Serum leptin, adiponectin, and resistin concentration in colorectal adenoma and carcinoma (CC) patients

Introduction  Leptin, adiponectin, and resistin are the proteins secreted by adipocytes, which affects the metabolism. While the role of leptin in colon carcinogenesis is documented, the effect of adiponectin and resistin remains unclear. It has been indicated that while leptin may potentiate the cancer cells growth, adiponectin and resistin may act oppositely. Aim  The aim of this study is to determine the concentration of leptin, adiponectin, and resistin in patients with adenomatous polyps and colorectal cancer. Methods  The serum concentration investigated adipohormones had been measured with ELISA in 37 patients with colorectal adenomas, 36 with colorectal cancer (CC) and in 25 controls with no colorectal pathology. Endoscopically removed polyps and CC biopsies had been evaluated with histopathology. Mean BMI value was calculated for all patients. Results  Among 37 adenomas, 25 revealed high-grade dysplasia (HGD) and 12 low-grade dysplasia (LGD). All cases of CC were adenocarcinomas. No difference in the level of investigated adipohormones in serum between patients with HGD and LGD polyps was observed. The serum concentration of leptin and adiponectin in CC patients was lower than in patients with adenomas (p < 0.05; p < 0.05, respectively) as well as in controls (p < 0.01; p < 0.05, respectively). The concentration of resistin in CC was not significantly different in the adenoma group (p > 0.05) but higher than in controls (p < 0.05). There was a correlation between adiponectin and leptin serum concentration (r = 0.61). Conclusion  We conclude that serum concentration of adiponectin and resistin may play an important role in colon carcinogenesis. We also assume that leptin may possibly have the prognostic value useful in clinical practice and its concentration is independent of BMI value.     

脂肪因子与支气管哮喘相关性的研究进展

肥胖和支气管哮喘(简称哮喘)的发病率均逐年增加,已经成为重要的社会经济问题,给社会和家庭带来沉重的负担.近十年来大量研究提示肥胖和哮喘之间存在关联,甚至提出肥胖型哮喘是一种新的疾病.但其发病机制目前尚未明确.脂肪因子是肥胖的特征性物质,已有较多研究发现脂肪因子与哮喘之间存在相关性,本文就3种主要的脂肪因子(瘦素、脂联素和抵抗素)在哮喘中的作用作一综述,探讨哮喘与脂肪因子之间可能的关系.     

Adipokines and ghrelin in gastric cancer cachexia

AIM： To investigate the roles of the adipocytokines, ghrelin and leptin in gastric cancer cachexia.
METHODS： Resistin, ghrelin, leptin, adiponectin, insulin and insulin-like growth factor （IGF-Ⅰ）, were measured in 30 healthy subjects, and 60 gastric cancer patients of which 30 suffered from cancerinduced cachexia and 30 served as a control group. The relationships between hormones, body mass index （BMI） loss ratio, age, gender, and Glasgow Prognostic Score （GPS） were investigated.
RESULTS： Cachexia patients had higher tumor stage and GPS when compared with non-cachexia patients （P 〈 0.05）. Ghrelin, resistin, leptin, adiponectin and IGF- Ⅰ, showed a significant correlation with BMI loss ratio and GPS （P 〈 0.05）. A strong correlation was seen between GPS and BMI loss （R = -0.570, P 〈 0.0001）. Multivariate analysis indicated that BMI loss was significantly independent as a predictor of ghrelin, resistin, leptin and IGF-Ⅰ （P 〈 0.05）. Existence of an important significant relationship between resistin and insulin resistance was also noted.
CONCLUSION： These results showed that serum ghrelin, leptin, adiponectin, and IGF-Ⅰ play important roles in cachexia-related gastric cancers. No relationship was found between resistin and cancer cachexia. Also, because of the correlation between these parameters and GPS, these parameters might be used as a predictor factor.     

