Visceral adipose tissue increased risk for Barrett’s esophagus
Larger quantities of visceral abdominal fat, relative to subcutaneous fat, significantly increased patient risk for Barrett’s esophagus, according to recent study results.
In a large-scale case-control study at the Michael E. DeBakey Department of Veterans Affairs Medical Center in Houston, standardized mid-abdominal noncontrast computed tomography (CT) scans were provided to 173 patients (mean age, 63.1 years; 98% men) with Barrett’s esophagus (BE) and two control groups (colonoscopy, n=343; endoscopy, n=172). Images were analyzed using semi-automated image segmentation software. The effect of visceral adipose tissue (VAT) and subcutaneous adipose tissue (SAT) surface areas and their ratio (VAT to SAT) on BE then were analyzed in logistic regression models.
“The amount of visceral, but not subcutaneous, abdominal fat was associated with a significant increase in the risk of BE,” the researchers reported. “The association can be partly explained by the presence of gastroesophageal reflux disease (GERD) symptoms, but also seen among those without GERD.”
Patients with BE were more than twice as likely to be in the highest tertile of VAT/SAT ratio (OR=2.42; 95% CI, 1.51-3.88) when compared with colonoscopy controls. When adjusted for age, race, gender, smoking, Helicobacter pylori and alcohol and nonsteroidal anti-inflammatory drug use, the association was attenuated (aOR=1.47; 95% CI, 0.88 to 2.45). Researchers said the association was particularly strong for patients with long segment (≥3 cm) BE (OR=3.42; 95% CI, 1.67-7.01; aOR=1.93; 95% CI, 0.92-4.09 for patients without GERD or using proton pump inhibitors) and for white men (aOR=2.12; 95% CI, 1.15-3.9).
“Our study showed that CT scan measuring visceral abdominal fat is a significant independent risk factor for BE,” the researchers concluded. “The mechanisms for this association need to be further examined.Targeting such mechanisms may have important implications in understanding the pathogenesis of Barrett’s as well as its prevention.”
Disclosure: The researchers report no relevant financial disclosures.