title: Association of low serum adiponectin levels with erosive esophagitis in men: an analysis of 2405 subjects undergoing physical check-ups.
abstract: BACKGROUND
  Obesity is a risk factor for gastro-esophageal reflux disease (GERD). It is generally considered that intra-abdominal pressure in obese subjects is involved in the pathogenesis of GERD through acid exposure to the esophagus. Recently, visceral fat has been recognized as an endocrine organ that secretes various adipocytokines including adiponectin. The aim of this study was to elucidate the relation between adiponectin and erosive esophagitis.
  
  
  METHODS
  This was a cross-sectional retrospective observational study: 2405 consecutive subjects who underwent screening esophago-gastro-duodenoscopy with serum adiponectin measurement as part of their physical check-up programs were analyzed. Clinical factors were compared between subjects with and without erosive esophagitis. The association between adiponectin and erosive esophagitis was assessed using a bootstrapping re-sampling method after adjustment for factors that tended to be different in univariate analysis.
  
  
  RESULTS
  Serum adiponectin levels were significantly lower in those with erosive esophagitis (8.17 μg/ml) than in those without (10.1). The erosive esophagitis group had a greater body mass index (BMI) and waist circumference (WC) and a higher prevalence of hiatal hernia. Using the bootstrap method, with a lower adiponectin cut-off value of 3-7 μg/ml, the lower limit of the 95% confidence interval of the adjusted odds ratio consistently exceeded 1 after adjustment for BMI and hiatal hernia in men. When adjusting for WC instead of BMI, the effect of adiponectin was reduced but remained significant at a lower cut-off value (3-3.5 μg/ml).
  
  
  CONCLUSIONS
  Low serum adiponectin levels may be associated with an increased risk for erosive esophagitis in men.
authors.affiliation: Department of Gastroenterology and Hepatology, Osaka University Graduate School of Medicine, 2-2 Yamadaoka, Suita, Osaka 565-0871, Japan.
authors.forename: Motohiko
authors.initials: M
authors.lastname: Kato
authors.forename: Kenji
authors.initials: K
authors.lastname: Watabe
authors.forename: Toshimitsu
authors.initials: T
authors.lastname: Hamasaki
authors.forename: Miyuki
authors.initials: M
authors.lastname: Umeda
authors.forename: Aiko
authors.initials: A
authors.lastname: Furubayashi
authors.forename: Kazuo
authors.initials: K
authors.lastname: Kinoshita
authors.forename: Osamu
authors.initials: O
authors.lastname: Kishida
authors.forename: Takashi
authors.initials: T
authors.lastname: Fujimoto
authors.forename: Akira
authors.initials: A
authors.lastname: Yamada
authors.forename: Yoshifumi
authors.initials: Y
authors.lastname: Tsukamoto
authors.forename: Shunsuke
authors.initials: S
authors.lastname: Yamamoto
authors.forename: Yoshihiro
authors.initials: Y
authors.lastname: Kamada
authors.forename: Yuichi
authors.initials: Y
authors.lastname: Yoshida
authors.forename: Shinichi
authors.initials: S
authors.lastname: Kiso
authors.forename: Shusaku
authors.initials: S
authors.lastname: Tsutsui
authors.forename: Shinji
authors.initials: S
authors.lastname: Kihara
authors.forename: Norio
authors.initials: N
authors.lastname: Hayashi
authors.forename: Yuji
authors.initials: Y
authors.lastname: Matsuzawa
mesh_terms: D052242:Adiponectin / Q000097:blood*; D000328:Adult; D000368:Aged; D015992:Body Mass Index; D003430:Cross-Sectional Studies; D016145:Endoscopy, Digestive System; D004941:Esophagitis / Q000209:etiology* / Q000473:pathology; D005260:Female; D006551:Hernia, Hiatal / Q000453:epidemiology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009765:Obesity / Q000150:complications*; D012189:Retrospective Studies; D012737:Sex Factors; D055105:Waist Circumference
chemical_list: D052242:Adiponectin