Adipocytokine levels in gastric cancer patients: resistin and visfatin as biomarkers of gastric cancer

Purpose  Adipocytokines are adipocyte-secreted hormones associated with some malignancies. We investigated the association of adipocytokines with gastric cancer. Methods  The levels of body mass index (BMI) and adiponectin, leptin, resistin, visfatin, and C-peptide in blood at diagnosis were measured in 156 gastric cancer patients and 156 age- and sex-matched controls. Logistic regression models were used to estimate odds ratio, and one-way analysis of variance was performed to examine the prevalence of each variable between 2 or more groups. Results  Adiponectin, C-peptide and BMI levels were significantly lower, and resistin and visfatin levels were significantly higher in the patients on multivariate analysis (P = 0.0004, 0.0006, 0.0051, 0.0006 and 0.0013, respectively). In the controls, the inverse correlation between BMI and adiponectin was comparatively strong, but was weak in the patients. The correlation between BMI and leptin was strong in both the controls and the patients. The correlation between BMI and resistin or visfatin was not clear in either the patients or the controls. The correlation between BMI and C-peptide was not clear in the controls, but might be weak in the patients. Leptin, C-peptide and BMI levels gradually decreased with stage progression, and resistin and visfatin levels gradually increased with stage progression (P < 0.0001 for all). Comparison between 38 patients with Stage I gastric cancer and the controls showed that adiponectin level tended to decrease in the patients (P = 0.0582), and BMI level was not different between two groups (P = 0.2480). Conclusions  Resistin and visfatin may be good biomarkers of gastric cancer.     

Association between obesity-related adipokines and colorectal cancer:A case-control study and meta-analysis

AIM:To examine the association between obesityrelated adipokines(adiponectin,leptin,resistin,interleukin-6(IL-6),and tumor necrosis factor-α(TNF-α)and colorectal cancer(CRC)risk.METHODS:Serum levels of adipokines were measured in 100 CRC patients and age-and sex-matched controls for the data analysis.Unconditional logistic regression models were used for estimating ORs and95%CIs related to each adipokine.For the metaanalysis,studies published before July 2013 available on Medline/PubMed and EMBASE were retrieved.The analysis included a total of 17 relevant studies(including the present case-control study):nine studies on adiponectin and eight on leptin.The effect sizes of ORs and 95%CIs were estimated using RevMan 5.1.Heterogeneity was evaluated using Cochran’s Q-test and I2 statistics.RESULTS:Among the five adipokines,only resistin levels were significantly higher in cases than in controls(P<0.001).The case-control study results showed no association between adiponectin and CRC and a negative association between leptin and CRC.However,the results of the meta-analysis showed a significant inverse association between adiponectin and CRC(OR=0.91,95%CI:0.83-1.00,P=0.04)and no association between CRC and leptin.After stratification by study design,an inverse association between adiponectin and CRC was observed in prospective studies only(OR=0.90,95%CI:0.82-0.99,P=0.03),whereas the association between leptin and CRC was inconsistent(prospective studies:OR=1.14,95%CI:1.02-1.27,P=0.02 and retrospective studies:OR=0.47,95%CI:0.29-0.74,P=0.001).The associations of resistin and TNF-αwith CRC risk were positive,but no association was observed for IL-6.CONCLUSION:Our results suggest a negative association of leptin,positive associations of resistin and TNF-α,and null associations of adiponectin and IL-6with CRC.However,further studies with larger number of prospective approaches are needed.     

MicroRNA biomarkers predicting risk,initiation and progression of colorectal cancer

Colorectal cancer is a major global cause of morbidity and mortality. Current strategies employed to increase detection of early, curable stages of this disease are contributing to a reduction of the negative health impact from it. While there is a genetic component to the risk of disease, diet and environment are known to have major effects on the risk of an individual for developing the disease. However, there is the potential to reduce the impact of this disease further by preventing disease development. Biomarkers which can either predict the risk for or early stages of colorectal cancer could allow intervention at a time when prospects could be modified by environmental factors, including lifestyle and diet choices. Thus, such biomarkers could be used to identify high risk individuals who would benefit from lifestyle and dietary interventions to prevent this disease. This review will give an overview on one type of biomarker in the form of microRNAs, which have the potential to predict an individual’s risk for colorectal cancer, as well as providing a highly sensitive and non-invasive warning of disease presence and/or progression. MicroRNA biomarkers which have been studied and whose levels look promising for this purpose include MiR-18a, MiR-21, MiR-92a, MiR-135b, MiR-760, MiR-601. Not only have several individual microRNAs appeared promising as biomarkers, but panels of these may be even more useful. Furthermore, understanding dietary sources and ways of dietary modulation of these microRNAs might be fruitful in reducing the incidence and slowing the progression of colorectal cancer.     

Obesity and colorectal cancer risk： A meta-analysis of cohort studies

TO evaluate the association between obesity and colorectal cancer risk. METHODS： We searched PubMed, EMBASE, and the Cochrane Library up to January 1, 2007. Cohort studies permitting the assessment of causal association between obesity and colorectal cancer, with clear definition of obesity and well-defined outcome of colorectal cancer were eligible. Study design, sample size at baseline, mean follow-up time, co-activators and study results were extracted. Pooled standardized effect sizes were calculated.     

