Serum levels of leptin as marker for patients at high risk of gastric cancer.
BACKGROUND
Serological screening for gastric cancer (GC) may reduce mortality. However, optimal serum markers for advanced gastric precursor lesions are lacking.


OBJECTIVE
To evaluate in a case-control study whether serum leptin levels correlate with intestinal metaplasia (IM) and can serve as a tool to identify patients at high risk for GC.


METHODS
Cases were patients with a previous diagnosis of IM or dysplasia, controls were patients without such a diagnosis. All patients underwent endoscopy. Fasting serum was collected for the measurement of leptin, pepsinogens I/II, gastrin, and Helicobacter pylori. Receiver operating characteristic (ROC) curves and their area under the curve (AUC) were provided to compare serum leptin levels with other serological markers.


RESULTS
One hundred nineteen cases and 98 controls were included. In cases, the median leptin levels were 116.6 pg/mL versus 81.9 pg/mL in controls (p = .01). After adjustment for age, sex and BMI, leptin levels remained higher in cases than in controls (p < .005). In multivariate analysis, male sex (p = .002), age (<0.001), low pepsinogen levels (p = .004) and high leptin levels (p = .04) were independent markers for the presence of IM. In addition, a ROC curve including age, sex and pepsinogen I levels had an AUC of 0.79 (95% CI (0.73-0.85)). Adding serum leptin levels increased the AUC to 0.81 (95% CI (0.75-0.86)).


CONCLUSIONS
High leptin levels are associated with an increased risk of IM. Moreover, serum leptin levels are a significant independent marker for the presence of IM. However, in combination with the serological test for pepsinogen I the additional value of serum leptin levels is rather limited.
Capelle
Lisette G
LG
Department of Gastroenterology, Erasmus MC University Medical Center, Rotterdam, The Netherlands. l.capelle@erasmusmc.nl
de Vries
Annemarie C
AC
Haringsma
Jelle
J
Steyerberg
Ewout W
EW
Looman
Caspar W N
CW
Nagtzaam
Nicole M A
NM
van Dekken
Herman
H
ter Borg
Frank
F
de Vries
Richard A
RA
Kuipers
Ernst J
EJ
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D015415:Biomarkers / Q000097:blood; D016022:Case-Control Studies; D005260:Female; D016481:Helicobacter Infections / Q000097:blood* / Q000453:epidemiology* / Q000473:pathology; D016480:Helicobacter pylori / Q000502:physiology; D006801:Humans; D007422:Intestines / Q000473:pathology; D020738:Leptin / Q000097:blood*; D008297:Male; D008679:Metaplasia / Q000473:pathology; D008875:Middle Aged; D012307:Risk Factors; D013274:Stomach Neoplasms / Q000097:blood* / Q000453:epidemiology* / Q000473:pathology; D055815:Young Adult
D015415:Biomarkers; D020738:Leptin