title: Metabolic syndrome as a risk factor for Barrett esophagus: a population-based case-control study.
abstract: OBJECTIVE
  To assess the association between Barrett esophagus (BE) and the metabolic syndrome in patients with and without reflux symptoms and to determine whether this association is reflux independent and metabolically driven.
  
  
  METHODS
  Case patients with BE and controls were residents of Olmsted County, Minnesota (1999-2006). Two control groups (one with and one without symptoms of gastroesophageal reflux) were identified from a cohort of patients who had responded to a validated gastrointestinal symptom questionnaire. Cases and controls were individually matched by age, sex, and duration of follow-up. Controls did not have a known diagnosis of BE. The association of the metabolic syndrome and its individual components with BE was assessed using univariate and multivariate conditional logistic regression separately for each control group.
  
  
  RESULTS
  A total of 309 patients were included (103 BE cases, 103 controls with reflux symptoms, and 103 controls without reflux symptoms). A total of 64% of cases, 47% of controls with reflux symptoms, and 50% of controls without reflux symptoms had the metabolic syndrome. The metabolic syndrome was associated with a 2-fold increased risk of BE relative to those with (odds ratio, 2.00; 95% CI, 1.10-3.65; P=.02) and without (odds ratio, 1.90; 95% CI, 1.03-3.60; P=.04) reflux symptoms. This association was independent of smoking, alcohol consumption, and body mass index and remained robust with sensitivity analysis.
  
  
  CONCLUSIONS
  The metabolic syndrome is associated with BE independent of reflux symptoms, which may reflect a reflux-independent pathway of BE pathogenesis.
authors: Division of Gastroenterology and Hepatology, Mayo Clinic, Rochester, MN, USA.
authors: Cadman L
authors: CL
authors: Leggett
authors: Eric M
authors: EM
authors: Nelsen
authors: Jianmin
authors: J
authors: Tian
authors: Cathy B
authors: CB
authors: Schleck
authors: Alan R
authors: AR
authors: Zinsmeister
authors: Kelly T
authors: KT
authors: Dunagan
authors: G Richard
authors: GR
authors: Locke
authors: Kenneth K
authors: KK
authors: Wang
authors: Nicholas J
authors: NJ
authors: Talley
authors: Prasad G
authors: PG
authors: Iyer
mesh_terms: D001471:Barrett Esophagus / Q000453:epidemiology*; D016022:Case-Control Studies; D015984:Causality; D015331:Cohort Studies; D015897:Comorbidity; D005260:Female; D005764:Gastroesophageal Reflux / Q000453:epidemiology*; D006801:Humans; D016015:Logistic Models; D008297:Male; D024821:Metabolic Syndrome / Q000453:epidemiology*; D008875:Middle Aged; D008910:Minnesota / Q000453:epidemiology; D009765:Obesity / Q000453:epidemiology; D016017:Odds Ratio; D012307:Risk Factors; D011795:Surveys and Questionnaires
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