Distribution of Body Fat and Its Influence on Esophageal Inflammation and Dysplasia in Patients With Barretts Esophagus
Clinical Gastroenterology and Hepatology , 07/05/2012
Nelsen EM et al. – Gastroesophageal junction (GEJ) and visceral fat are associated with Barrett's esophagus (BE), and with increased esophageal inflammation and high–grade dysplasia in BE subjects, independent of body mass index (BMI). Visceral fat therefore might promote esophageal metaplasia and dysplasia.Methods
- The authors collected data from 50 BE cases and 50 controls (matched for age and sex, identified from a radiology trauma database) seen at the Mayo Clinic in 2009.
- Abdominal (subcutaneous and visceral) and gastroesophageal junction (GEJ) fat area was measured using computed tomography with standard techniques.
- Esophageal inflammation (based on a histologic score) and dysplasia grade were assessed from esophageal biopsies of BE cases by a gastrointestinal pathologist.
- Conditional logistic regression was used to assess the association of body fat depot area with BE status, esophageal inflammation, and dysplasia.
- All BE subjects had controlled reflux symptoms without esophagitis, based on endoscopy.
- The GEJ fat area (odds ratio [OR], 6.0; 95% confidence interval [CI], 1.3-27.7; P=.02), visceral fat area (OR, 4.9; 95% CI, 1.0-22.8; P=.04), and abdominal circumference (OR, 9.1; 95% CI, 1.4-57.2; P=0.02) were associated with BE, independent of body mass index (BMI).
- The subcutaneous fat area was not associated with BE.
- Visceral and GEJ fat were significantly greater in BE subjects with esophageal inflammation (compared with those without, P=.02) and high-grade dysplasia (compared with those without, P=.01), independent of BMI.