[Review of the association between obesity and gastroesophageal reflux and its complications].
Esophageal adenocarcinoma and its precursor Barrett's esophagus are increasing in incidence in western populations. Gastroesophageal reflux and high body mass index (BMI) are known risk factors. Studies about Barrett's esophagus in obese patients have emphasised the role of central adiposity as a stronger risk factor than BMI in the development of specialized intestinal metaplasia and subsequently esophagus adenocarcinoma. The proinflammatory impact of adipocytokines of the abdominal fat associated with the metabolic syndrome is also relevant. Except cardiovascular diseases, type 2 diabetes and non alcoholic steatohepatitis, abdominal obesity and metabolic syndrome are responsible of an increase of prevalence of esophageal adenocarcinoma, but also other cancer sites. In this review, we study the up to date main epidemiologic and physiopathologic data concerning this association that could be important in future for a preventive action in obese patients, especially when metabolic syndrome is present.
Béchade
D
D
Service de clinique médicale, hôpital du Val-de-Grâce, 74, boulevard de Port-Royal, 75230 Paris cedex 05, France. dominique.bechade94@orange.fr
Blondon
H
H
Sekkach
Y
Y
Desramé
J
J
Algayres
J-P
JP
D000230:Adenocarcinoma / Q000209:etiology; D004938:Esophageal Neoplasms / Q000209:etiology; D004942:Esophagitis, Peptic / Q000209:etiology; D005764:Gastroesophageal Reflux / Q000150:complications* / Q000453:epidemiology; D006801:Humans; D009765:Obesity / Q000150:complications* / Q000453:epidemiology