Inverse Association Between Gluteofemoral Obesity and Risk of Barrett's Esophagus in a Pooled Analysis

Bradley J. Kendall, Joel H. Rubenstein, Michael B. Cook, Thomas L. Vaughan, Lesley A. Anderson, Liam J. Murray, Nicholas J. Shaheen, Douglas A. Corley, Apoorva K. Chandar, Li Li, Katarina B. Greer, Amitabh Chak, Hashem B. El-Serag, David C. Whiteman, Aaron P. Thrift*

*Corresponding author for this work

Research output: Contribution to journalArticle

7 Citations (Scopus)

Abstract

Background & Aims Gluteofemoral obesity (determined by measurement of subcutaneous fat in the hip and thigh regions) could reduce risks of cardiovascular and diabetic disorders associated with abdominal obesity. We evaluated whether gluteofemoral obesity also reduces the risk of Barrett's esophagus (BE), a premalignant lesion associated with abdominal obesity. Methods We collected data from non-Hispanic white participants in 8 studies in the Barrett's and Esophageal Adenocarcinoma Consortium. We compared measures of hip circumference (as a proxy for gluteofemoral obesity) from cases of BE (n = 1559) separately with 2 control groups: 2557 population-based controls and 2064 individuals with gastroesophageal reflux disease (GERD controls). Study-specific odds ratios (ORs) and 95% confidence intervals (95% CIs) were estimated using individual participant data and multivariable logistic regression and combined using a random-effects meta-analysis. Results We found an inverse relationship between hip circumference and BE (OR per 5-cm increase, 0.88; 95% CI, 0.81–0.96), compared with population-based controls in a multivariable model that included waist circumference. This association was not observed in models that did not include waist circumference. Similar results were observed in analyses stratified by frequency of GERD symptoms. The inverse association with hip circumference was statistically significant only among men (vs population-based controls: OR, 0.85; 95% CI, 0.76–0.96 for men; OR, 0.93; 95% CI, 0.74–1.16 for women). For men, within each category of waist circumference, a larger hip circumference was associated with a decreased risk of BE. Increasing waist circumference was associated with an increased risk of BE in the mutually adjusted population-based and GERD control models. Conclusions Although abdominal obesity is associated with an increased risk of BE, there is an inverse association between gluteofemoral obesity and BE, particularly among men.

Original languageEnglish
Pages (from-to)1412-1419.e3
Number of pages11
JournalClinical Gastroenterology and Hepatology
Volume14
Issue number10
Early online date2 Jun 2016
DOIs
Publication statusPublished - 1 Oct 2016

Keywords

  • BEACON
  • Epidemiology
  • Esophageal Cancer
  • Obesity
  • Risk Factors

ASJC Scopus subject areas

  • Hepatology
  • Gastroenterology

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    Kendall, B. J., Rubenstein, J. H., Cook, M. B., Vaughan, T. L., Anderson, L. A., Murray, L. J., Shaheen, N. J., Corley, D. A., Chandar, A. K., Li, L., Greer, K. B., Chak, A., El-Serag, H. B., Whiteman, D. C., & Thrift, A. P. (2016). Inverse Association Between Gluteofemoral Obesity and Risk of Barrett's Esophagus in a Pooled Analysis. Clinical Gastroenterology and Hepatology, 14(10), 1412-1419.e3. https://doi.org/10.1016/j.cgh.2016.05.032