Rafat Mohamed N, Younus Hosni Abd-ElKareem, El-Shorpagy Mohamed S, Hemida Mahmoud Haddad, El Shahawy Mohamed S, El Sayed Atiia Ahmed Abd El Aziz
Department of Internal Medicine, Immunology Unit, Faculty of Medicine AL-Azhar University Cairo Egypt.
Department of Internal Medicine, Faculty of Medicine AL-Azhar University Assiut Egypt.
JGH Open. 2018 Jan 28;2(1):21-27. doi: 10.1002/jgh3.12038. eCollection 2018 Feb.
Visceral 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.
In this study, 150 subjects were selected and divided into four groups: Group І ( = 40) were healthy individuals with an average body mass index and had no gastrointestinal tract symptoms; Group ІІ ( = 50) were patients with mild to moderate erosive esophagitis; Group ІІІ ( = 40) were patients with severe erosive esophagitis; and finally, Group ІV ( = 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.
Our 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 (-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 (-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%.
Low 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.
内脏脂肪是一个重要的内分泌器官,可分泌不同的生物活性物质,如脂肪细胞因子。本研究旨在探讨糜烂性胃食管反流病(GERD)患者血清脂联素水平的变化及其在发病机制中的作用。
本研究选取150名受试者,分为四组:第一组(n = 40)为平均体重指数正常且无胃肠道症状的健康个体;第二组(n = 50)为轻至中度糜烂性食管炎患者;第三组(n = 40)为重度糜烂性食管炎患者;最后,第四组(n = 20)为巴雷特食管患者。仅对第二、三、四组进行上消化道内镜检查,对巴雷特食管可疑病例进行组织病理学评估。使用酶联免疫吸附测定(ELISA)试验对所有组进行血清脂联素检测。
我们的结果显示,与健康对照组相比,不同程度GERD患者以及巴雷特食管患者的血清脂联素水平显著降低(P值<0.001)。此外,血清脂联素水平与不同程度的GERD相关,脂联素水平最高的是对照组(11.05±2.58),其次是轻至中度GERD(6.39±1.64),然后是重度GERD(2.42±1.00);最后,巴雷特食管组检测到的水平最低(1.99±