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 purpose of this study was to determine the extent to which the adipokines leptin and adiponectin, both of which are deregulated in obese states, mediate the obesity-BE relationship. In this case-control study based in western Washington State, 106 male and 71 female patients newly diagnosed with BE were compared with 112 male and 64 female controls from the general population. Relationships between leptin and adiponectin, obesity, and BE were examined using unconditional logistic regression. Females in the highest tertiles of body mass index and waist circumference were at the greatest risk of BE (adjusted OR=4.3 (95% CI=1.7–10.7), Ptrend= <.01; OR=4.9 (95% CI=1. 9–12.5), Ptrend= <.01, respectively) compared to females in the lowest tertiles. Adjustment for leptin and adiponectin attenuated these associations by 43% and 41%, respectively. Similarly, males in the highest tertiles of waist circumference and waist-to-hip ratio were at the greatest risk of BE (adjusted OR=2.1 (95% CI=1.1–4.2), Ptrend=.08; OR=2.7 (95% CI=1.3–5.7), Ptrend=.01, respectively) compared to males in the lowest tertiles. However, adjustment for leptin and adiponectin attenuated these associations by only 6% and 8%, respectively. Our study results are consistent with the notion that circulating leptin and adiponectin partially mediate the obesity-BE relationship, particularly in women. Leptin and adiponectin’s role in the progression from normal epithelium to BE and on to EA should be further elucidated.
