RESUMO
BACKGROUND: Obesity is a risk factor for developing Barrett's esophagus (BE), a precursor to esophageal cancer. Long BE lengths are associated with greater risk for malignancy. How weight gains from young adulthood (defined as ages 19 to 29 years) affect BE length is unknown. OBJECTIVE: To examine current body mass index (BMI), weight gains from young adulthood, and evening snacking near bedtime during young adulthood in BE patients. DESIGN: Cross-sectional analysis of 71 patients from 2001 to 2008 from a 600-bed tertiary care center in the United States who were newly diagnosed with BE by endoscopy and mucosal biopsies. MAIN OUTCOME MEASURES: Barrett's esophagus length and age at presentation. STATISTICAL ANALYSES PERFORMED: Pearson's correlation coefficient (r) measured the linear association between continuous variables. The Kruskal-Wallis test was used to compare medians by segment length and the chi-squared test or Fisher's exact test for categorical data. Quantile regression was used for multivariable adjustment. RESULTS: Younger patients had higher BMIs at diagnosis (r=-0.32, P=0.007). Patients who gained more than 23 kg from young adulthood were diagnosed at an adjusted median age of 18.0 years younger 95% CI (6.1-29.9, P=0.004) than patients with no weight gains. BMI was not correlated with BE length (r=-0.12, P=0.33). Weight gains from young adulthood were not associated with BE length after multivariable adjustment (P=0.19). Patients whose late evening snack or bedtime was less than 4 hours from dinner had longer median BE lengths than those who went to bed later (5 vs 2 cm, P=0.02). CONCLUSIONS: Longer BE lengths were associated with shorter dinner-bedtime intervals during young adulthood but not with current BMI or weight gains from young adulthood.
Assuntos
Esôfago de Barrett/epidemiologia , Índice de Massa Corporal , Comportamento Alimentar , Aumento de Peso , Adulto , Idoso , Estudos Transversais , Feminino , Humanos , Modelos Lineares , Masculino , Pessoa de Meia-Idade , Obesidade/epidemiologia , Fatores de Risco , Lanches , Adulto JovemRESUMO
BACKGROUND: Barrett's Esophagus (BE), particularly long-segment Barrett's Esophagus, and the age of onset of Barrett's Esophagus are risk factors for esophageal adenocarcinoma. However, it is unknown if lifestyle factors such as alcohol abuse, tobacco use, weight gains that increase the risk of developing BE and esophageal adenocarcinoma affect its length or age at diagnosis. METHODS: In a retrospective, cross-sectional analysis, we analyzed 158 newly diagnosed adult BE patients at a 600-bed tertiary care center in the United States from 1999 to 2008. We constructed generalized linear models for the outcomes of BE length and age at diagnosis. Predictors of interest included current or prior alcohol abuse, tobacco use, weight gain over the last 5 years, and body mass index (BMI). RESULTS: 71 (45%) had length ≥ 3 cm. Barrett's Esophagus length was positively correlated with hiatal hernia length (r=0.67, p<0.001) and heartburn duration (r=0.36, p<0.001). Multivariate results showed no significant relationship between alcohol abuse, tobacco use, weight gain or BMI and BE length. Patients with weight gain, current tobacco use, and male gender were diagnosed at a significantly younger age than their peers (for example, the adjusted mean age at diagnosis for current tobacco users vs. non-smokers was 49.2 years vs. 54.7 years, p=0.029). CONCLUSIONS: Lifestyle factors did not appear to affect Barrett's Esophagus length but weight gains, smoking, and male gender were associated with a diagnosis at a significantly younger age.
