title: Metabolic syndrome and the risk of Barrett's oesophagus in white males.
abstract: BACKGROUND
  Few studies have examined the association between metabolic syndrome and Barrett's oesophagus (BO). Whether metabolic syndrome confers a risk greater than the sum of its components is unknown.
  
  
  OBJECTIVE
  To investigate associations between metabolic syndrome, its components and BO in white males.
  
  
  METHODS
  We conducted a case-control study among eligible symptomatic patients scheduled for elective oesophagogastroduodenoscopy and a sample of patients eligible for screening colonoscopy recruited at primary care clinics. Metabolic syndrome was defined as the presence of at least three of: high waist-to-hip ratio (WHR), hypertriglyceridaemia, low high-density lipoprotein cholesterol, hypertension or diabetes. We used multivariate logistic regression to calculate odds ratios (OR) and 95% confidence intervals (95% CI).
  
  
  RESULTS
  There were 244 BO cases, 209 colonoscopy and 615 endoscopy controls. Comparing BO cases with all controls, metabolic syndrome was significantly associated with BO (OR = 1.59, 95% CI 1.05-2.40) and there was a dose effect with increasing number of metabolic syndrome components (Ptrend <0.001); when all five components were present, the OR was 2.61 (95% CI 1.14-5.99). We found that among the components, high WHR, hypertension and hypertriglyceridaemia were associated with increased risk of BO. When we compared cases with the control groups separately, metabolic syndrome was associated with BO for comparisons with endoscopy controls (OR = 1.67, 95% CI 1.10-2.55) but not colonoscopy controls (OR = 0.87, 95% CI 0.49-1.54). Associations with individual components also depended on the comparison group.
  
  
  CONCLUSIONS
  Metabolic syndrome is associated with an increased risk of Barrett's oesophagus in men undergoing endoscopy. Metabolic syndrome may confer additional risk of Barrett's oesophagus separate from obesity.
authors: Section of Gastroenterology and Hepatology, Department of Medicine, Baylor College of Medicine, Houston, TX, USA; Dan L. Duncan Cancer Center, Baylor College of Medicine, Houston, TX, USA.
authors: A P
authors: AP
authors: Thrift
authors: J
authors: J
authors: Hilal
authors: H B
authors: HB
authors: El-Serag
mesh_terms: D000368:Aged; D001471:Barrett Esophagus / Q000209:etiology*; D016022:Case-Control Studies; D016145:Endoscopy, Digestive System; D006801:Humans; D016015:Logistic Models; D008297:Male; D024821:Metabolic Syndrome / Q000150:complications*; D008875:Middle Aged; D009765:Obesity / Q000150:complications*; D016017:Odds Ratio; D012307:Risk Factors