Association of Serum Levels of Adipokines and Insulin With Risk of Barrett's Esophagus: A Systematic Review and Meta-Analysis

Chandar, Apoorva K.; Devanna, Swapna; Lu, Cheng‐Hsun; Singh, Siddharth; Greer, Katarina B.; Chak, Amitabh; Iyer, Prasad G.

doi:10.1016/j.cgh.2015.06.041

Cited by 37 publications

(26 citation statements)

References 49 publications

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“…Adipokines such as adiponectin and leptin may influence the association between visceral obesity and BE. High levels of leptin are associated with a two-fold increased risk of BE 27 where as adiponectin seems to have a protective effect atleast in some studies 28 . Leptin levels are known to be higher in women than in men after adjusting for total body fat 29 .…”

Section: Discussionmentioning

confidence: 99%

Racial Disparity in the Sex Distribution, the Prevalence, and the Incidence of Dysplasia in Barrett’s Esophagus

Thota

Zackria²,

Sanaka³

et al. 2017

Journal of Clinical Gastroenterology

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Goals Our aim was to study the prevalence of dysplasia and progression to high-grade dysplasia (HGD) and esophageal adenocarcinoma (EAC) in African Americans (AA) with Barrett’s esophagus (BE) and compare to Non-Hispanic White (NHW) controls. Background BE, a precursor of EAC, is a disease of predominantly white men and is uncommon in AA. The prevalence of dysplasia and progression to HGD and EAC in AA with BE is not clearly known. Study All AA or NHW patients with confirmed BE i.e. specialized intestinal metaplasia seen between 2002 and 2013 at our institution were included. Variables such as age, gender, medication use, body mass index, date of endoscopy, hiatal hernia size, BE length, and histological findings were noted. Progression to HGD/EAC was evaluated. Results Fifty two AA and 2394 NHW patients with BE were identified. There was a higher percentage of women in AA cohort (46.2%) than NHW cohort (24.9% p< 0.001). Nondysplastic BE was more prevalent in AA than in NHW (80.8% vs. 68.4%, p= 0.058). In the surveillance cohort of 20 AA and 991 NHW, no racial differences in progression to HGD/EAC were observed during a median follow-up of 43 months. Conclusions This study includes the largest number of AA with histologically confirmed BE reported so far. 46.2 % of AA with BE in our study were women. There was a trend towards higher prevalence of nondysplastic BE in AA compared to NHW.

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Section: Discussionmentioning

confidence: 99%

Racial Disparity in the Sex Distribution, the Prevalence, and the Incidence of Dysplasia in Barrett’s Esophagus

Thota

Zackria²,

Sanaka³

et al. 2017

Journal of Clinical Gastroenterology

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“…Multiple studies have demonstrated an association between levels of different circulating adipokines and BE or EA. 5,21,27-29 It seems unlikely that a single factor is responsible for all of the risk attributable to obesity; rather it would seem that abdominal obesity (if not counteracted by gluteofemoral obesity) results in a milieu of circulating metabolic factors that promote BE and EA. Risk prediction models for BE that include a term for waist-to-hip ratio have been shown to have reasonable discriminatory ability; 30,31 whether gluteofemoral (hip circumference) and abdominal (waist circumference) obesity separately discriminate better between persons with and without BE than waist-to-hip ratio is unknown and requires further study.…”

Section: Discussionmentioning

confidence: 99%

“…4 These systemic effects have been associated with non-esophageal cancers and a recent meta-analysis found they may be important in BE. 5 …”

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confidence: 99%

Inverse Association Between Gluteofemoral Obesity and Risk of Barrett’s Esophagus in a Pooled Analysis

