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Adiponectin Level Found to be Independent Risk Factor for Endometrial Cancer: Presented at SGO

By Karla Harby

MIAMI BEACH, FL -- March 24, 2005 -- Serum levels of adiponectin -- one of several proteins secreted by adipocytes (fat cells) -- has been found to be an independent risk factor for endometrial cancer, even for patients who are not obese.

Pamela Soliman, MD, fellow, University of Texas M.D. Anderson Cancer Center, Houston, Texas, United States, and colleagues based their observations on 117 patients with endometrial cancer and 238 healthy women who served as controls.

Dr. Soliman presented her findings here on March 23^rd at the 2005 Annual Meeting on Women's Cancer of the Society of Gynecologic Oncologists.

Obesity is a known risk factor for endometrial cancer, which is projected to be diagnosed in 40,880 women in the United States in 2005, and expected to cause 7,310 U.S. deaths this year, Dr. Soliman said. Women with a body mass index (BMI) greater than 32 kg/m² have a 4-fold increased risk of the disease, and those with a BMI greater than 35 kg/m² have a 6-fold greater risk.

Adipocytes are active producers of hormones, including estrogens, but elevated endogenous estrogens fail to fully account for the increased incidence of endometrial cancer observed in women with excess adiposity, Dr. Soliman said. She hypothesized that insulin resistance, a prediabetic state, may be implicated instead, and be independent of BMI. Adiponectin levels are a marker for insulin resistance and are inversely related to obesity.

In this study, the serum adiponectin levels of patients and healthy women were measured using an enzyme-linked immunosorbent assay. The investigators performed univariate and multivariate logistic regressions adjusting for both age and BMI.

Among the patients with endometrial cancer, 64 met the U.S. Center for Disease Control's BMI criterion for being obese (BMI of 30.0 kg/m²) or overweight (BMI of 25.0 kg/m² to 29.9 kg/m²), with a median BMI of 33.2 kg/m² among the obese/overweight patients. This compares with 68 of the healthy women who were overweight or obese, who had a median BMI of 28.0 kg/m².

The investigators found that mean serum adiponectin levels were significantly lower among patients with endometrial cancer than among controls (88.8 ng/mL ± 63.3 ng/mL vs. 148.2 ng/mL ± 68.3 ng/mL, P <.001). The relationship was maintained after controlling for age and BMI.

Patients with serum adiponectin levels in the intermediate range and the lowest tertiles had a significantly higher risk of endometrial cancer compared with those in the highest tertile. As they had expected, the researchers also found BMI to be an independent risk factor for endometrial cancer (odds ratio 2.7, with 95% confidence interval of 1.31 to 5.53, P =.01).

From these findings, it remains unclear whether adiponectin might be a surrogate marker for something else, rather than a causative factor on its own, Dr. Soliman noted. She added that a prospective study would be required to explore this possibility.


[Presentation title: Adiponectin as a Marker for Insulin Resistance and Endometrial Cancer Risk. Abstract 61]

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