This study investigates the connection between obesity and the advancement of Barrett’s esophagus (BE).
The researchers conducted a systematic review and meta-analysis of 20 studies involving 38,565 patients, with 74.4% being male, among whom 1,684 were diagnosed with HGD or cancer. The analysis focused on the impact of body mass index (BMI) on the progression of non-dysplastic BE or low-grade dysplasia (LGD) to more severe conditions. The researchers used a two-stage dose-response meta-analysis to determine the relationship between BMI and malignant progression.
The findings showed that out of 6,647 male patients with non-dysplastic BE/LGD at baseline, 555 progressed to HGD/EAC, resulting in a pooled annual progression rate of 0.02%. In contrast, 1,992 female patients showed a lower progression rate of 0.01%. Notably, there was no significant difference in progression rates between genders (p=0.15).
Every 5 kg/m² increase in BMI was linked to a 6% increased risk of malignant progression, with an adjusted odds ratio of 1.06 (95% CI 1.02-1.10; p<0.001; I²=0%). This indicates a clear dose-response relationship between obesity and the risk of progression.
The study concludes that obesity is associated with an increased risk of malignant progression in BE, emphasizing the necessity for additional high-quality cohort studies to validate these findings.
https://www.cghjournal.org/article/S1542-3565(24)00796-1/fulltext