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BMC Gastroenterology
Published in: BMC Gastroenterology 1/2013

Open Access 01-12-2013 | Research article

Association between obesity and Barrett’s esophagus in a Japanese population: a hospital-based, cross-sectional study

Authors: Jiro Watari, Kazutoshi Hori, Fumihiko Toyoshima, Noriko Kamiya, Takahisa Yamasaki, Takuya Okugawa, Haruki Asano, Zhao Liang Li, Takashi Kondo, Hisatomo Ikehara, Jun Sakurai, Toshihiko Tomita, Tadayuki Oshima, Hirokazu Fukui, Hiroto Miwa

Published in: BMC Gastroenterology | Issue 1/2013

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Abstract

Background

The association between obesity and Barrett’s esophagus (BE) in the Japanese population remains unclear. The prevalence of BE and its associated risk factors was examined.

Methods

A cross-sectional study of 1581 consecutive individuals who underwent upper gastrointestinal endoscopy was conducted. The prevalence of endoscopically suspected BE (ESBE) was evaluated. Obesity was evaluated by body mass index (BMI, ≥ 25 kg/m2) and waist circumference (WC) (males, ≥ 85 cm; females, ≥ 90 cm). Because endoscopic diagnosis of ultra-short ESBE (<1 cm in extent) is difficult and highly unreliable, this type of ESBE was excluded from the study.

Results

In proton pump inhibitor (PPI) non-users, the prevalence of ESBE ≥ 1 cm was 5.6%. In univariate analysis, male sex and reflux esophagitis (RE) were significantly associated with BE, but BMI, WC, and reflux symptoms were not. In multivariate logistic regression analysis, only RE (odds ratio [OR] = 3.48, 95% confidence interval [CI] 1.89-6.41, p < 0.0001) was an independent risk factor for BE; obesity and the other factors were not. In contrast, RE (OR 5.67, p = 0.0004) and large WC (OR 5.09, p = 0.0005) were significant risk factors for ESBE ≥ 1 cm in PPI users. Only male sex, but not obesity or the other risk factors, was associated with an increased risk of RE in patients not taking PPIs.

Conclusions

RE, but not obesity, may have an independent association with the risk of ESBE in the Japanese population. Furthermore, obesity measures were not independent risks for RE. Interestingly, PPI-refractory RE and large WC were risk factors for ESBE ≥1 cm in patients taking PPIs.
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Metadata
Title
Association between obesity and Barrett’s esophagus in a Japanese population: a hospital-based, cross-sectional study
Authors
Jiro Watari
Kazutoshi Hori
Fumihiko Toyoshima
Noriko Kamiya
Takahisa Yamasaki
Takuya Okugawa
Haruki Asano
Zhao Liang Li
Takashi Kondo
Hisatomo Ikehara
Jun Sakurai
Toshihiko Tomita
Tadayuki Oshima
Hirokazu Fukui
Hiroto Miwa
Publication date
01-12-2013
Publisher
BioMed Central
Published in
BMC Gastroenterology / Issue 1/2013
Electronic ISSN: 1471-230X
DOI
https://doi.org/10.1186/1471-230X-13-143

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