title: Higher prevalence of obesity in gastric cardia adenocarcinoma compared to gastric non-cardia adenocarcinoma.
abstract: OBJECTIVE
  Obesity is one of the main risk factors for gastric cardia adenocarcinoma (GCA) in the West. Also, recent studies have suggested that GCA is distinct from distal stomach tumor, with differing risk factors, tumor characteristics, and biological behavior. The objective of our research was to evaluate the relationship between obesity and GCA compared to non-cardia adenocarcinoma.
  
  
  METHODS
  A total of 298 patients who were diagnosed with gastric adenocarcinoma and underwent surgery at Seoul National University Bundang Hospital were evaluated. Ninety-one cases were GCA, and 207 cases were non-cardiac adenocarcinoma. Obesity was estimated by body mass index (BMI, kg/m(2)). The degree of obesity was determined by using BMI <18.5, 18.5-23.9, 24-27.9, and ≥ 28 (kg/m(2)) as the cut-off points for underweight, normal weight, overweight, and obese, respectively. Association with obesity was estimated by odds ratio (OR) and 95% confidence interval (CI).
  
  
  RESULTS
  Obesity was more prevalent in patients with GCA at the time of diagnosis for gastric cancer. Among obese persons with a BMI of 28 kg/m(2) or higher, the OR was 3.937 (95% CI, 1.492-10.389; p = 0.006) for GCA compared to non-cardia adenocarcinoma. For overweight individuals, the OR was 2.194 (95% CI, 1.118-4.305; p = 0.022). Multivariate analysis of age, Helicobacter pylori infection, smoking, stage, and BMI with logistic regression was performed. BMI was an independent risk factor for GCA (OR, 1.123; 95% CI, 1.037-1.217; p = 0.004).
  
  
  CONCLUSIONS
  Obesity was more prevalent in patients with GCA compared to that in patients with gastric non-cardia adenocarcinoma. Also, BMI was an independent risk factor for GCA.
authors.affiliation: Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Korea. presh_yuri@hanmail.net
authors.forename: Yuri
authors.initials: Y
authors.lastname: Cho
authors.forename: Dong Ho
authors.initials: DH
authors.lastname: Lee
authors.forename: Hong Sang
authors.initials: HS
authors.lastname: Oh
authors.forename: Ji Yeon
authors.initials: JY
authors.lastname: Seo
authors.forename: Dong Hyeon
authors.initials: DH
authors.lastname: Lee
authors.forename: Nayoung
authors.initials: N
authors.lastname: Kim
authors.forename: Sook Hyang
authors.initials: SH
authors.lastname: Jeong
authors.forename: Jin Wook
authors.initials: JW
authors.lastname: Kim
authors.forename: Jin Hyuk
authors.initials: JH
authors.lastname: Hwang
authors.forename: Young Soo
authors.initials: YS
authors.lastname: Park
authors.forename: Sang Hyub
authors.initials: SH
authors.lastname: Lee
authors.forename: Cheol Min
authors.initials: CM
authors.lastname: Shin
authors.forename: Hyun Jin
authors.initials: HJ
authors.lastname: Jo
authors.forename: Hyun Chae
authors.initials: HC
authors.lastname: Jung
authors.forename: Yong Bum
authors.initials: YB
authors.lastname: Yoon
authors.forename: In Sung
authors.initials: IS
authors.lastname: Song
mesh_terms: D000230:Adenocarcinoma / Q000209:etiology / Q000473:pathology*; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D015992:Body Mass Index; D002299:Cardia / Q000473:pathology*; D015331:Cohort Studies; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D009765:Obesity / Q000150:complications* / Q000453:epidemiology / Q000473:pathology; D016017:Odds Ratio; D015995:Prevalence; D056910:Republic of Korea / Q000453:epidemiology; D012189:Retrospective Studies; D012307:Risk Factors; D013274:Stomach Neoplasms / Q000209:etiology / Q000473:pathology*