title: Serum levels of leptin as marker for patients at high risk of gastric cancer.
abstract: 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.
authors.affiliation: Department of Gastroenterology, Erasmus MC University Medical Center, Rotterdam, The Netherlands. l.capelle@erasmusmc.nl
authors.forename: Lisette G
authors.initials: LG
authors.lastname: Capelle
authors.forename: Annemarie C
authors.initials: AC
authors.lastname: de Vries
authors.forename: Jelle
authors.initials: J
authors.lastname: Haringsma
authors.forename: Ewout W
authors.initials: EW
authors.lastname: Steyerberg
authors.forename: Caspar W N
authors.initials: CW
authors.lastname: Looman
authors.forename: Nicole M A
authors.initials: NM
authors.lastname: Nagtzaam
authors.forename: Herman
authors.initials: H
authors.lastname: van Dekken
authors.forename: Frank
authors.initials: F
authors.lastname: ter Borg
authors.forename: Richard A
authors.initials: RA
authors.lastname: de Vries
authors.forename: Ernst J
authors.initials: EJ
authors.lastname: Kuipers
mesh_terms: 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
chemical_list: D015415:Biomarkers; D020738:Leptin