Relationship between body mass index and the risk of early gastric cancer and dysplasia regardless of Helicobacter pylori infection

• Published in: Gastric cancer : official journal of the International Gastric Cancer Association and the Japanese Gastric Cancer Association Vol. 18; no. 4; pp. 762 - 773
• Main Authors: Kim, Hee Jin, Kim, Nayoung, Kim, Hyun Young, Lee, Hye Seung, Yoon, Hyuk, Shin, Cheol Min, Park, Young Soo, Park, Do Joong, Kim, Hyung Ho, Lee, Kyoung-Ho, Kim, Young-Hoon, Kim, Hee Man, Lee, Dong Ho
• Format: Journal Article
• Language: English
• Published: Tokyo Springer Japan 01.10.2015; Springer Nature B.V
• Subjects: Abdominal Surgery; Adenocarcinoma - epidemiology; Adult; Aged; Aged, 80 and over; Body Mass Index; Cancer Research; Case-Control Studies; Female; Gastric cancer; Gastroenterology; Helicobacter Infections - complications; Helicobacter Infections - epidemiology; Helicobacter pylori; Humans; Male; Medicine; Medicine & Public Health; Middle Aged; Obesity - complications; Oncology; Original Article; Precancerous Conditions - epidemiology; Republic of Korea; Risk Factors; Sex Factors; Stomach Neoplasms - epidemiology; Surgical Oncology; Republic of Korea; Body mass index; Gastric cancer; Gastric dysplasia; Helicobacter pylori
• ISSN: 1436-3291; 1436-3305
• DOI: 10.1007/s10120-014-0429-0

s Background Obesity is known to be associated with an increased risk of gastric cardia cancer but not with noncardia cancer. In terms of gastric dysplasia, few studies have evaluated its relationship with obesity. In addition, no study on the relationship between obesity and the risk of gastric cancer has analyzed the status of Helicobacter pylori infection. Methods A case–control study was designed to investigate the relationship between obesity and the risk of gastric cancer and dysplasia adjusted for the status of H. pylori infection in Koreans. Nine hundred ninety-eight gastric cancer patients, 313 gastric dysplasia patients, and 1,288 subjects with normal endoscopic findings were included. Results As gender differences could be the largest confounding factor, the risk of gastric cancer and dysplasia with an increasing body mass index (BMI) was analyzed in men and women, separately, and was adjusted for age, smoking, drinking, family history of gastric cancer, H. pylori infection, atrophic gastritis, intestinal metaplasia, and serum pepsinogen I/pepsinogen II ratio. Obesity (BMI 25 kg/m 2 or greater but less than 30 kg/m 2 ) was associated with increased risk of early gastric cancer [adjusted odds ratio (aOR) 1.657; 95 % confidence interval (CI) 1.086–2.528; P  = 0.019] and well or moderately differentiated adenocarcinoma (aOR 1.566; 95 % CI 1.011–2.424; P  = 0.044) compared with normal BMI status (BMI < 23 kg/m 2 ) in men. Obesity was related to gastric dysplasia (aOR 2.086; 95 % CI 1.011–4.302; P  = 0.047) in women. Conclusions The effect of obesity on gastric cancer showed a gender difference. That is, in men it was related to increased risk of early gastric cancer and well or moderately differentiated adenocarcinoma, but it was associated with gastric dysplasia in women regardless of H. pylori infection in Korea. Further research into this difference is necessary.