Obesity increases risk of Barrett’s esophagus

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Abdominal Obesity is associated with a higher risk of Barrett’s esophagus, a condition in which cells that line the esophagus become abnormal that may be a precursor to cancer, according to a new report.

Obesity has previously been linked to an increased risk of Gastroesophageal Reflux Disease (GERD), inflammation caused by back up of stomach acid into the esophagus, which often precedes Barrett’s esophagus, the authors explain. But the effect of Obesity and body fat distribution on the risk of Barrett’s esophagus is unknown.

Dr. Hashem B. El-Serag from Baylor College of Medicine, Houston, and colleagues analyzed data from 129 patients who underwent upper endoscopy for non-urgent problems, 36 of whom had Barrett’s esophagus and 93 of whom had no such findings, to investigate the association between Obesity and abdominal fat distribution on the risk for Barrett’s esophagus.

Body-mass index (BMI) was significantly higher among patients who had Barrett’s esophagus than among the patients who did not, the authors report in the American Journal of Gastroenterology, with each unit increase in BMI conferring an 11-percent increase in the risk for Barrett’s esophagus.

Increases in visceral abdominal fat tissue—fat that accumulates around the abdominal organs—were also associated with an increased risk for Barrett’s esophagus, the results indicate, 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 esophagus.

“This study shows a significant increase in the risk of Barrett’s esophagus with Obesity, and specifically, visceral Obesity as measured by cross-sectional CT images,” the authors conclude.

“Larger studies utilizing prospective enrollment of patients are required to further examine this issue,” the investigators add.

SOURCE: American Journal of Gastroenterology, October 2005.

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