Association of adiponectin multimers with Barrett's oesophagus

Abstract

Objective Barrett’s oesophagus is associated with abdominal obesity. Adiponectin is a peptide that is secreted from adipocytes and circulates in three multimeric forms: low molecular weight (LMW), middle molecular weight (MMW), and high molecular weight (HMW). The anti-inflammatory effects of adiponectin are specific to individual multimers, with LMW being most anti-inflammatory. We postulated that circulating levels of adiponectin and its multimers would be associated with the risk of Barrett’s oesophagus. Design Cross-sectional study. Setting Outpatient clinic in North Carolina, USA. Patients Cases of Barrett’s oesophagus and controls undergoing upper endoscopy for gastro-oesophageal reflux disease (GORD). Main outcome measures Adjusted odds ratios of plasma adiponectin levels and its multimers for Barrett’s oesophagus. Results There were 112 cases of Barrett’s oesophagus and 199 GORD controls. Total adiponectin was not associated with Barrett’s oesophagus (3rd tertile vs 1st tertile adjusted odds ratio (aOR) = 0.88; 95% confidence interval (CI) = 0.44 to 1.78). High levels of LMW adiponectin were associated with a decreased risk of Barrett’s oesophagus (3rd tertile vs 1st tertile aOR = 0.33; 95% CI, 0.16 to 0.69), and a high LMW/total ratio appeared particularly inversely associated with Barrett’s oesophagus (3rd tertile vs 1st tertile aOR = 0.27; 95% CI, 0.13 to 0.58). Conclusions High levels of LMW adiponectin are associated with a decreased risk of Barrett’s oesophagus among patients with GORD. Further human studies are required to confirm these findings, and in vitro studies are needed to understand if there is a mechanism whereby adiponectin may affect Barrett’s metaplasia.

Association of low serum adiponectin levels with erosive esophagitis in men: an analysis of 2405 subjects undergoing physical check-ups

“…A recent epidemiological study by Rubenstein et al indicated that high levels of low-molecular-weight adiponectin were associated with a decreased risk of Barrett's esophagus in patients with GERD [38]. In the present study, no association was found between the total level of adiponectin and the presence of Barrett's esophagus.…”

Association between the Body Mass Index and the Risk of Barrett's Esophagus in Japan

“…On the other hand, visceral fat is metabolically active, secreting multiple proinflammatory cytokines such as leptin and adiponectin, which could modulate esophageal inflammation and metaplasia via their proinflammatory actions [58,59]. Actually, it has been reported that higher levels of these cytokines are associated with BE formation [60,61]. Thus, these two adipokines could be involved in the pathogenesis of BE as GERD-independent mechanisms.…”

Obesity and Oesophageal Cancer

“…For instance, a case-control study among individuals undergoing oesophagogastroduodenoscopy showed that circulating leptin and proinflammatory cytokines were positively associated with Barrett's oesophagus [38]. In addition, it has been observed that among individuals with GERD symptoms high concentrations of the antiinflammatory low-molecular weight adiponectin are associated with lower risk of Barrett's oesophagus [39]. Findings from another case-control study suggest that blood concentrations of leptin and adiponectin mediate part of the positive association between obesity and risk of Barrett's oesophagus [40].…”