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. 2013 Dec;62(12):1684-91.
doi: 10.1136/gutjnl-2012-303753. Epub 2013 Jan 26.

Sex-specific associations between body mass index, waist circumference and the risk of Barrett's oesophagus: a pooled analysis from the international BEACON consortium

Ai Kubo  1 , Michael Blaise Cook, Nicholas J Shaheen, Thomas L Vaughan, David C Whiteman, Liam Murray, Douglas A Corley
Affiliations

Sex-specific associations between body mass index, waist circumference and the risk of Barrett's oesophagus: a pooled analysis from the international BEACON consortium

Ai Kubo et al. Gut. 2013 Dec.

Abstract

Objective: Barrett's oesophagus is a precursor lesion of oesophageal adenocarcinoma, a cancer that, in the USA, has increased in incidence over 600% during the past 40 years. Barrett's oesophagus and oesophageal adenocarcinoma are much more common among men than among women; this finding is unexplained and most earlier studies lacked sufficient numbers of women to evaluate sex-specific risk factors. We leveraged the power of an international consortium to assess sex-specific relationships between body mass index (BMI), abdominal circumference and Barrett's oesophagus.

Design: Four case-control studies provided a total of 1102 cases (316 women, 786 men) and 1400 population controls (436 women, 964 men) for analysis. Study-specific estimates, generated using individual participant data, were combined using random effects meta-analysis.

Results: Waist circumference was significantly associated with Barrett's oesophagus, even after adjustment for BMI; persons in the highest versus the lowest quartiles of waist circumference had approximately 125% and 275% increases in the odds of Barrett's oesophagus among men and women, respectively (OR 2.24, 95% CI 1.08 to 4.65, I(2)=57; OR 3.75, 95% CI 1.47 to 9.56, I(2)=0). In contrast, there was no evidence of a significant association between BMI and the risk of Barrett's oesophagus, with or without adjustment for waist circumference.

Conclusions: Waist circumference, independent of BMI, was found to be a risk factor for Barrett's oesophagus among both men and women. Future studies examining the biological mechanisms of this association will extend our knowledge regarding the pathogenesis of Barrett's oesophagus.

Keywords: Barrett's Oesophagus; Gastroesophageal Reflux Disease; Nutrition; Obesity.

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Figures

Figure 1
Figure 1
Forrest plots of the relationship between quartiles of waist circumference and Barrett’s oesophagus for men (a) and women (b). (a) Men, model was adjusted for age (categorical), race, education, smoking (pack-years) and body mass index (BMI) (continuous). (b) Women, model was adjusted for age (categorical), race, education, smoking (pack-years) and BMI (continuous).
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Supplementary concepts