Comparison of Blood Leptin Concentration and Colonic Mucosa Leptin Expression in Colon Adenoma Patients and Healthy Control

Jang Seok Oh; Hyun Hee Kim; Hyun Sik Hwang; Dae Young Yun; Byung Seok Kim; Chang Hyeong Lee; Jimin Han; Ho Gak Kim; Jin Tae Jung; Joong Goo Kwon; Eun Young Kim

doi:10.4166/kjg.2014.63.6.354

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Oh, Kim, Hwang, Yun, Kim, Lee, Han, Kim, Jung, Kwon, and Kim: Comparison of Blood Leptin Concentration and Colonic Mucosa Leptin Expression in Colon Adenoma Patients and Healthy Control

Original Article

Korean J Gastroenterol 2014;63(6):354-360.

Published online: 4 October 2014

DOI: https://doi.org/10.4166/kjg.2014.63.6.354

Comparison of Blood Leptin Concentration and Colonic Mucosa Leptin Expression in Colon Adenoma Patients and Healthy Control

Jang Seok Oh, Hyun Hee Kim, Hyun Sik Hwang, Dae Young Yun, Byung Seok Kim, Chang Hyeong Lee, Jimin Han, Ho Gak Kim, Jin Tae Jung, Joong Goo Kwon, Eun Young Kim

Department of Internal Medicine, Catholic University of Daegu School of Medicine, Daegu, Korea

Correspondence to: Eun Young Kim, Department of Internal Medicine, Catholic University of Daegu School of Medicine, 33 Duryugongwon-ro 17-gil, Nam-gu, Daegu 705-718, Korea. Tel: +82-53-650-4092, Fax: +82-53-624-3281, E-mail: kimey@cu.ac.kr

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Background/Aims

Obesity increases the risk of colorectal cancer and adenomatous polyp, and one of the underlying mechanisms of this increase is considered to be due to the growth promoting effects of adipokines, such as leptin. In order to investigate this finding, leptin expression in the colonic tissue and blood leptin concentration of the colonic adenoma patients were compared to those of the control group.

Methods

Colonic adenoma tissues were obtained by polypectomy (n=60). In these patients, normal colonic mucosa at remote areas from the polyp was also obtained and blood samples were collected as well. Age and sex matched control subjects were selected among those who showed normal colonic mucosa in health screening colonoscopy (n=60).

Results

There was no significant difference in serum leptin concentration between the colonic adenoma patients and control subjects. Leptin expression was noted in 43.3% of the colonic adenomas, but only in 6.7% of normal colonic mucosa from the control subjects (p＜0.01). There were ten cases of concurrent adenocarcinoma in situ in adenoma patients, eight cases of which expressed leptin (p=0.01). In adenoma group, leptin expression rate was significantly high in larger adenomas and in obese patients (p＜0.05). However, there was no statistically significant relationship between leptin expression in colonic mucosa and serum leptin level.

Conclusions

Leptin expression was more frequently observed in colonic adenomas, especially in larger adenomas associated with adenocarcinoma in situ, but blood leptin level was not related to tissue leptin expression. Leptin expression was more frequently observed in obese patients from the adenoma group. Therefore, leptin may play an important role in colonic tumorigenesis and progression, especially in obese patient.

Keywords: Adenomatous polyps, Colonic neoplasms, Leptin, Obesity

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Fig. 1.

Immunochemical leptin stain in colonic adenoma and normal colonic mucosa. (A) Leptin(+) in colonic adenoma (arrows) (×200). (B) Leptin(−) in normal colonic mucosa (×200).

Table 1.

Clinical Characteristics of Colonic Adenoma Patients and Healthy Control

	Adenoma	Control	p-value ^a
Male： female ^b	40 (66.7)：20 (33.3)	40 (66.7)：20 (33.3)	−
Age (yr)	58.4±8.9 (37–74)	56.7±9.5 (31–79)	0.316
BMI (kg/m²)	23.3±2.6 (15.9–34.2)	24.2±2.2 (19.2–31.2)	0.049
Waist circumference (cm)	83.1±7.8 (65–97)	83.8±6.8 (70–96)	0.737
Waist hip ratio	0.89±0.07 (0.66–0.98)	0.89±0.05 (0.78–1.00)	0.542

Values are presented as n (%) or mean±SD (range).

