Association of adiponectin multimers with Barrett’s oesophagus (original) (raw)

Association of adiponectin multimers with Barrett’s oesophagus

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  1. J H Rubenstein1,2,
  2. J Y Kao2,
  3. R D Madanick3,
  4. M Zhang2,
  5. M Wang2,
  6. M B Spacek3,
  7. J L Donovan2,
  8. S D Bright3,
  9. N J Shaheen3
  10. 1
    Veterans Affairs Center for Clinical Management Research, Ann Arbor, Michigan, USA
  11. 2
    Division of Gastroenterology, University of Michigan Medical School, Ann Arbor, Michigan, USA
  12. 3
    Division of Gastroenterology, University of North Carolina Medical School, Chapel Hill, North Carolina, USA
  13. Correspondence to Dr J H Rubenstein, VA Medical Center 111-D, 2215 Fuller Road, Ann Arbor, MI 48105, USA; jhr{at}umich.edu

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.

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