Role of diet and gut microbiota on colorectal cancer immunomodulation

Colorectal cancer(CRC) is one of the most commonly diagnosed cancers, and it is characterized by genetic and epigenetic alterations, as well as by inflammatory cell infiltration among malignant and stromal cells. However, this dynamic infiltration can be influenced by the microenvironment to promote tumor proliferation, survival and metastasis or cancer inhibition. In particular, the cancer microenvironment metabolites can regulate the inflammatory cells to induce a chronic inflammatory response that can be a predisposing condition for CRC retention. In addition, some nutritional components might contribute to a chronic inflammatory condition by regulating various immune and inflammatory pathways. Besides that, diet strongly modulates the gut microbiota composition,which has a key role in maintaining gut homeostasis and is associated with the modulation of host inflammatory and immune responses. Therefore, diet has a fundamental role in CRC initiation, progression and prevention. In particular,functional foods such as probiotics, prebiotics and symbiotics can have a potentially positive effect on health beyond basic nutrition and have antiinflammatory effects. In this review, we discuss the influence of diet on gut microbiota composition, focusing on its role on gut inflammation and immunity.Finally, we describe the potential benefits of using probiotics and prebiotics to modulate the host inflammatory response, as well as its application in CRC prevention and treatment.     

Role of adipocytokines and its correlation with endocrine pancreatic function in patients with pancreatic cancer

IntroductionSome authors suggest that adipocytokines contribute to the induction of pancreatic carcinogenesis as well as the development of endocrine insufficiency.AimsWe evaluate the circulating concentrations of leptin, resistin and visfatin in patients with newly diagnosed pancreatic cancer (PC) and relationship between serum adipocytokines level and clinicopathological features of PC. Moreover the usefulness of those adipocytokines as possible biomarkers of endocrine pancreatic function in PC has been assessed.MethodsThe pilot study group consisted of 45 individuals (mean age 65.6 ± 11.5 years, BMI 21.8 ± 3.4 kg/m²) with newly diagnosed PC (within last 1–3 months) and 13 healthy individuals with age, gender and BMI matched to the study group. Among PC patients 18 (40%) had recently diagnosed diabetes. Fasting plasma leptin, resistin, visfatin concentrations were determined with ELISA (R&D Systems, Phoenix Pharmaceuticals) and insulin by RIA (DakoCytomation).ResultsPatients with PC as compared to controls had significantly lower plasma leptin (40.6 ± 21.3 vs 63.2 ± 16.3 pg/mL; p < 0,0008). In contrast PC patients showed more than six fold higher level of resistin (126.2 ± 143.2 vs 18.9 ± 7.2 ng/mL; p < 0.009) than controls. The median plasma visfatin was 2.8 ± 1.8 ng/mL, which was not significantly different from the controls (3.8 ± 1.1 ng/mL). When PC patients with and without diabetes were considered separately, plasma leptin concentrations among nondiabetic patients were slightly, but not significantly higher (44.6 ± 21.0) as compared to diabetics (34.5 ± 20.7). Moreover there was no difference between visfatin and resistin level in PC, among patients with and without diabetes. No significant differences between serum level of leptin, visfatin and resistin and age, gender, BMI, smoking status, tumor localization, distant metastases and pain has been found.ConclusionThe results of this study confirm previous findings that patients with newly diagnosed pancreatic cancer are characterized with lower level of leptin. This pilot study showed significantly higher resistin concentrations in patients with PC in comparison to healthy controls, which may be helpful in PC early diagnosis. Changes in leptin and resistin level in PC are not likely related to endocrine disorders.     

