Serum levels of leptin as marker for patients at high risk of gastric cancer

Helicobacter. 2009 Dec;14(6):596-604. doi: 10.1111/j.1523-5378.2009.00728.x.


Background: Serological screening for gastric cancer (GC) may reduce mortality. However, optimal serum markers for advanced gastric precursor lesions are lacking.

Aim: To evaluate in a case-control study whether serum leptin levels correlate with intestinal metaplasia (IM) and can serve as a tool to identify patients at high risk for GC.

Materials and methods: Cases were patients with a previous diagnosis of IM or dysplasia, controls were patients without such a diagnosis. All patients underwent endoscopy. Fasting serum was collected for the measurement of leptin, pepsinogens I/II, gastrin, and Helicobacter pylori. Receiver operating characteristic (ROC) curves and their area under the curve (AUC) were provided to compare serum leptin levels with other serological markers.

Results: One hundred nineteen cases and 98 controls were included. In cases, the median leptin levels were 116.6 pg/mL versus 81.9 pg/mL in controls (p = .01). After adjustment for age, sex and BMI, leptin levels remained higher in cases than in controls (p < .005). In multivariate analysis, male sex (p = .002), age (<0.001), low pepsinogen levels (p = .004) and high leptin levels (p = .04) were independent markers for the presence of IM. In addition, a ROC curve including age, sex and pepsinogen I levels had an AUC of 0.79 (95% CI (0.73-0.85)). Adding serum leptin levels increased the AUC to 0.81 (95% CI (0.75-0.86)).

Conclusions: High leptin levels are associated with an increased risk of IM. Moreover, serum leptin levels are a significant independent marker for the presence of IM. However, in combination with the serological test for pepsinogen I the additional value of serum leptin levels is rather limited.

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Aged, 80 and over
  • Biomarkers / blood
  • Case-Control Studies
  • Female
  • Helicobacter Infections / blood*
  • Helicobacter Infections / epidemiology*
  • Helicobacter Infections / pathology
  • Helicobacter pylori / physiology
  • Humans
  • Intestines / pathology
  • Leptin / blood*
  • Male
  • Metaplasia / pathology
  • Middle Aged
  • Risk Factors
  • Stomach Neoplasms / blood*
  • Stomach Neoplasms / epidemiology*
  • Stomach Neoplasms / pathology
  • Young Adult


  • Biomarkers
  • Leptin