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Body Mass Index and Barrett’s Oesophagus in Women
  1. Brian C Jacobson (brian.jacobson{at}bmc.org)
  1. Boston University Medical Center, United States
    1. Andrew T Chan
    1. Channing Laboratory, Brigham and Women's Hospital, Harvard Medical School, United States
      1. Edward L Giovannucci
      1. Harvard School of Public Health, United States
        1. Charles S Fuchs
        1. Channing Laboratory, Brigham and Women's Hospital, Harvard Medical School, United States

          Abstract

          Objective: Excess body mass is associated with symptoms of gastroesophageal reflux disease, and cross-sectional studies suggest an association between body mass index (BMI) and Barrett’s oesophagus. We sought to prospectively examine the influence of BMI and other anthropomorphic measures on the risk for Barrett’s oesophagus among women.

          Design: Prospective cohort study.

          Setting: Nurses’ Health Study.

          Participants: 15,861 women without a history of cancer, who underwent upper gastrointestinal endoscopy for any reason between 1986 and 2004.

          Main outcome measures: 261 cases of pathologically confirmed specialised intestinal metaplasia within the oesophagus (Barrett’s oesophagus). Self-reported data on weight were collected from biennial questionnaires. Self-reported height was collected in 1976, and self-reported waist and hip circumferences were collected in 1986.

          Results: Compared to women with BMI 20-24.9 kg/m2, women with BMI 25-29.9 had a multivariate odds ratio for Barrett’s oesophagus of 0.92 (95% CI 0.66-1.27), women with BMI >30 had a multivariate odds ratio of 1.52 (95% CI 1.02-2.28), and women with BMI <20 had a multivariate odds ratio of 0.92 (95% CI 0.65-1.31). Results were similar when controlling for symptoms of gastroesophageal reflux, and among the entire Nurses’ Health Study cohort (n=93,609) regardless of a history of endoscopy. In contrast, waist-to-hip ratio, waist circumference, and height did not appear to be associated with Barrett’s oesophagus.

          Conclusions: Obese, but not overweight, women appear to be at increased risk for Barrett’s oesophagus.

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