In addition to the mechanical effects of abdominal obesity, that is, increase of the intra-abdominal pressure by the presence of a large amount of adipose tissue, circulating factors secreted from the visceral adipose tissue, such as tumor necrosis factor-α(TNF-α), interleukin-6 (IL-6), leptin, and adiponectin, have also been proposed to be pathogenically linked to BE and esophageal adenocarcinoma [21-26]. This evidence concerns the gene TNF and esophageal adenocarcinoma.