Fukuda Sho, Watanabe Kenta, Kubota Dai, Yamamichi Nobutake, Takahashi Yu, Watanabe Yoshitaka, Adachi Kyoichi, Ishimura Norihisa, Koike Tomoyuki, Sugawara Hideyuki, Asanuma Kiyotaka, Abe Yasuhiko, Kon Takashi, Ihara Eikichi, Haraguchi Kazuhiro, Otsuka Yoshihiro, Yoshimura Rie, Iwaya Yugo, Okamura Takuma, Manabe Noriaki, Horiuchi Akira, Matsumoto Mio, Onochi Kengo, Takahashi So, Yoshida Tatsuki, Shimodaira Yosuke, Iijima Katsunori
Department of Gastroenterology, Akita University Graduate School of Medicine, 1-1-1 Hondo, Akita, Akita, 010-8543, Japan.
Next-Generation Endoscopic Computer Vision, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan.
J Gastroenterol. 2025 Feb 10. doi: 10.1007/s00535-025-02222-2.
Given the high prevalence of esophageal adenocarcinoma and Barrett's esophagus (BE), a precancerous lesion, among males, it is important to understand the characteristics of BE by sex to develop an effective endoscopic surveillance program in Japan. The present study examined the age distribution and risk factors for BE in the Japanese health check-up cohort by sex.
The data set at baseline of our preceding multicenter study, comprising a total of 33,478 individuals who underwent upper endoscopic screening at 17 health check-up institutes across Japan, was utilized. BE and long-segment BE (LSBE) were defined as a columnar-lined esophagus ≥ 1 cm and ≥ 3 cm, respectively. Logistic regression analyses were performed to ascertain the factors associated with BE.
BE was relatively common (10-20%) across all 10-year age groups in men and women. Although the prevalence of LSBE was rare (0.2%), it began to increase at younger ages in men. In the multivariable analysis of the male cohort, while body mass index (BMI) was negatively associated with BE with an adjusted odds ratio (95% confidence interval) of 0.84 (0.74-0.95), waist circumference (WC) was positively associated with 1.26 (1.13-1.41). Furthermore, this association was more pronounced in LSBE. In contrast, no such association was observed between BMI or WC and BE in women.
The nationwide Japanese multicenter study yielded insights into the age distribution of BE in the Japanese population. Furthermore, our findings indicate that a low BMI/high WC represents a significant risk factor for BE in the Japanese male population.
鉴于食管腺癌和癌前病变巴雷特食管（BE）在男性中的高患病率，了解BE的性别特征对于在日本制定有效的内镜监测计划很重要。本研究按性别检查了日本健康检查队列中BE的年龄分布和危险因素。
利用我们之前多中心研究的基线数据集，该数据集包括在日本17家健康检查机构接受上消化道内镜筛查的总共33478人。BE和长段BE（LSBE）分别定义为柱状上皮化生食管≥1cm和≥3cm。进行逻辑回归分析以确定与BE相关的因素。
BE在男性和女性的所有10岁年龄组中都相对常见（10%-20%）。虽然LSBE的患病率很低（0.2%），但在男性中其患病率在较年轻的年龄就开始增加。在男性队列的多变量分析中，虽然体重指数（BMI）与BE呈负相关，调整后的优势比（95%置信区间）为0.84（0.74-0.95），但腰围（WC）与BE呈正相关，为1.26（1.13-1.41）。此外，这种关联在LSBE中更为明显。相比之下，在女性中未观察到BMI或WC与BE之间存在这种关联。
这项全国性的日本多中心研究深入了解了日本人群中BE的年龄分布。此外，我们的研究结果表明，低BMI/高WC是日本男性人群中BE的一个重要危险因素。
