title: Relationship between kyphosis and Barrett's esophagus in Japanese patients.
abstract: BACKGROUND
  Kyphosis is a risk factor for the presence of hiatal hernia, which is a strong predictor of Barrett's esophagus. However, the association between kyphosis and Barrett's esophagus has not yet been clarified. To investigate this relationship, the Cobb angle, a marker of kyphosis, was measured in patients with and without Barrett's esophagus.
  
  
  METHODS
  From January 2006 to December 2010, 26 patients with long-segment Barrett's esophagus (LSBE) were retrospectively enrolled. As the comparative groups, 100 consecutive patients with short-segment Barrett's esophagus (SSBE) and 100 consecutive control patients without Barrett's esophagus were also enrolled in this study. Cobb angles were measured on lateral chest radiographs, and kyphosis was defined as a Cobb angle of greater than 50°. Kyphosis, along with other patient characteristics, were evaluated as possible predictors for SSBE and LSBE.
  
  
  RESULTS
  The mean Cobb angles in the non-BE, SSBE, and LSBE groups were 31.6° (95% CIs, 29.3°-33.9°), 34.8° (32.1°-37.4°) and 49.4° (44.9°-53.9°), respectively. Statistically significant differences were found between the LSBE and the other 2 groups (p<0.001). The mean Cobb angles were 33.3°±12.4° and 37.0°±14.1°, respectively in patients without and with hiatal hernia (p=0.039). Predictors for Barrett's esophagus of any length were erosive esophagitis and hiatal hernia. Kyphosis had the highest odds ratio for the presence of LSBE (OR, 1.50; 95% CI, 1.05-1.94; p=0.033). Other predictors were hiatal hernia and the absence of Helicobacter pylori infection.
  
  
  CONCLUSIONS
  Kyphosis is a risk factor for the presence of LSBE in Japanese patients.
authors.affiliation: Division of Endoscopy, Shimane University Hospital, Japan.
authors.forename: Goichi
authors.initials: G
authors.lastname: Uno
authors.forename: Yuji
authors.initials: Y
authors.lastname: Amano
authors.forename: Takafumi
authors.initials: T
authors.lastname: Yuki
authors.forename: Akihiko
authors.initials: A
authors.lastname: Oka
authors.forename: Norihisa
authors.initials: N
authors.lastname: Ishimura
authors.forename: Shunji
authors.initials: S
authors.lastname: Ishihara
authors.forename: Yoshikazu
authors.initials: Y
authors.lastname: Kinoshita
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D044466:Asian People; D001471:Barrett Esophagus / Q000209:etiology* / Q000473:pathology; D016022:Case-Control Studies; D005260:Female; D016481:Helicobacter Infections / Q000150:complications; D016480:Helicobacter pylori; D006551:Hernia, Hiatal / Q000150:complications; D006801:Humans; D007564:Japan; D007738:Kyphosis / Q000150:complications* / Q000473:pathology; D008297:Male; D008875:Middle Aged; D016017:Odds Ratio; D012189:Retrospective Studies; D012307:Risk Factors