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15-04-2010 | Gastroenterology | Article

Central obesity and the metabolic syndrome similarly common in BE and GERD

Abstract

Free abstract

MedWire News: Central obesity and the metabolic syndrome may not impact on the development of Barrett’s esophagus (BE) in reflux patients, Irish researchers say.

They found that central obesity and the metabolic syndrome were similarly common in patients with proven BE or gastroesophageal reflux disease (GERD).

However, the team adds that the importance of obesity and the metabolic syndrome in BE disease progression merits further study.

Obesity is an established risk factor for esophageal adenocarcinoma, although the mechanism behind this is unclear, note John Reynolds and colleagues at St James’s Hospital in Dublin.

A pathway from reflux to inflammation through metaplasia is the dominant hypothesis, they say, but an added role relating to visceral adiposity and the metabolic syndrome has been mooted in BE patients.

Reynolds et al investigated whether the obesity and metabolic syndrome profiles of BE and GERD differed by conducting a nutritional and metabolic assessment of patients with either condition randomly identified from unit registry data.

Obesity, defined as a body mass index of more than 30 kg/m2, was similarly common in the 118 BE patients and the 113 age- and gender-matched GERD control individuals, at 36% and 38%, respectively.

The pattern of fat deposition was predominantly central, with a corresponding estimated trunk fat mass of 13 kg and 14 kg, respectively.

The metabolic syndrome was significantly more common in BE than GERD patients using criteria outlined by the National Cholesterol Education Program, at 30% versus 20%, respectively.

However, there was no significant difference when the International Diabetes Federation criteria were used.

Reporting in the journal Diseases of the Esophagus, the authors conclude: “Obesity, in particular central obesity, is common in both BE and GERD.

“There is a modest trend for higher metabolic and inflammatory responses in the BE cohort but no differential pattern emerged.”

MedWire (www.medwire-news.md) is an independent clinical news service provided by Current Medicine Group, a trading division of Springer Healthcare Limited. © Springer Healthcare Ltd; 2010

By Anita Wilkinson