TY - JOUR
T1 - Waist-to-hip ratio, but not body mass index, is associated with an increased risk of barrett's esophagus in white men
AU - Kramer, Jennifer R.
AU - Fischbach, Lori A.
AU - Richardson, Peter
AU - Alsarraj, Abeer
AU - Fitzgerald, Stephanie
AU - Shaib, Yasser
AU - Abraham, Neena S.
AU - Velez, Maria
AU - Cole, Rhonda
AU - Anand, Bhupinderjit
AU - Verstovsek, Gordana
AU - Rugge, Massimo
AU - Parente, Paola
AU - Graham, David Y.
AU - El-Serag, Hashem B.
N1 - Funding Information:
Funding Supported in part by National Institutes of Health grant National Cancer Institute R01 116845 , the Houston VA HSR&D Center of Excellence ( HFP90-020 ), and the Texas Digestive Disease Center National Institutes of Health ( DK58338 ). Also supported by the National Institute of Diabetes and Digestive and Kidney Diseases ( K24-04-107 to H.B.E.-S.). The views expressed in this article are those of the authors and do not necessarily reflect the position or policy of the Department of Veterans Affairs or the United States government.
PY - 2013/4
Y1 - 2013/4
N2 - Background & Aims: Abdominal obesity increases the risk of gastroesophageal reflux disease (GERD) and also might contribute to the development of Barrett's esophagus (BE), although results are inconsistent. We examined the effects of waist-to-hip ratio (WHR) and body mass index (BMI) on the risk of BE and investigated whether race, GERD symptoms, or hiatus hernia were involved. Methods: We conducted a case-control study using data from eligible patients who underwent elective esophagogastroduodenoscopy; 237 patients had BE and the other 1021 patients served as endoscopy controls. We also analyzed data and tissue samples from enrolled patients who were eligible for screening colonoscopies at a primary care clinic (colonoscopy controls, n = 479). All patients underwent esophagogastroduodenoscopy, completed a survey, and had anthropometric measurements taken. WHR was categorized as high if it was 0.9 or greater for men or 0.85 or greater for women. Data were analyzed with logistic regression. Results: There was no association between BMI and BE. However, more patients with BE had a high WHR (92.4%) than endoscopy controls (79.5%) or colonoscopy controls (84.6%) (P < .001 and P = .008, respectively). In adjusted analysis, patients with BE were 2-fold more likely to have a high WHR than endoscopy controls (odds ratio [OR], 1.93; 95% confidence interval [CI], 1.1-3.5), this association was stronger for patients with long-segment BE (OR, 2.81; 95% CI, 1.0-7.9). A high WHR was associated significantly with BE only in whites (OR, 2.5; 95% CI, 1.2-5.4), but not in blacks or Hispanics. GERD symptoms, hiatus hernia, or gastroesophageal valve flap grade could not account for the association. Conclusions: High WHR, but not BMI, is associated with a significant increase in the risk of BE, especially long-segment BE and in whites. The association is not caused by GERD symptoms or hiatus hernia.
AB - Background & Aims: Abdominal obesity increases the risk of gastroesophageal reflux disease (GERD) and also might contribute to the development of Barrett's esophagus (BE), although results are inconsistent. We examined the effects of waist-to-hip ratio (WHR) and body mass index (BMI) on the risk of BE and investigated whether race, GERD symptoms, or hiatus hernia were involved. Methods: We conducted a case-control study using data from eligible patients who underwent elective esophagogastroduodenoscopy; 237 patients had BE and the other 1021 patients served as endoscopy controls. We also analyzed data and tissue samples from enrolled patients who were eligible for screening colonoscopies at a primary care clinic (colonoscopy controls, n = 479). All patients underwent esophagogastroduodenoscopy, completed a survey, and had anthropometric measurements taken. WHR was categorized as high if it was 0.9 or greater for men or 0.85 or greater for women. Data were analyzed with logistic regression. Results: There was no association between BMI and BE. However, more patients with BE had a high WHR (92.4%) than endoscopy controls (79.5%) or colonoscopy controls (84.6%) (P < .001 and P = .008, respectively). In adjusted analysis, patients with BE were 2-fold more likely to have a high WHR than endoscopy controls (odds ratio [OR], 1.93; 95% confidence interval [CI], 1.1-3.5), this association was stronger for patients with long-segment BE (OR, 2.81; 95% CI, 1.0-7.9). A high WHR was associated significantly with BE only in whites (OR, 2.5; 95% CI, 1.2-5.4), but not in blacks or Hispanics. GERD symptoms, hiatus hernia, or gastroesophageal valve flap grade could not account for the association. Conclusions: High WHR, but not BMI, is associated with a significant increase in the risk of BE, especially long-segment BE and in whites. The association is not caused by GERD symptoms or hiatus hernia.
KW - Epidemiologic Study
KW - Risk Factors
KW - Veterans Affairs
KW - Visceral Obesity
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UR - http://www.scopus.com/inward/citedby.url?scp=84875368191&partnerID=8YFLogxK
U2 - 10.1016/j.cgh.2012.11.028
DO - 10.1016/j.cgh.2012.11.028
M3 - Article
C2 - 23220167
AN - SCOPUS:84875368191
SN - 1542-3565
VL - 11
SP - 373-381.e1
JO - Clinical Gastroenterology and Hepatology
JF - Clinical Gastroenterology and Hepatology
IS - 4
ER -