title: Circulating inflammatory cytokines and adipokines are associated with increased risk of Barrett's esophagus: a case-control study.
abstract: OBJECTIVE
  Obesity is associated with Barrett's esophagus (BE) and with changes in circulating levels of adipokines (leptin and adiponectin) and cytokines. Although studies have reported that adipokines and inflammatory cytokines are necessary for the development of BE, their role is controversial.
  
  
  METHODS
  We performed a case-control study; cases (n = 141) were patients who underwent esophagogastroduodenoscopy and were found to have BE, which was based on endoscopy and histology, and controls (n = 139) were primary care patients eligible for screening colonoscopies who agreed to undergo esophagogastroduodenoscopy. We examined the association between BE and circulating levels of adipokines and cytokines (interleukin [IL]-1β, IL-6, IL-8, IL-10, and IL-12p70; tumor necrosis factor-α; and interferon-γ). Cases and controls were compared by calculating odds ratios (ORs) and 95% confidence intervals (CIs) and using unadjusted and multiple logistic regression, adjusting for age, sex, race, waist-hip ratio, use of proton pump inhibitors and nonsteroidal anti-inflammatory drugs, and Helicobacter pylori infection.
  
  
  RESULTS
  The adjusted ORs for BE were 2.62 (95% CI, 1.0-6.8), 5.18 (95% CI, 1.7-15.7), and 8.02 (95% CI, 2.79-23.07) for the highest quintile vs the lowest quintile of levels of IL-12p70, IL-8, and leptin, respectively, but the OR was not significant for IL-6 (2.39; 95% CI, 0.84-6.79). The adjusted OR for BE was 0.14 for highest quintile of IL-10 compared with lowest quintile (95% CI, 0.05-0.35) and 0.03 for IL-1β ≥ median vs none detected (95% CI, 0.006-0.13). Higher levels of IL-8 and leptin and lower levels of IL-10 and IL-1β were associated with the presence of long-segment (≥3 cm) and short-segment BE. There were no differences between cases and controls in levels of interferon-γ, tumor necrosis factor-α, adiponectin, or insulin.
  
  
  CONCLUSIONS
  BE is associated with circulating inflammatory cytokines and leptin and low levels of anti-inflammatory cytokines. These findings could partly explain the effect of obesity on BE.
authors: Department of Medicine, Michael E. DeBakey Veterans Affairs Medical Center, Houston, Texas; Department of Medicine, Baylor College of Medicine, Houston, Texas; Huffington Center on Aging, Baylor College of Medicine, Houston, Texas.
authors: Jose M
authors: JM
authors: Garcia
authors: Department of Medicine, Michael E. DeBakey Veterans Affairs Medical Center, Houston, Texas; Department of Medicine, Baylor College of Medicine, Houston, Texas.
authors: Andres E
authors: AE
authors: Splenser
authors: Department of Medicine, Baylor College of Medicine, Houston, Texas; VA Health Services Research and Development Center of Excellence, Houston, Texas.
authors: Jennifer
authors: J
authors: Kramer
authors: Department of Medicine, Baylor College of Medicine, Houston, Texas; VA Health Services Research and Development Center of Excellence, Houston, Texas.
authors: Abeer
authors: A
authors: Alsarraj
authors: Department of Medicine, Baylor College of Medicine, Houston, Texas; VA Health Services Research and Development Center of Excellence, Houston, Texas.
authors: Stephanie
authors: S
authors: Fitzgerald
authors: Department of Medicine, Baylor College of Medicine, Houston, Texas; VA Health Services Research and Development Center of Excellence, Houston, Texas.
authors: David
authors: D
authors: Ramsey
authors: Department of Medicine, Michael E. DeBakey Veterans Affairs Medical Center, Houston, Texas; Department of Medicine, Baylor College of Medicine, Houston, Texas; VA Health Services Research and Development Center of Excellence, Houston, Texas. Electronic address: hasheme@bcm.edu.
authors: Hashem B
authors: HB
authors: El-Serag
mesh_terms: D054392:Adipokines / Q000097:blood*; D000368:Aged; D001471:Barrett Esophagus; D016022:Case-Control Studies; D016207:Cytokines / Q000097:blood*; D005260:Female; D006801:Humans; D007378:Interleukins / Q000097:blood; D020738:Leptin / Q000097:blood; D008297:Male; D008875:Middle Aged; D009765:Obesity / Q000453:epidemiology; D018570:Risk Assessment; D014409:Tumor Necrosis Factor-alpha / Q000097:blood
chemical_list: D054392:Adipokines; D016207:Cytokines; D007378:Interleukins; D020738:Leptin; D014409:Tumor Necrosis Factor-alpha
keywords: Adipokines; Adiponectin; BE; BMI; Barrett's esophagus; CI; EGD; GERD; H2RA; IFN; IL; Insulin; JNK; Leptin; MEDVAMC; Michael E. DeBakey VA Medical Center; NSAID; OR; Obesity; PCP; PPI; TNF; W/H; body mass index; confidence interval; esophagogastroduodenoscopy; gastroesophageal reflux disease; histamine 2 receptor antagonist; interferon; interleukin; jun N-terminal protein kinase; nonsteroidal anti-inflammatory drug; odds ratio; primary care provider; proton pump inhibitor; tumor necrosis factor; waist/hip
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