Stein D J, El-Serag H B, Kuczynski J, Kramer J R, Sampliner R E
Southern Arizona VA Healthcare System and University of Arizona Health Science Center, Tucson, USA.
Aliment Pharmacol Ther. 2005 Nov 15;22(10):1005-10. doi: 10.1111/j.1365-2036.2005.02674.x.
Obesity has been linked to gastro-oesophageal reflux disease symptoms and oesophageal adenocarcinoma; however, there is no published evidence for an association with Barrett's oesophagus.
To investigate the association between obesity and Barrett's oesophagus.
We conducted a retrospective cross-sectional study of patients who underwent upper endoscopy at the Southern Arizona Veteran's Affairs Healthcare System between 1998 and 2004. We examined male patients without malignancy, with available information on weight and height. Based on endoscopic and histological findings, patients were classified as cases with Barrett's oesophagus or non-cases without Barrett's oesophagus. Multivariable logistic regression analysis was conducted to examine the association of body mass index and obesity with Barrett's oesophagus and Barrett's oesophagus length while adjusting for age and race.
There were 65 cases with Barrett's oesophagus and 385 non-cases without Barrett's oesophagus. The mean body mass index was significantly higher in cases than in non-cases (29.8 vs. 28.0, P = 0.03). Cases had significantly greater mean weight than controls (206 lb vs. 190,P = 0.005). The proportions of cases with body mass index 25-30 and body mass index > or =30 were greater than those in non-cases (44.6% vs. 37.7%) and (40.0% vs. 33.5%), respectively (P = 0.08). In the multivariable logistic regression model adjusting for race and age, when compared with body mass index < 25, the odds ratio was 2.43 (95% confidence interval: 1.12-5.31) for body mass index 25-30 and 2.46 (1.11-5.44) for body mass index > or =30. When examined as a continuous variable the adjusted odd ratio for each five-point increase in body mass index was 1.35 (95% confidence interval: 1.06-1.71, P = 0.01). The association between weight and Barrett's oesophagus was also statistically significant (adjusted odd ratio for each 10 pound increase = 1.10, 1.03-1.17, P =0.002). Among the 65 cases of Barrett's oesophagus, there was no correlation between the length of Barrett's oesophagus at the time of diagnosis and the body mass index (correlation coefficient = 0.03, P = 0.79).
This retrospective cross-sectional study in male veterans shows that overweight is associated with a two-and-half-fold increased risk of Barrett's oesophagus. Larger studies of the underlying mechanism are warranted to better understand how and why obese patients are at greater risk for Barrett's oesophagus.
肥胖与胃食管反流病症状及食管腺癌相关；然而，尚无已发表的证据表明其与巴雷特食管有关联。
研究肥胖与巴雷特食管之间的关联。
我们对1998年至2004年间在亚利桑那州南部退伍军人事务医疗系统接受上消化道内镜检查的患者进行了一项回顾性横断面研究。我们检查了无恶性肿瘤且有体重和身高信息的男性患者。根据内镜和组织学检查结果，将患者分为巴雷特食管病例组和无巴雷特食管的非病例组。进行多变量逻辑回归分析，以检验体重指数和肥胖与巴雷特食管及巴雷特食管长度之间的关联，并对年龄和种族进行校正。
有65例巴雷特食管病例和385例无巴雷特食管的非病例。病例组的平均体重指数显著高于非病例组（29.8对28.0，P = 0.03）。病例组的平均体重显著高于对照组（206磅对190磅，P = 0.005）。体重指数在25至30之间以及体重指数≥30的病例比例分别高于非病例组（44.6%对37.7%）和（40.0%对33.5%）（P = 0.08）。在对种族和年龄进行校正的多变量逻辑回归模型中，与体重指数<25相比，体重指数在25至30之间的比值比为2.43（95%置信区间：1.12 - 5.31），体重指数≥30的比值比为2.46（1.11 - 5.44）。当将体重指数作为连续变量进行检验时，体重指数每增加5个单位，校正后的比值比为1.35（95%置信区间：1.06 - 1.71，P = 0.01）。体重与巴雷特食管之间的关联也具有统计学意义（体重每增加10磅，校正后的比值比 = 1.10，1.03 - 1.17，P = 0.002）。在65例巴雷特食管病例中，诊断时巴雷特食管的长度与体重指数之间无相关性（相关系数 = 0.03，P = 0.79）。
这项针对男性退伍军人的回顾性横断面研究表明，超重与巴雷特食管风险增加两倍半相关。有必要对潜在机制进行更大规模的研究，以更好地理解肥胖患者患巴雷特食管风险更高的方式和原因。
