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Type 2 diabetes linked to greater risk for Barrett’s esophagus

Issue: November 25, 2012

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LAS VEGAS — Patients with type 2 diabetes are at increased risk for developing Barrett’s esophagus, according to data presented at the 2012 American College of Gastroenterology Annual Scientific Meeting.

In a population-based, case-control study, researchers evaluated data from 14,245 patients with Barrett’s esophagus (BE) along with 70,361 matched controls without BE, and assessed potential associations between BE and type 2 diabetes (DM2).

Patients with BE had significantly higher BMI (27 vs. 26.8) and were more likely to have smoked (52% vs. 49.9%), consumed alcohol (66% vs. 60%) and have had diagnoses of GERD (84% vs. 32%) and DM2 (5.8% vs. 5.3%) than controls (P<.001 for all).

Investigators observed a significant association between BE and DM2 diagnosed before BE (OR=2.03; 95% CI, 1.2-3.6) after adjusting for known risk factors. Greater BE risk was observed among those with BMI between 25 and 29.9 (OR=1.2; 95% CI, 1.04-1.40), patients with GERD at baseline (OR=10.17; 95% CI, 8.68-11.92), and patients who had ever consumed alcohol (OR=1.42; 95% CI, 1.15-1.74). Researchers also noted an increased risk among patients diagnosed with DM2 for more than 1 year (OR=7.7; P=.004).

The association between DM2 and BE was stronger among men (OR=2.03; 95% CI, 1.01-4.04) than women (OR=1.37; 95% CI, 0.63-2.97). In a press release, researcher Prasad G. Iyer, MD, Mayo Clinic College of Medicine, Rochester, Minn., suggested that the elevated risk could be due to men carrying more abdominal fat than women.

“DM2 was a risk factor for BE independent of obesity and other known risk factors of BE,” the researchers concluded. “This supports the role of increased visceral fat and visceral fat produced mediators such as the insulin-insulin growth factor pathway in BE pathogenesis and esophageal carcinogenesis. Patients with DM2 may constitute a high-risk group for BE.”

For more information:

Iyer PG. #49: Diabetes Mellitus Increases the Risk of Barrett’s Esophagus: Results from a Large Population Based Case Control Study. Presented at: the 2012 American College of Gastroenterology Annual Scientific Meeting; Oct. 19-24, Las Vegas.

Disclosure: Industry support was provided by Takeda Pharmaceuticals.