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Influence of obesity on the risk of esophageal disorders

Nature Reviews Gastroenterology & Hepatology volume 8, pages 340–347 (2011)Cite this article

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Abstract

Obesity is associated with an increased risk of esophageal disorders, including esophageal adenocarcinoma, Barrett esophagus and GERD. For reasons yet unknown, the association between obesity and esophageal adenocarcinoma seems to be stronger than that for other types of obesity-related cancers. Predominantly abdominal or intra-abdominal adiposity (representing visceral fat and other fat within the abdominal cavity), which is more frequently observed in men than in women, is more strongly linked with these esophageal disorders than BMI alone, a finding that might contribute to the striking male predominance of esophageal adenocarcinoma. Research has identified potential mechanisms underlying the strong link between obesity and esophageal conditions. These findings are summarized in this Review, but more research remains to be carried out before these mechanisms are established.

Key Points

  • Obesity, particularly with a predominantly abdominal distribution of fat, is associated with an increased risk of esophageal adenocarcinoma, Barrett esophagus and GERD

  • Increase in BMI correlates clearly and proportionally with an increased risk of esophageal adenocarcinoma and GERD; however, corresponding data regarding Barrett esophagus are less clear

  • Body fat distribution, especially the presence of abdominal adiposity, is a factor in the link between obesity and esophageal disorders

  • Molecular mechanisms involving leptin, adiponectin and estrogen have been proposed to explain the association between obesity and these esophageal conditions

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Acknowledgements

The author is supported by grants from the Swedish Cancer Society and the Swedish Research Council. These funding agencies were not involved in the design or implementation of the study, the collection, management, analysis, or interpretation of the data, or the preparation, review, or approval of the manuscript. C. P. Vega, University of California, Irvine, CA, is the author of and is solely responsible for the content of the learning objectives, questions and answers of the Medscape, LLC-accredited continuing medical education activity associated with this article.

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  1. Department of Molecular Medicine and Surgery, Karolinska Institutet, Upper Gastrointestinal Research, Norra Stationsgatan 67, 2nd floor, SE-171 76, Stockholm, Sweden

    Jesper Lagergren

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Lagergren, J. Influence of obesity on the risk of esophageal disorders. Nat Rev Gastroenterol Hepatol 8, 340–347 (2011). https://doi.org/10.1038/nrgastro.2011.73

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