Inverse association between gluteofemoral obesity and risk of Barrett's esophagus in a pooled analysis

Kendall, Bradley J., Rubenstein, Joel H., Cook, Michael B., Vaughan, Thomas L., Anderson, Lesley A., Murray, Liam J., Shaheen, Nicholas J., Corley, Douglas A., Chandar, Apoorva K., Li, Li, Greer, Katarina B., Chak, Amitabh, El-Serag, Hashem B., Whiteman, David C. and Thrift, Aaron 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. doi:10.1016/j.cgh.2016.05.032

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Author Kendall, Bradley J.
Rubenstein, Joel H.
Cook, Michael B.
Vaughan, Thomas L.
Anderson, Lesley A.
Murray, Liam J.
Shaheen, Nicholas J.
Corley, Douglas A.
Chandar, Apoorva K.
Li, Li
Greer, Katarina B.
Chak, Amitabh
El-Serag, Hashem B.
Whiteman, David C.
Thrift, Aaron P.
Title Inverse association between gluteofemoral obesity and risk of Barrett's esophagus in a pooled analysis
Journal name Clinical Gastroenterology and Hepatology   Check publisher's open access policy
ISSN 1542-7714
Publication date 2016-10-01
Sub-type Article (original research)
DOI 10.1016/j.cgh.2016.05.032
Open Access Status File (Author Post-print)
Volume 14
Issue 10
Start page 1412
End page 1419.e3
Total pages 9
Place of publication Maryland Heights, MO, United States
Publisher W.B. Saunders
Collection year 2017
Language eng
Formatted 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.

Although abdominal obesity is associated with an increased risk of BE, there is an inverse association between gluteofemoral obesity and BE, particularly among men.
Keyword BEACON
Esophageal cancer
Risk factors
Q-Index Code C1
Q-Index Status Provisional Code
Institutional Status UQ

Document type: Journal Article
Sub-type: Article (original research)
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