Abdominal obesity is associated with a higher risk of Barrett's oesophagus, a condition in which cells lining the oesophagus become abnormal and may lead to cancer. Obesity has previously been linked to an increased risk of gastroesophageal reflux disease (GERD), inflammation caused by back up of stomach acid into the oesophagus, which often precedes Barrett's oesophagus. But the effect of obesity and body fat distribution on the risk of Barrett's oesophagus is unknown. Researchers from the Baylor College of Medicine, Houston, USA analysed the data from 129 patients who underwent upper endoscopy for non-urgent problems, 36 of whom had Barrett's oesophagus and 93 of whom had no such findings. Body-mass index (BMI) was significantly higher among patients who had Barrett's oesophagus than among the patients who did not, with each unit increase in BMI conferring an 11-percent increase in the risk for Barrett's oesophagus. Increases in visceral abdominal fat tissue (fat that accumulates around the abdominal organs) were also associated with an increased risk for Barrett's oesophagus, but increases in subcutaneous fat tissue (fat that sits just under the skin) were not. In further analyses, visceral fat tissue remained independently associated with Barrett's oesophagus. This study shows a significant increase in the risk of Barrett's oesophagus with obesity, and specifically, visceral obesity as measured by cross-sectional CT images. Hence, larger studies utilizing prospective enrollment of patients are required to further examine this issue.
American Journal of Gastroenterology,
November 2005