title: Visceral obesity and the risk of Barrett's esophagus in Japanese patients with non-alcoholic fatty liver disease.
abstract: BACKGROUND
  The association between obesity and the risk of Barrett's esophagus (BE) is unclear. Furthermore, the association between visceral obesity and the risk of BE is entirely unknown.
  
  
  METHODS
  We conducted a retrospective study in 163 patients with non-alcoholic fatty liver disease (NAFLD) who underwent both endoscopy and abdominal CT at an interval of less than a year at our institution. BE was endoscopically diagnosed based on the Prague C & M Criteria. The surface areas of visceral adipose tissue (VAT) and subcutaneous adipose tissue (SAT) were calculated from CT images at the level of the umbilicus. The correlations between the BMI, VAT, and SAT and the risk of BE were examined by univariate and multivariate analyses.
  
  
  RESULTS
  Sixty-nine of the 163 study participants (42.3%) were diagnosed to have endoscopic BE, which was classified as short-segment BE (SSBE) in almost all of the cases. There were no significant differences in the age or gender distribution between the groups with and without BE. According to the results of the univariate analysis, VAT was significantly associated with the risk of BE; the BMI tended to be higher in the group with BE than in the group without BE, but this relation did not reach statistical significance. VAT was independently associated with the risk of BE even after adjustment for the BMI.
  
  
  CONCLUSIONS
  In Japanese patients with NAFLD, obesity tended to be associated with the risk of BE, and this risk appeared to be mediated for the most part by abdominal visceral adiposity.
authors.affiliation: Gastroenterology Division, Yokohama City University School of Medicine, 3-9 Fukuura, Kanazawa-ku, Yokohama, Japan. t066002g@yokohama-cu.ac.jp
authors.forename: Tomoyuki
authors.initials: T
authors.lastname: Akiyama
authors.forename: Masato
authors.initials: M
authors.lastname: Yoneda
authors.forename: Masahiko
authors.initials: M
authors.lastname: Inamori
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Iida
authors.forename: Hiroki
authors.initials: H
authors.lastname: Endo
authors.forename: Kunihiro
authors.initials: K
authors.lastname: Hosono
authors.forename: Kyoko
authors.initials: K
authors.lastname: Yoneda
authors.forename: Koji
authors.initials: K
authors.lastname: Fujita
authors.forename: Tomoko
authors.initials: T
authors.lastname: Koide
authors.forename: Chikako
authors.initials: C
authors.lastname: Tokoro
authors.forename: Hirokazu
authors.initials: H
authors.lastname: Takahashi
authors.forename: Ayumu
authors.initials: A
authors.lastname: Goto
authors.forename: Yasunobu
authors.initials: Y
authors.lastname: Abe
authors.forename: Hiroyuki
authors.initials: H
authors.lastname: Kirikoshi
authors.forename: Noritoshi
authors.initials: N
authors.lastname: Kobayashi
authors.forename: Kensuke
authors.initials: K
authors.lastname: Kubota
authors.forename: Satoru
authors.initials: S
authors.lastname: Saito
authors.forename: Atsushi
authors.initials: A
authors.lastname: Nakajima
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001471:Barrett Esophagus / Q000453:epidemiology* / Q000208:ethnology / Q000503:physiopathology; D015992:Body Mass Index; D016145:Endoscopy, Digestive System; D005234:Fatty Liver / Q000150:complications* / Q000208:ethnology / Q000503:physiopathology; D005260:Female; D006801:Humans; D050152:Intra-Abdominal Fat / Q000000981:diagnostic imaging / Q000473:pathology / Q000503:physiopathology*; D007564:Japan; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D009765:Obesity / Q000150:complications* / Q000208:ethnology / Q000503:physiopathology; D012189:Retrospective Studies; D012307:Risk Factors; D050151:Subcutaneous Fat / Q000000981:diagnostic imaging / Q000473:pathology / Q000503:physiopathology; D014057:Tomography, X-Ray Computed