Relation Between Serum Leptin, Leptin Receptor Polymorphism Gln223Arg With Gastro Esophageal Reflux Disease

BACKGROUND:Gastro-esophageal reflux disease (GERD) is an upper gastrointestinal dysmotility disease. Although there is a growing incidence in recent years, but its pathogenesis is not yet clear. It is suggested that GERD has relation with the decline of anti reflux defense and the enhanced role of reflux on esophageal mucosa. it is reported that transient lower esophageal sphincter relaxations(TLESR)、lower esophageal sphincter pressure(LESP) and delayed gastric emptying are considered as the main factors that can cause GERD. In the digestive system, Leptin can work with other gastrointestinal hormones、nervous system to regulate gastrointestinal function, such as delayed gastric emptying, involved in the inflammatory response, promoted gastric mucosa cells growth, etc. Leptin must combine with leptin receptor(LEPR) to exert its physiological function. Some studies indicated that LEPR genovariation can cause multiple diseases, such as obesity diabetes, hepatopathy, hypertension. The aim of this study is to investigate the relation between serum leptin and LEPR polymorphism Gln223Arg with gastro-esophageal reflux disease, so that provide a new theoretical foundation for the pathogenesis of GERD.OBJECTIVE:The aim of this study is to detect the concentration of serum leptin and the disposition of Gln223Arg in leptin receptor gene of patients with GERD. Investigate the relation between serum leptin and LEPR polymorphism G2n223Arg with GERD, and look for GERD-related genes. Make further elaboration of the pathogenesis of GERD.METHODS: 62patients with GERD were selected according to reflux disease questionnaire and gastroscope inspection. Patients were divided into two groups:the reflux esophagitis (RE) group; non-erosive reflux disease (NERD) group, and63cases of healthy people were selected as control group.1. The serum leptin levels were determined by enzyme-linked immune sorbent assay method (ELISA).2. Using polymerase chain reaction-restriction fragment length polymorphisms assay (PCR-RFLP) to examine the LEPR Gln223Arg polymorphism.RESULTS:1. The levels of leptin in RE group and NERD group were both significantly higher than control group (P<0.05).2. The degrees of inflammation in RE group were positively correlated with leptin levels.3. There were significant differences of leptin levels between GA+AA and GG gene type in GERD patients (P<0.05).4. GA+AA genotype and A allele frequency of LEPR gene of RE group and NERD group were significantly higher than control group (P<0.05).CONCLUSIONS:1. The levels of serum leptin were higher in GERD patients than that in normal controls. This result suggests that serum leptin levels are associated with GERD.2. It hints that the leptin levels can reflect the extent of inflammation in RE group.3. The high levels of leptin are associated with the polymorphism of LEPR gene Gln223Arg in GERD patients.4. The polymorphism of LEPR gene Gln223Arg is associated with GERD.