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Association of adiponectin multimers with Barrett’s oesophagus
  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
  1. 1
    Veterans Affairs Center for Clinical Management Research, Ann Arbor, Michigan, USA
  2. 2
    Division of Gastroenterology, University of Michigan Medical School, Ann Arbor, Michigan, USA
  3. 3
    Division of Gastroenterology, University of North Carolina Medical School, Chapel Hill, North Carolina, USA
  1. Correspondence to Dr J H Rubenstein, VA Medical Center 111-D, 2215 Fuller Road, Ann Arbor, MI 48105, USA; jhr{at}


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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  • Funding JHR is the Damon Runyon-Gordon Family Clinical Investigator supported in part by the Damon Runyon Cancer Research Foundation (CI-36-07), and was supported by K23 DK079291. JYK was supported by K08 DK0669907 and the Foundation of Digestive Health and Nutrition. NJS was funded by K23 DK59311 and R03 DK075842. This work utilised the Chemistry Core of the Michigan Diabetes Research and Training Center funded by NIH5P60 DK020572 from the National Institute of Diabetes and Digestive and Kidney Diseases. None of the study sponsors had a role in data collection, analysis or interpretation.

  • Competing interests None.

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • See Commentary, p 1576

  • Ethics approval The protocol for this study was approved by the Committee on the Protection of Human Rights at the University of North Carolina.

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