Nutritional Sciences Program, The University of Washington, Seattle, Washington, USA.
Obesity (Silver Spring). 2010 Nov;18(11):2204-11. doi: 10.1038/oby.2009.508. Epub 2010 Jan 28.
Persons diagnosed with Barrett's esophagus (BE) are at increased risk of developing esophageal adenocarcinoma (EA). Obesity is a major risk factor for both BE and EA. The primary purposes of this study were to determine whether circulating levels of leptin and adiponectin, both of which are deregulated in obese states, predict risk of specialized intestinal metaplasia (SIM) occurring in the esophagus (BE) and/or gastroesophageal junction, and evaluate the extent to which they mediate the relationship between obesity and these conditions. In this case-control study, 177 persons newly diagnosed with SIM were compared with 173 general population controls using unconditional logistic regression. Females in the highest tertiles of BMI and waist circumference were at the greatest risk (adjusted odds ratio (OR) = 4.6 (95% confidence interval (CI) = 1.9, 11.6), P(trend) = 0.002; OR = 5.1 (95% CI = 2.0, 13.0), P(trend) = 0.002, respectively) compared to females in the lowest tertiles. Adjustment for leptin and adiponectin attenuated these associations by 52 and 42%, respectively. Males in the highest tertile of waist-to-hip ratio were at the greatest risk (adjusted OR = 2.8 (95% CI = 1.3, 5.9), P(trend) = 0.014) compared to males in the lowest tertile. However, adjustment for leptin and adiponectin did not attenuate these associations. Our study results are consistent with the notion that circulating leptin and adiponectin partially mediate the obesity-BE relationship in women. Leptin and adiponectin's role in the progression from normal epithelium to SIM/BE and on to EA should be further elucidated.
被诊断患有 Barrett 食管 (BE) 的人患食管腺癌 (EA) 的风险增加。肥胖是 BE 和 EA 的主要危险因素。本研究的主要目的是确定循环中瘦素和脂联素的水平是否可以预测肥胖状态下发生的食管 (BE) 和/或胃食管交界处的特殊肠上皮化生 (SIM) 的风险，以及评估它们在多大程度上调节肥胖与这些疾病之间的关系。在这项病例对照研究中，177 名新诊断为 SIM 的患者与 173 名普通人群对照进行了比较，使用无条件逻辑回归。BMI 和腰围最高三分位的女性风险最大（调整后的优势比 (OR) = 4.6 (95%置信区间 (CI) = 1.9, 11.6)，P(trend) = 0.002；OR = 5.1 (95% CI = 2.0, 13.0)，P(trend) = 0.002）与 BMI 和腰围最低三分位的女性相比。瘦素和脂联素的调整分别减弱了这些关联的 52%和 42%。腰围与臀围比最高三分位的男性风险最大（调整后的 OR = 2.8 (95% CI = 1.3, 5.9)，P(trend) = 0.014)与最低三分位的男性相比。然而，瘦素和脂联素的调整并没有减弱这些关联。我们的研究结果与循环瘦素和脂联素部分调节女性肥胖与 BE 关系的观点一致。瘦素和脂联素在从正常上皮到 SIM/BE 再到 EA 的进展中的作用应进一步阐明。
