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Gut 58:i-ii doi:10.1136/gut.2009.200840
  • Digest

Digest

Association of adiponectin with Barrett’s oesophagus

Obesity is a known risk factor for both Barrett’s oesophagus and reflux. The current study explores the possibility that the link with obesity is due to metabolic factors rather than reflux alone. Adiponectin is secreted by adipose tissue into the blood in multimeric complexes, trimers (low molecular weight, LMW), hexamers (middle molecular weight, MMW) and octadectimers (high molecular weight HMW) and total blood levels are inversely related to obesity. While HMW are pro-inflammatory, LMW are anti-inflammatory. This study examined 311 subjects undergoing endoscopy for reflux symptoms or Barrett’s surveillance. They found the ratio of LMW/Total adiponectin to be decreased in Barrett’s oesophagus particularly in females (figure). High LMW was associated with reduced risk of Barrett’s versus low LMW, OR 0.33 while the top tercile of the LMW/total ratio compared with the lowest tercile had an OR of 0.27 (0.13 – 0.58) overall and 0.2 for women alone. The authors conclude that it is the balance of the anti- and pro-inflammatory forms of Adiponectin that determine whether reflux leads to Barrett’s oesophagus. See page 1582

Box plot showing ratio of LMW/total Adiponectin stratified by gender in cases of Barrett’s and controls with just reflux.

NSAID induced small intestinal ulceration is increased by insoluble dietary fibre

Small intestinal (SI) ulceration due to NSAIDs is of increasing clinical importance. Non-specific cyclooxygenase inhibitors such as indomethacin (IND) induce a compensatory increase in leukotriene synthesis associated with ileal hypermotility. The current study examined the impact of insoluble dietary fibre on IND-induced SI injury which was strikingly increased on …

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