Abdominal obesity is a strong risk factor for Barrett's esophagus, according to a study led by Dr. Thomas Vaughan of the Public Health Sciences Division. Aside from chronic reflux, there is scant knowledge about the cause of Barrett's. The study is one of the first to look at the association between the condition and multiple measures of obesity.
Barrett's esophagus is a precancerous condition in the lining of the esophagus, the tube that runs from the mouth to the stomach. Barrett's develops in 10 percent to 15 percent of people with reflux disease, a condition that causes chronic heartburn. People with Barrett's esophagus develop esophageal cancer at a rate 30 to 45 times greater than in the normal population. It is the most rapidly increasing cancer in the United States, rising 600 percent in the last 30 years, with the most dramatic rise in white males.
Vaughan and PHS colleagues Zoe Edelstein and Diana Farrow conducted the study in 404 gastroenterology patients and controls over a three-year period. Drs. Mary Bronner and Sheldon Rosen of the Cleveland Clinic and Group Health Cooperative, respectively, also contributed to the research.
The study found a history of cigarette smoking also predicted risk of Barrett's esophagus, but there was no evidence of increased risk with longer exposure to cigarettes, nor was there evidence of decreased risk after patients quit smoking.
The researchers believe abdominal obesity may affect risk of Barrett's independently of reflux by altering metabolic activity or increasing inflammation. The findings help explain the male preponderance of this precancerous condition.
The observations suggest weight loss might be a fruitful approach to preventing Barrett's esophagus and esophageal cancer, the authors said.
Read the Vaughan paper at www.gastrojournal.org/article/PIIS0016508507010086/abstract.