Study Explores Links Between Leptin, Ghrelin and Barrett's
(HealthDay News) – In men, leptin is associated with Barrett's esophagus, especially in those with gastroesophageal reflux disease (GERD), while serum ghrelin is positively associated with Barrett's esophagus and inversely associated with GERD, according to a study published in the December issue of Gastroenterology.
Joel H. Rubenstein, MD, from the Ann Arbor Veterans Affairs Medical Center in Michigan, and colleagues examined the correlations between diabetes mellitus and serum levels of insulin, leptin, and ghrelin and GERD and Barrett's esophagus in a case-control study involving 822 men undergoing colorectal cancer screening who also underwent upper endoscopy. Serum levels of insulin, leptin, and ghrelin were assessed in 104 fasting men with Barrett's esophagus without diabetes and in 271 men without Barrett's esophagus or diabetes.
The researchers observed an inverse association between diabetes and Barrett's esophagus (adjusted odds ratio, 0.383) among men with GERD. Hyperinsulinemia correlated positively with Barrett's esophagus among men without diabetes, although the correlation was attenuated after adjustment for leptin and ghrelin. A positive association was seen for leptin with Barrett's esophagus, after adjustment for obesity, GERD, and levels of insulin and ghrelin (odds ratio for third vs. first tertile, 3.25), and the correlation was more robust in men with GERD. There was a positive association between ghrelin and Barrett's esophagus (odds ratio for an increment of 400pg/mL, 1.39) and an inverse association for ghrelin with GERD (odds ratio for third vs. first tertile, 0.364).
"Confirming these associations and understanding their underlying mechanisms of action could lead to improved control of the rising burden of esophageal adenocarcinoma," the authors write.