title: Total body fat and the risk of Barrett's oesophagus - a bioelectrical impedance study.
abstract: BACKGROUND
  Body mass index is associated with the risk of Barrett's oesophagus (BO). It is uncertain whether this is related to total body fat or other factors that correlate with body mass index. We aimed to quantify the association between total body fat (measured by bioelectrical impedance) and risk of BO and examine if this association was modified by gastro-oesophageal reflux (GOR) and abdominal obesity.
  
  
  METHODS
  In 2007-2009, we surveyed 235 cases (69% Males, Mean age 62.1 years) and 244 age and sex matched population controls from a population based case-control study of BO. We conducted structured interviews, standard anthropometry and bioimpedance analysis of total body fat. Odds ratios (OR) and 95% confidence intervals (CI) were estimated using multivariable logistic regression analysis.
  
  
  RESULTS
  There was a significantly increased risk of BO among those in the highest tertile of total body fat weight (OR 2.01; 95%CI 1.26-3.21) and total body fat percentage (OR 1.86; 95%CI 1.10-3.15). These risks were largely attenuated after adjustment for GOR and waist circumference. There was a significantly increased risk of BO among those in the highest tertile of waist circumference (OR 2.21; 95%CI 1.39-3.51) and this was minimally attenuated after adjustment for total body fat and moderately attenuated after adjustment for GOR.
  
  
  CONCLUSIONS
  Total body fat is associated with an increased risk of BO but this appears to be mediated via both abdominal obesity and GOR. These findings provide evidence that abdominal obesity is more important than total body fat in the development of BO.
authors.affiliation: Cancer Program, QIMR Berghofer Medical Research Institute, Brisbane, Australia; School of Medicine University of Queensland, Brisbane, Australia; Department of Gastroenterology and Hepatology, Princess Alexandra Hospital, Brisbane, Australia. Electronic address: bradley.kendall@qimrberghofer.edu.au.
authors.forename: Bradley J
authors.initials: BJ
authors.lastname: Kendall
authors.affiliation: School of Medicine University of Queensland, Brisbane, Australia; Department of Gastroenterology and Hepatology, Princess Alexandra Hospital, Brisbane, Australia.
authors.forename: Graeme A
authors.initials: GA
authors.lastname: Macdonald
authors.affiliation: Diamantina Institute, University of Queensland, Brisbane, Australia; Mater Medical Research Institute, Brisbane, Australia.
authors.forename: Johannes B
authors.initials: JB
authors.lastname: Prins
authors.affiliation: Cancer Program, QIMR Berghofer Medical Research Institute, Brisbane, Australia.
authors.forename: Suzanne
authors.initials: S
authors.lastname: O'Brien
authors.affiliation: Cancer Program, QIMR Berghofer Medical Research Institute, Brisbane, Australia.
authors.forename: David C
authors.initials: DC
authors.lastname: Whiteman
mesh_terms: D000328:Adult; D000368:Aged; D001315:Australia / Q000453:epidemiology; D001471:Barrett Esophagus / Q000453:epidemiology* / Q000503:physiopathology; D015992:Body Mass Index; D016022:Case-Control Studies; D003625:Data Collection; D017097:Electric Impedance; D005260:Female; D006801:Humans; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D009765:Obesity / Q000453:epidemiology* / Q000503:physiopathology; D012307:Risk Factors
keywords: Cancer; Case–control study; Obesity; Oesophagus; Risk factors
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