Central adiposity linked to risk of esophageal cancer

(HealthDay)—A systematic review and meta-analysis of observational studies shows that central adiposity, independent of body mass index (BMI), is associated with increased risk of esophageal inflammation, metaplasia, and adenocarcinoma, according to research published in the November issue of Clinical Gastroenterology and Hepatology.

Siddharth Singh, M.B.B.S., of the Mayo Clinic in Rochester, Minn., and colleagues conducted a systematic review and meta-analysis to assess the association between central adiposity and erosive esophagitis (EE), Barrett's esophagus (BE), and esophageal adenocarcinoma (EAC).

The researchers found that, compared with patients with normal physique, those with central adiposity had an increased risk of EE (19 studies; adjusted odds ratio [aOR], 1.87). An association between central adiposity and increased risk of BE (17 studies; aOR, 1.98) was found, and persisted after adjustment for BMI (five studies; aOR, 1.88). In studies using gastroesophageal reflux disease (GERD) patients as controls or adjusting for GERD symptoms, a reflux-independent association between visceral fat and BE (11 studies; aOR, 2.04) was identified. Central adiposity also was linked with greater risk of EAC (six studies; aOR, 2.51).

"Future studies aimed at understanding the mechanistic effect of obesity on esophageal inflammation and neoplasia should focus on visceral fat rather than overall obesity," the authors write.