Associations of Serum Adiponectin and Leptin With Barrett's Esophagus.
OBJECTIVE
Central adiposity is a risk factor for Barrett's esophagus (BE). Serum levels of adiponectin and leptin are deregulated in obese states and are implicated as putative mediators in the pathophysiology of esophageal columnar metaplasia. We describe associations between serum adiponectin and leptin levels with BE.


METHODS
Patients were recruited prospectively for a case-control study. Fasting serum levels of adiponectin and leptin were measured in 135 patients with BE and compared with 2 separate control groups: 133 subjects with gastroesophageal reflux disease (GERD) and 1157 colon screening controls.


RESULTS
Multivariate analyses adjusted for age, race, and waist-to-hip ratio showed that patients within the highest tertile of serum adiponectin level had decreased odds of BE compared with screening colonoscopy controls (odds ratio [OR], 0.42; 95% confidence interval [CI], 0.22-0.80). This effect was more pronounced in men (OR, 0.35; 95% CI, 0.17-0.74) compared with women (OR, 0.71; 95% CI, 0.17-3.03). In comparisons of BE cases with GERD controls, subjects within the highest tertile of serum adiponectin level showed decreased odds of BE (OR, 0.65; 95% CI, 0.31-1.36), however, this was not statistically significant. Patients in the highest tertile of serum leptin level did not have a significantly increased risk of BE in comparison with GERD (OR, 1.32; 95% CI, 0.61-2.88) or screening colonoscopy controls (OR, 1.57; 95% CI, 0.82-3.04) in analyses including both sexes. Based on sex-specific analyses, sex did not significantly alter the association of leptin with odds of BE.


CONCLUSIONS
Serum adiponectin was associated inversely with BE and this effect was more pronounced in men, whereas serum leptin showed no evidence of association with BE in comparisons with multiple control groups. The exact mechanism, if any, by which these adipokines promote metaplasia in the esophagus needs to be explored further.
Division of Gastroenterology and Liver Disease, Department of Medicine, University Hospitals Case Medical Center, Cleveland, Ohio. Electronic address: Katarina.greer@UHhospitals.org.
Katarina B
KB
Greer
Division of Gastroenterology, Department of Internal Medicine, Hospital of the University of Pennsylvania, Philadelphia, Pennsylvania.
Gary W
GW
Falk
Division of Gastroenterology and Liver Disease, Department of Medicine, University Hospitals Case Medical Center, Cleveland, Ohio.
Beth
B
Bednarchik
Department of Family Medicine, University Hospitals Case Medical Center, Cleveland, Ohio.
Li
L
Li
Division of Gastroenterology and Liver Disease, Department of Medicine, University Hospitals Case Medical Center, Cleveland, Ohio.
Amitabh
A
Chak
D052242:Adiponectin / Q000097:blood*; D000328:Adult; D000368:Aged; D001471:Barrett Esophagus / Q000473:pathology*; D016022:Case-Control Studies; D005260:Female; D006801:Humans; D020738:Leptin / Q000097:blood*; D008297:Male; D008875:Middle Aged; D044967:Serum / Q000737:chemistry*; D012737:Sex Factors
D052242:Adiponectin; D020738:Leptin
Adipokine; Epidemiology; Esophagus