^a Mann-Whitney test (p<0.05 was considered statistically significant).

^b Sex was presented as number and percentage of patients.

Table 2.

Positive Rate of Leptin Expression and Blood Leptin Concentration

	Adenoma	Normal	OR (95% CI)	p-value
Positive leptin stain	26 (43.3)	4 (6.7)	10.7 (3.4–33.3)	＜0.001 ^a
Leptin concentration (ng/mL)	4.35±4.47	3.63±2.96		0.916

Values are presented as n (%) or mean±SD.

^a Fisher's exact test; p＜0.05 was considered statistically significant.

Table 3.

Correlation between Leptin Expression and Clinicopathologic Variables in Adenoma Patients

	Negative leptin expression (n=34)	Positive leptin expression (n=26)	p-value
Age (yr)	56.5±9.3 (37–74)	60.9±57.4 (45–74)	0.053
Waist (cm)	82.1±7.8 (65–95)	84.3±7.7 (68–97)	0.302
Waist hip ratio	0.89±0.07 (0.66–0.98)	0.90±0.06 (0.72–0.97)	0.622
BMI (kg/m²)	22.9±1.79 (19.8–27.8)	23.7±3.4 (15.9–34.2)	0.286
Leptin concentrateion (ng/mL)	4.94±4.83 (0–23.7)	3.57±3.91 (0–14.3)	0.098
Adenoma size (mm)	8.9±7.9 (2–35)	15.8±8.6 (5–42)	＜0.001

Values are presented as mean±SD (range).

Table 4.

Cross Tabulation Analysis between Positive and Negative Leptin Expression in Adenoma Patients

	Negative leptin expression (n=34)	Positive leptin expression (n=26)	OR (95% CI)	p-value ^a
Obesity ^b
BMI ^c	2 (5.9)	8 (30.8)	7.1 (1.4–37.2)	0.015
Waist ^d	9 (26.5)	9 (34.6)	1.5 (0.5–4.5)	0.575
Waist hip ratio ^e	23 (67.6)	17 (65.4)	0.9 (0.3–2.7)	1.000
Smoking (+)	14 (41.2)	10 (38.5)	0.9 (1.3–2.5)	1.000
Alcohol (+)	15 (44.1)	14 (53.8)	1.5 (0.5–4.1)	0.603
Accompanied CIS	2 (5.9)	8 (30.8)	7.1 (1.4–7.2)	0.015

Values are presented as n (%).

^a Fisher's exact test; p<0.05 was considered statistically significant.

^b Obesity criteria in Korea

^c ≥25 kg/m²

^d ≥90 cm in male, ≥85 cm in female

^e ≥0.9 in male, ≥0.85 in female. CIS, carcinoma in situ.

Table 5.

Multivariate Analysis of Clinical Characteristics for Leptin Expression in Colonic Adenoma Patients

	OR (95% CI)	p-value ^a
Age	1.11 (1.01–1.23)	0.037
Obecity ^b
BMI ^c	49.32 (2.09–1163.30)	0.016
Waist ^d	0.54 (0.06–4.60)	0.569
Waist hip ratio ^e	3.14 (0.47–21.01)	0.238
Smoking (+)	0.16 (0.02–1.33)	0.090
Alcohol (+)	5.42 (0.75–39.36)	0.095
Leptin concentration	0.85 (0.64–1.14)	0.286
Adenoma size	1.15 (1.04–1.28)	0.007
Accompanied CIS	8.11 (0.93–70.38)	0.058

^a Multivariate logistic regression analysis.

^b Obesity criteria in Korea

^c ≥25 kg/m²

^d ≥90 cm in male, ≥85 cm in female

^e ≥0.9 in male, ≥0.85 in female.

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