Kendall

Rubenstein

Cook

et al. 2016

Clinical Gastroenterology and Hepatology

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Background & Aims Gluteofemoral obesity (determined by measurement of subcutaneous fat in hip and thigh regions) could reduce risks of cardiovascular and diabetic disorders associated with abdominal obesity. We evaluated whether gluteofemoral obesity also reduces risk of Barrett's esophagus (BE), a premalignant lesion associated with abdominal obesity. Methods We collected data from non-Hispanic white participants in 8 studies in the Barrett's and Esophageal Adenocarcinoma Consortium. We compared measures of hip circumference (as a proxy for gluteofemoral obesity) from cases of BE (n=1559) separately with 2 control groups: 2557 population-based controls and 2064 individuals with gastroesophageal reflux disease (GERD controls). Study-specific odds ratios (OR) and 95% confidence intervals (95% CI) were estimated using individual participant data and multivariable logistic regression and combined using random effects meta-analysis. Results We found an inverse relationship between hip circumference and BE (OR per 5 cm increase, 0.88; 95% CI, 0.81–0.96), compared with population-based controls in a multivariable model that included waist circumference. This association was not observed in models that did not include waist circumference. Similar results were observed in analyses stratified by frequency of GERD symptoms. The inverse association with hip circumference was only statistically significant among men (vs population-based controls: OR, 0.85; 95% CI, 0.76–0.96 for men; OR, 0.93; 95% CI, 0.74–1.16 for women). For men, within each category of waist circumference, a larger hip circumference was associated with decreased risk of BE. Increasing waist circumference was associated with increased risk of BE in the mutually adjusted population-based and GERD control models. Conclusions Although abdominal obesity is associated with increased risk of BE, there is an inverse association between gluteofemoral obesity and BE—particularly among men.

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“…Higher adiponectin levels were independently associated with aberrant healing of esophageal injury in GERD (positive correlation not negative). Parallel to our study, another study by Chandar et al 22 summarized data from nine observational studies (10 independent cohorts; 1432 patients with BE and 3550 controls). When patients with BE were matched to population controls in five studies, subjects within the highest tertile of serum adiponectin level showed decreased odds of BE (odds ratio: 0.65; 95% CI: 0.31-1.36).…”

Section: Discussionmentioning

confidence: 72%

Section: Discussionmentioning

confidence: 80%

Adiponectin level changes among Egyptians with gastroesophageal reflux disease

et al. 2018

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Background and AimVisceral fat is an important endocrine organ that secretes different bioactive substances such as adipocytokines. The aim of this study was to investigate the adiponectin level changes among patients with erosive gastroesophageal reflux disease (GERD)and its consequence on pathogenesis.MethodsIn this study, 150 subjects were selected and divided into four groups: Group І (n = 40) were healthy individuals with an average body mass index and had no gastrointestinal tract symptoms; Group ІІ (n = 50) were patients with mild to moderate erosive esophagitis; Group ІІІ (n = 40) were patients with severe erosive esophagitis; and finally, Group ІV (n = 20) were patients with Barrett's esophagus. Upper gastrointestinal endoscopy was performed for Groups II, III, and IV only, and histopathological assessment was conducted for the suspicious cases of Barrett's esophagus. The measurement of serum adiponectin was performed for all groups using the ELISA test.ResultsOur results revealed that the serum level of adiponectin was significantly lower in patients with different grades of GERD as well Barrett's esophagus as compared to healthy controls (P‐value < 0.001). Additionally, the serum level of adiponectin was correlated with different grades of GERD as the highest level of the adiponectin was found in the control group (11.05 ± 2.58) followed by mild to moderate GERD (6.39 ± 1.64) and then severe GERD (2.42 ± 1.00); finally, the lowest level was detected in the Barrett's esophagus group (1.99 ± 0.47). Our study showed significant correlation between body mass index, waist circumference, and waist–hip ratio on one hand and serum adiponectin level on the other hand, with a statistically significant difference (P‐value < 0.001). The best cut‐off value for serum adiponectin was 7.7 (μg/mL), with a sensitivity of 91.8% and specificity of 97.5%.ConclusionsLow serum adiponectin level appears to be associated with an increased risk of erosive esophagitis, and visceral fat accumulation is related to the impaired secretion of adiponectin, which may have an influence on the pathogenesis of GERD.

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Association of Serum Levels of Adipokines and Insulin With Risk of Barrett's Esophagus: A Systematic Review and Meta-Analysis

Cited by 37 publications

References 49 publications

Racial Disparity in the Sex Distribution, the Prevalence, and the Incidence of Dysplasia in Barrett’s Esophagus

Racial Disparity in the Sex Distribution, the Prevalence, and the Incidence of Dysplasia in Barrett’s Esophagus

Inverse Association Between Gluteofemoral Obesity and Risk of Barrett’s Esophagus in a Pooled Analysis

Adiponectin level changes among Egyptians with gastroesophageal reflux disease

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