Akiyama Tomoyuki, Yoneda Masato, Inamori Masahiko, Iida Hiroshi, Endo Hiroki, Hosono Kunihiro, Yoneda Kyoko, Fujita Koji, Koide Tomoko, Tokoro Chikako, Takahashi Hirokazu, Goto Ayumu, Abe Yasunobu, Kirikoshi Hiroyuki, Kobayashi Noritoshi, Kubota Kensuke, Saito Satoru, Nakajima Atsushi
Gastroenterology Division, Yokohama City University School of Medicine, 3-9 Fukuura, Kanazawa-ku, Yokohama, Japan.
BMC Gastroenterol. 2009 Jul 21;9:56. doi: 10.1186/1471-230X-9-56.
The association between obesity and the risk of Barrett's esophagus (BE) is unclear. Furthermore, the association between visceral obesity and the risk of BE is entirely unknown.
We conducted a retrospective study in 163 patients with non-alcoholic fatty liver disease (NAFLD) who underwent both endoscopy and abdominal CT at an interval of less than a year at our institution. BE was endoscopically diagnosed based on the Prague C & M Criteria. The surface areas of visceral adipose tissue (VAT) and subcutaneous adipose tissue (SAT) were calculated from CT images at the level of the umbilicus. The correlations between the BMI, VAT, and SAT and the risk of BE were examined by univariate and multivariate analyses.
Sixty-nine of the 163 study participants (42.3%) were diagnosed to have endoscopic BE, which was classified as short-segment BE (SSBE) in almost all of the cases. There were no significant differences in the age or gender distribution between the groups with and without BE. According to the results of the univariate analysis, VAT was significantly associated with the risk of BE; the BMI tended to be higher in the group with BE than in the group without BE, but this relation did not reach statistical significance. VAT was independently associated with the risk of BE even after adjustment for the BMI.
In Japanese patients with NAFLD, obesity tended to be associated with the risk of BE, and this risk appeared to be mediated for the most part by abdominal visceral adiposity.
肥胖与巴雷特食管（BE）风险之间的关联尚不清楚。此外，内脏肥胖与BE风险之间的关联完全未知。
我们对163例非酒精性脂肪性肝病（NAFLD）患者进行了一项回顾性研究，这些患者在我们机构接受了间隔时间不到一年的内镜检查和腹部CT检查。根据布拉格C&M标准通过内镜诊断BE。从脐水平的CT图像计算内脏脂肪组织（VAT）和皮下脂肪组织（SAT）的表面积。通过单因素和多因素分析研究BMI、VAT和SAT与BE风险之间的相关性。
163名研究参与者中有69名（42.3%）被诊断为内镜下BE，几乎所有病例均被分类为短节段BE（SSBE）。有BE组和无BE组之间在年龄或性别分布上无显著差异。根据单因素分析结果，VAT与BE风险显著相关；有BE组的BMI往往高于无BE组，但这种关系未达到统计学显著性。即使在调整BMI后，VAT仍与BE风险独立相关。
在日本NAFLD患者中，肥胖倾向于与BE风险相关，并且这种风险似乎在很大程度上由腹部内脏脂肪过多介导。
