Impact of anthropometric measures and serum leptin on severity of gastroesophageal reflux disease

Abstract

The aim of this prospective study was to evaluate the impact of obesity, determined by different anthropometric measures, on clinical and endoscopic severity of GERD and the relation between serum leptin and clinical and endoscopic severity of GERD in Egyptian patients. The study was carried out at Ain Shams University Hospitals and Theodor Bilharz Research Institute, Cairo, Egypt. A total of 60 patients with clinically and endoscopically evident gastroesophageal reflux disease (GERD) were enrolled in this study as well as 20 healthy subjects matched for age and gender serving as the control group. Patients were divided according to their body mass index (BMI) into two groups: group 1 (n = 30): overweight and obese (BMI ≥ 25 and/or waist-to-height ratio [WHtR] ≥ 0.5) and group 2 (n = 30): normal weight (BMI ≥ 18 to < 25 and/or WHtR ≥ 0.4 to < 0.5). Upper gastrointestinal endoscopy, anthropometric measures, and symptom severity score questionnaire were done for all patients. Serum leptin hormone was assessed for patients and control groups.The evidence revealed statistically significant difference between the two groups in terms of different anthropometric measures (P < 0.00) except the height (P < 0.9), abdominal fat depot equations (P < 0.00), endoscopic findings according to Los Angeles classification (P < 0.001), symptom severity score (P < 0.00), and serum leptin hormone (43.96 ± 23.50 in group 1 vs. 7.5133 ± 8.18294 in group 2 and 6.98 ± 5.90 in the control group) (P = 0.00). Obesity in general and central (abdominal) obesity specifically has significant impact on clinical and endoscopic severity of GERD. Increased leptin hormone level is associated with clinical and endoscopic severity of GERD. Future trial on larger number of patients is emphasized.

Relationship between body mass index, waist circumference, waist hip ratio and erosive gastroesophageal reflux disease in a tertiary centre in Nigeria: A case control study

“…Obesity, particularly the central type with increased leptin levels have been associated with clinically and endoscopically severe GERD. 25 WHR was not associated with GERD among female cases compared with controls, though WC was. It may be that female cases with GERD equally had high HC, as shown by the mean value of HC among cases and controls which was statistically significant (p < 0.05).…”

“…18,24 It may thus point to the fact that GERD is evolving among people from Africa, a fact that has been raised among researchers in Kenya. 25 Among people from Africa, few studies have shown an association between central obesity and GERD. A study from Southwest Nigeria reported a weak association between central obesity and GERD.…”

Roles of Adipokines in Digestive Diseases: Markers of Inflammation, Metabolic Alteration and Disease Progression

“…In obese patients with GERD, leptin, and ObR levels were found to be higher and lower, respectively, than in nonobese patients with GERD [167,168]. Consistent with this finding, leptin resistance in individuals with overweight and obesity is associated with features of GERD, and leptin levels are positively associated with frequent GERD symptoms [169] and with the clinical and endoscopic severity of GERD [170]. The multi-biomarker score derived from multiple parameters, including leptin levels and GERD frequency and duration, can identify patients with Barrett's esophagus [171].…”

Rethinking gastroesophageal reflux disorder

“…39 Adipokines have also been implicated in GERD. Increased leptin levels have an association with clinical GERD severity, 40 whereas ghrelin levels have an inverse relationship with GERD. 41 The mechanism underpinning the association between obesity and GERD is complex and multifactorial, working in concert, increasing the TPG, and impairing acid clearance from the esophageal lumen.…”