6. Toshiaki Gunji
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  7. Nobuyuki Matsuhashi
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Correspondence to Genki Usui.

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Usui, G., Shinozaki, T., Jinno, T. et al. Association between visceral abdominal obesity and long-segment Barrett’s esophagus in a Japanese population. J Gastroenterol 55, 189–197 (2020). https://doi.org/10.1007/s00535-019-01640-3

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  • DOI: https://doi.org/10.1007/s00535-019-01640-3

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