Visceral obesity and the risk of Barrett's esophagus in Japanese patients with non-alcoholic fatty liver disease.
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.
Akiyama
Tomoyuki
T
Gastroenterology Division, Yokohama City University School of Medicine, 3-9 Fukuura, Kanazawa-ku, Yokohama, Japan. t066002g@yokohama-cu.ac.jp
Yoneda
Masato
M
Inamori
Masahiko
M
Iida
Hiroshi
H
Endo
Hiroki
H
Hosono
Kunihiro
K
Yoneda
Kyoko
K
Fujita
Koji
K
Koide
Tomoko
T
Tokoro
Chikako
C
Takahashi
Hirokazu
H
Goto
Ayumu
A
Abe
Yasunobu
Y
Kirikoshi
Hiroyuki
H
Kobayashi
Noritoshi
N
Kubota
Kensuke
K
Saito
Satoru
S
Nakajima
Atsushi
A
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