Eicosanoid pathway in colorectal cancer:Recent updates

Enzymatic metabolism of the 20 C polyunsaturated fatty acid(PUFA) arachidonic acid(AA) occurs via the cyclooxygenase(COX) and lipoxygenase(LOX) pathways, and leads to the production of various bioactive lipids termed eicosanoids. These eicosanoids have a variety of functions, including stimulation of homeostatic responses in the cardiovascular system, induction and resolution of inflammation, and modulation of immune responses against diseases associated with chronic inflammation, such as cancer. Because chronic inflammation is essential for the development of colorectal cancer(CRC), it is not surprising that many eicosanoids are implicated in CRC. Oftentimes, these autacoids work in an antagonistic and highly temporal manner in inflammation; therefore, inhibition of the pro-inflammatory COX-2 or 5-LOX enzymes may subsequently inhibit the formation of their essential products, or shunt substrates from one pathway to another, leading to undesirable side-effects. A better understanding of these different enzymes and their products is essential not only for understanding the importance of eicosanoids, but also for designing more effective drugs that solely target the inflammatory molecules found in both chronic inflammation and cancer. In this review, we have evaluated the cancer promoting and anti-cancer roles of different eicosanoids in CRC, and highlighted the most recent literature which describes how those molecules affect not only tumor tissue, but also the tumor microenvironment. Additionally, we have attempted to delineate the roles that eicosanoids with opposing functions play in neoplastic transformation in CRC through their effects on proliferation, apoptosis, motility, metastasis, and angiogenesis.     

Decreased circulating protective adiponectin level is associated with angiographic coronary disease progression in patients with angina pectoris

Adipocyte cytokines regulate glucose metabolism and insulin resistance and adiponectin is thought to have a protective effect against atherosclerosis. Studies have shown that adiponectin expression is decreased in obese subjects and those with metabolic syndrome or diabetes mellitus. The purpose of this study was to investigate the relationship between circulating adipocyte cytokine concentrations and angiographic coronary artery disease (CAD) progression in patients with chest pain. Patients with stable angina pectoris who underwent repeat coronary angiograms and had serum samples at the time of first catheterization between March 1999 and January 2004 were enrolled. A modified Gensini scoring system was used to define angiographic coronary artery progression between the index and follow-up angiograms. Those who had significant angiographic progression of coronary lesions were classified into the progression group (N = 55). Those who did not have CAD progression were classified into the non-progression group (N = 102). Univariate analysis showed that CAD progression was associated with male gender (93% vs. 78%, p = 0.038), higher baseline total cholesterol (187 ± 43 vs. 173 ± 39 mg/dl, p = 0.037) and higher baseline fasting blood glucose (128 ± 57 vs. 110 ± 40 mg/dl, p = 0.037). Patients in the progression group had a significantly lower serum adiponectin level (14.3 ± 7.9 vs. 18.9 ± 13.2 μg/ml, p = 0.007) than, but resistin (28.9 ± 13.4 vs. 34.4 ± 26.0 ng/ml, p = 0.142) and leptin (7.4 ± 4.6 vs. 7.7 ± 6.5 ng/ml, p = 0.675) levels similar to, those in the non-progression group. In a multivariate binary logistic regression model, male gender (odds ratio 4.283, p = 0.015), higher serum cholesterol (odds ratio 1.010, p = 0.032) and lower serum adiponectin (odds ratio 0.959, p = 0.030) were all significant independent predictors of CAD progression. In conclusion, we found that a decreased circulating level of adiponectin is associated with angiographic CAD progression in patients with angina pectoris.     

Role of epigenetics in transformation of inflammation into colorectal cancer

Molecular mechanisms associated with inflammation-promoted tumorigenesis have become an important topic in cancer research. Various abnormal epigenetic changes, including DNA methylation, histone modification, chromatin remodeling, and noncoding RNA regulation, occur during the transformation of chronic inflammation into colorectal cancer(CRC). These changes not only accelerate transformation but also lead to cancer progression and metastasis by activating carcinogenic signaling pathways. The NF-κB and STAT3 signaling pathways play a particularly important role in the transformation of inflammation into CRC, and both are critical to cellular signal transduction and constantly activated in cancer by various abnormal changes including epigenetics. The NF-κB and STAT3 signals contribute to the microenvironment for tumorigenesis through secretion of a large number of pro-inflammatory cytokines and their crosstalk in the nucleus makes it even more difficult to treat CRC. Compared with gene mutation that is irreversible, epigenetic inheritance is reversible or can be altered by the intervention. Therefore, understanding the role of epigenetic inheritance in the inflammation-cancer transformation may elucidate the pathogenesis of CRC and promote the development of innovative drugs targeting transformation to prevent and treat this malignancy. This review summarizes the literature on the roles of epigenetic mechanisms in the occurrence and development of inflammation-induced CRC. Exploring the role of epigenetics in the transformation of inflammation into CRC may help stimulate futures studies on the role of molecular therapy in CRC.     

