Central Obesity and H. pylori Infection Influence Risk of Barrett's Esophagus in an Asian Population

• Published in: PloS one Vol. 11; no. 12; p. e0167815
• Main Authors: Chen, Chih-Cheng, Hsu, Yao-Chun, Lee, Ching-Tai, Hsu, Chia-Chang, Tai, Chi-Ming, Wang, Wen-Lun, Tseng, Cheng-Hao, Hsu, Chao-Tien, Lin, Jaw-Town, Chang, Chi-Yang
• Format: Journal Article
• Language: English
• Published: United States Public Library of Science 09.12.2016; Public Library of Science (PLoS)
• Subjects: Adult; Aged; Asian Continental Ancestry Group; Barrett esophagus; Barrett Esophagus - microbiology; Big Data; Biology and Life Sciences; Biopsy; Body mass; Body mass index; Body size; Cholesterol; Comparative analysis; Complications and side effects; Confidence intervals; Endoscopy; Esophagus; Female; Gastroenterology; Health risks; Helicobacter infections; Helicobacter pylori; Helicobacter pylori - pathogenicity; Humans; Infections; Internal medicine; Male; Medicine; Medicine and Health Sciences; Metabolic syndrome; Middle Aged; Obesity; Obesity, Abdominal - pathology; People and Places; Physical Sciences; Population; Regression analysis; Research and Analysis Methods; Risk analysis; Risk factors; Statistical analysis; Studies; Systematic review; Urease; United States
• ISSN: 1932-6203; 1932-6203
• DOI: 10.1371/journal.pone.0167815

The prevalence rates of Barrett's esophagus (BE) in western countries are higher than Asian ones, but little is known about their difference among risk factors of BE. The aim of this study is to investigate the associations of various risk factors including central obesity, body mass index (BMI), metabolic syndrome and H. pylori infection, with BE. A total of 161 subjects with BE were enrolled and compared to age- and gender-matched controls randomly sampled (1:4) from check-up center in same hospital. Central obesity was defined by waist circumference (female>80cm; male>90cm), metabolic syndrome by the modified National Cholesterol Education Program Adult Treatment Panel III criteria in Taiwan. Independent risk factors for BE were identified by multiple logistic regression analyses. The mean age for BE was 53.8±13.7 years and 75.8% was male. H. pylori infection status was detected by the rapid urease test with the prevalence of 28.4% and 44.4% in the BE patients and controls, respectively. The univariate logistic regression analyses showed the risk was associated with higher waist circumference (odds ratio [OR], 2.53; 95% confidence interval [CI], 1.78-3.60), metabolic syndrome (OR, 2.02; 95% CI, 1.38-2.96) and negative H. pylori infection (OR, 0.50; 95% CI, 0.34-0.74). However, multivariate logistic regression analyses revealed that BE associated with higher waist circumference (adjusted OR, 2.79; 95% CI, 1.89-4.12) and negative H. pylori infection (adjusted OR, 0.46; 95% CI, 0.30-0.70). Central obesity is associated with a higher risk of BE whereas H. pylori infection with a lower risk in an ethnic Chinese population.