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ToolsKo, Mie Thu, Thomas, Tom, Holden, Emily, Beales, Ian L. P. and Alexandre, Leo (2024) The association between obesity and malignant progression of Barrett’s Esophagus: A systematic review and dose-response meta-analysis. Clinical Gastroenterology and Hepatology. ISSN 1542-3565
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Abstract
Background and Aims: Obesity is a risk factor for both Barrett's esophagus (BE) and esophageal adenocarcinoma (EAC). However, it is unclear whether obesity drives the malignant progression of BE. We aimed to assess whether obesity is associated with high-grade dysplasia (HGD) or cancer in patients with BE. Methods: We searched MEDLINE and EMBASE from inception through April 2024 for studies reporting the effect of body mass index (BMI) on the progression of nondysplastic BE or low-grade dysplasia (LGD) to HGD or EAC. A 2-stage dose-response meta-analysis was performed to estimate the dose-response relationship between BMI with malignant progression. Study quality was appraised using a modified Newcastle-Ottawa scale. Results: Twenty studies reported data on 38,565 patients (74.4% male) in total, of whom 1684 patients were diagnosed with HGD/cancer. Nineteen studies were considered moderate to high quality. Eight cohort studies reported data on 6647 male patients with baseline nondysplastic BE/LGD, of whom 555 progressed to HGD/EAC (pooled annual rate of progression, 0.02%; 95% confidence interval [CI], 0.01%–0.03%), and 1992 female patients with baseline nondysplastic BE/LGD, with 110 progressors (pooled annual rate of progression, 0.01%; 95% CI, 0.01%–0.02%). There was no significant difference in pooled annual rate of progression between males and females (P =.15). Each 5-kg/m 2 increase in BMI was associated with a 6% increase in the risk of malignant progression (adjusted odds ratio, 1.06; 95% CI, 1.02–1.10; P <.001; I 2 = 0%). Conclusion: Our meta-analysis provides some evidence that obesity as measured by BMI is associated with malignant progression of BE with a dose-response relationship. This finding requires confirmation in future high-quality cohort studies. Future risk prediction models could incorporate measures of obesity to potentially improve risk stratification in patients with BE. PROSPERO, Number: CRD42017051046.
| Item Type: | Article |
|---|---|
| Additional Information: | Data availability statement: The dataset is available from the corresponding author. |
| Uncontrolled Keywords: | barrett's esophagus,eac,obesity,risk factor,gastroenterology,hepatology,sdg 3 - good health and well-being ,/dk/atira/pure/subjectarea/asjc/2700/2715 |
| Faculty \ School: | Faculty of Medicine and Health Sciences > Norwich Medical School |
| UEA Research Groups: | Faculty of Medicine and Health Sciences > Research Centres > Metabolic Health Faculty of Science > Research Groups > Norwich Epidemiology Centre Faculty of Medicine and Health Sciences > Research Groups > Norwich Epidemiology Centre Faculty of Medicine and Health Sciences > Research Groups > Gastroenterology and Gut Biology |
| Related URLs: | |
| Depositing User: | LivePure Connector |
| Date Deposited: | 10 Sep 2024 16:30 |
| Last Modified: | 18 Nov 2024 00:56 |
| URI: | https://ueaeprints.uea.ac.uk/id/eprint/96678 |
| DOI: | 10.1016/j.cgh.2024.07.041 |
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