PTEN在大肠癌癌变过程中的表达及意义

目的探讨在大肠癌癌变过程中,即大肠正常组织、大肠增生性息肉、大肠腺瘤和大肠癌中PTEN的表达及意义。方法应用免疫组织化学SP法检测122例大肠组织标本中PTEN蛋白的表达,应用等级相关的秩和检验分析PTEN在大肠组织中表达的意义及其与临床病理特征间的关系。结果PTEN蛋白在正常大肠组织、大肠增生性息肉、大肠腺瘤、大肠癌中表达差异有明显统计学意义（P=0．000）。大肠癌中PTEN蛋白表达与肿瘤分化程度、临床肿瘤分期及性别无关（P〉0．05）,但与患者的年龄相关（P=0．002）。结论PTEN蛋白在大肠癌癌变过程中存在异常表达,PTEN蛋白的低表达与大肠癌的发生和浸润转移相关。     

体质量指数与结直肠癌相关性的研究现状

结直肠癌(colorectal cancer,CRC)是消化系统常见的严重危害人们健康的杀手,全球每年约有120万新发病例,其中中国约有13万.随着我国社会经济发展和饮食结构的改变,CRC的发病率和死亡率呈逐年上升趋势,且平均发病年龄低于西方国家约20岁,居所有恶性肿瘤中的第2位,在中国发达地区已经接近西方发达国家.CRC的发病是多种因素综合作用的结果,近四分之一的CRC患者可以通过良好的生活习惯来避免患病.目前全球有2/3的成年人正在与超重和肥胖做斗争.近期大量研究表明,高体质量指数(body mass index,BMI)与结直肠癌的发病具有一定关系.本文就BMI与CRC相关性的研究现状作一综述.     

肥胖与大肠肿瘤的关系研究进展

大肠癌是临床常见的恶性肿瘤之一,发病呈上升趋势。肥胖被认为是乳腺癌、大肠癌等肿瘤的危险因素之一,大量流行病学资料显示肥胖与大肠癌发病危险增高明显相关,此文着重介绍肥胖相关因子如胰岛素、瘦素、脂联素、胰岛素样生长因子等与大肠肿瘤之间流行病学关系及其可能的发病机制,肥胖干预可能有助于大肠肿瘤的防治。     

Prognostic value of innate and adaptive immunity in colorectal cancer

Colorectal cancer(CRC) remains one of the major public health problems throughout the world.Originally depicted as a multi-step dynamical disease,CRC develops slowly over several years and progresses through cytologically distinct benign and malignant states,from single crypt lesions through adenoma,to malignant carcinoma with the potential for invasion and metastasis.Moving from histological observations since a long time,it has been recognized that inflammation and immunity actively participate in the pathogenesis,surveillance and progression of CRC.The advent of immunohistochemical techniques and of animal models has improved our understanding of the immune dynamical system in CRC.It is well known that immune cells have variable behavior controlled by complex interactions in the tumor microenvironment.Advances in immunology and molecular biology have shown that CRC is immunogenic and that host immune responses influence survival.Several lines of evidence support the concept that tumor stromal cells,are not merely a scaffold,but rather they influence growth,survival,and invasiveness of cancer cells,dynamically contributing to the tumor microenvironment,together with immune cells.Different types of immune cells infiltrate CRC,comprising cells of both the innate and adaptive immune system.A relevant issue is to unravel the discrepancy between the inhibitory effects on cancer growth exerted by the local immune response and the promoting effects on cancer proliferation,invasion,and dissemination induced by some types of inflammatory cells.Here,we sought to discuss the role played by innate and adaptive immune system in the local progression and metastasis of CRC,and the prognostic information that we can currently understand and exploit.     

Obesity and pancreatic cancer: An update of epidemiological evidence and molecular mechanisms

Despite advances in therapy and achievements in translational research, pancreatic cancer (PC) remains an invariably fatal malignancy. Risk factors that affect the incidence of PC include diabetes, smoking, obesity, chronic pancreatitis, and diet. The growing worldwide obesity epidemic is associated with an increased risk of the most common cancers, including PC. Chronic inflammation, hormonal effects, circulating adipokines, and adipocyte-mediated inflammatory and immunosuppressive microenvironment are involved in the association of obesity with PC. Herein, we systematically review the epidemiology of PC and the biological mechanisms that may account for this association. Included in this review is a discussion of adipokine-mediated inflammation, lipid metabolism, and the interactions of adipocytes with cancer cells. We consider the influence of bariatric surgery on the risk of PC risk as well as potential molecular targets of therapy. Our review leads us to conclude that targeting adipose tissue to achieve weight loss may represent a new therapeutic strategy for preventing and treating PC.