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Background Gastropathy is a medical broad term applied for stomach diseases that affect mucosal lining characterized by epithelial injury. There are many types of gastropathy ranging from harmless conditions to more serious ones like cancer. Aim of the study to assess the significant effect of adiponectin and its level in patients with gastropathy. Patients and methods This case-control study includes 35 patients with gastropathy confirmed by gastroscope and thirty control group. Anthropometric Measurements like Weight, height, waist circumference, body mass index, and waist circumference. Blood sample was collected from the patients and control group and serum tested for lipid profile that includes (cholesterol, triglyceride, HDLP, LDLP) (Human-Germany), and adiponectin (Shanghai Biologic Technology-China) using Enzyme-Linked Immunosorbent Assay (ELISA). Results There is a significant difference between the two groups regarding height, weight, waist circumference, and waist to hip ratio (P-value 0.002,0.009, 0.002 and 0.015 respectively). Regarding adiponectin, there is no significant difference between patients (9.54 ± 5.821 and control 9.119 ± 7.062)(P = 0.796). Lipid profile showed a significant increase in cholesterol (p = 0.0001) and triglyceride (0.007) in patients group while there is no significant difference in HDL, LDL and LDL/HDL ratio. Conclusions Adiponectin had no role in the development of gastropathy. Patients with gastropathy had a significant increase in the serum level of cholesterol and triglyceride. There is a significant negative correlation between adiponectin and weight, body mass index, waist circumference, triglyceride, and low-density lipoprotein.