Kendall Bradley J, Macdonald Graeme A, Prins Johannes B, O'Brien Suzanne, Whiteman David C
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.
School of Medicine University of Queensland, Brisbane, Australia; Department of Gastroenterology and Hepatology, Princess Alexandra Hospital, Brisbane, Australia.
Cancer Epidemiol. 2014 Jun;38(3):266-72. doi: 10.1016/j.canep.2014.03.006. Epub 2014 Apr 13.
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.
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.
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.
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.
体重指数与巴雷特食管（BO）风险相关。尚不确定这是否与全身脂肪或与体重指数相关的其他因素有关。我们旨在量化全身脂肪（通过生物电阻抗测量）与BO风险之间的关联，并研究这种关联是否因胃食管反流（GOR）和腹型肥胖而改变。
在2007 - 2009年，我们从一项基于人群的BO病例对照研究中调查了235例病例（69%为男性，平均年龄62.1岁）和244名年龄及性别匹配的人群对照。我们进行了结构化访谈、标准人体测量以及全身脂肪的生物阻抗分析。使用多变量逻辑回归分析估计比值比（OR）和95%置信区间（CI）。
全身脂肪重量最高三分位数组（OR 2.01；95%CI 1.26 - 3.21）和全身脂肪百分比最高三分位数组（OR 1.86；95%CI 1.10 - 3.15）的人群患BO的风险显著增加。在对GOR和腰围进行调整后，这些风险大幅降低。腰围最高三分位数组的人群患BO的风险显著增加（OR 2.21；95%CI 1.39 - 3.51），在对全身脂肪进行调整后，这种风险略有降低，在对GOR进行调整后，风险中度降低。
全身脂肪与BO风险增加相关，但这似乎是通过腹型肥胖和GOR介导的。这些发现提供了证据，表明在BO的发生发展中，腹型肥胖比全身脂肪更重要。
