Circulating adiponectin, leptin and adiponectin-leptin ratio and endometrial cancer risk: Evidence from a meta-analysis of epidemiologic studies
Circulating adiponectin, leptin and adiponectin-leptin ratio and endometrial cancer risk: Evidence from a meta-analysis of epidemiologic studies
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循环脂联素、瘦素和脂联素-瘦素比率与子宫内膜癌风险：来自流行病学研究荟萃分析的证据。
DOI：
10.1002/ijc.29561
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发表时间：
2015-10-15
影响因子：
6.4
通讯作者：
Ma, Xiao-Xin
中科院分区：
文献类型：
--
作者：
Gong, Ting-Ting;Wu, Qi-Jun;Ma, Xiao-Xin
我们对流行病学研究进行了荟萃分析，以调查循环脂联素、瘦素以及脂联素-瘦素 (A/L) 比率与子宫内膜癌风险之间的关联。通过搜索 PubMed 和 ISI Web of Science 数据库以及手动搜索检索到的手稿中引用的参考文献来确定相关手稿。使用随机效应模型来估计上述关联的汇总比值比 (SOR) 和 95% 置信区间 (CI)。分析中纳入了 13 项研究（5 项巢式病例对照研究和 8 项病例对照研究）的 14 份手稿，累计涉及 1,963 例子宫内膜癌病例和 3,503 例非病例。总体而言，将脂联素、瘦素和 A/L 比值循环浓度位于顶部三分位的人与这些生物标记物浓度位于底部三分位的人进行比较，得出的 SOR 分别为 0.47（95% CI：0.34-0.65；I-2=63.7%；n=13）、2.19（95% CI：1.44-3.31；n=13）。 I-2=64.2%；n=7) 和 0.45 (95% CI：0.24-0.86；I-2=90.1%；n=5)。值得注意的是，循环脂联素浓度每增加 5 g/mL，风险就会降低 18%（SOR=0.82；95% CI：0.74-0.90；I-2=49%；n=8）。根据研究特征以及这些研究是否考虑或调整潜在的混杂因素进行分层，结果在循环脂联素和瘦素的分析中是稳健的。没有发现发表偏倚的证据。总之，这项荟萃分析的结果表明，循环脂联素和 A/L 比率增加或瘦素浓度降低与子宫内膜癌风险降低相关。有必要进行进一步的前瞻性设计研究来证实我们的发现。有什么新鲜事？肥胖如何导致子宫内膜癌风险增加？一些研究表明脂肪因子可能参与其中，特别是脂联素、瘦素以及两者之间的比例。脂联素通常与抗糖尿病和抗炎作用有关，而瘦素则有助于细胞增殖和转移。在这项研究中，作者收集了有关脂联素、瘦素和子宫内膜癌风险的现有文献，并对合并数据进行了分析。他们得出的结论是，循环脂联素增加或瘦素减少，或较高的 A/L 比率，对应于子宫内膜癌风险的降低。
We performed this meta-analysis of epidemiologic studies to investigate the associations between circulating adiponectin, leptin and adiponectin-leptin (A/L) ratio and endometrial cancer risk. Relevant manuscripts were identified by searching PubMed and ISI Web of Science databases as well as by manual searching the references cited in retrieved manuscripts. Random-effects models were used to estimate summary odds ratio (SOR) and 95% confidence intervals (CIs) for aforementioned associations. Fourteen manuscripts with 13 studies (five nested case-control and eight case-control studies) cumulatively involving a total of 1,963 endometrial cancer cases and 3,503 noncases were included in the analyses. Overall, comparing persons with circulating concentrations of adiponectin, leptin and A/L ratio in the top tertile with persons with concentrations of these biomarkers in the bottom tertile yielded SORs of 0.47 (95% CI: 0.34-0.65; I-2=63.7%; n=13), 2.19 (95% CI: 1.44-3.31; I-2=64.2%; n=7),and 0.45 (95% CI: 0.24-0.86; I-2=90.1%; n=5), respectively. Notably, there was an 18% reduction in risk for per each 5 g/mL increment in circulating adiponectin concentrations (SOR=0.82; 95% CI: 0.74-0.90; I-2=49%; n=8). Stratifying by study characteristics and whether these studies considered or adjusted for potential confounders, the findings were robust in the analyses of circulating adiponectin and leptin. No evidence of publication bias was detected. In conclusion, the findings from this meta-analysis suggest that increased circulating adiponectin and A/L ratio or decreased leptin concentrations were associated with reduced risk of endometrial cancer. Further prospective designed studies are warranted to confirm our findings.What's new? How does obesity confer an increase in endometrial cancer risk? Some studies have suggested that adipokines could be involved, in particular, adiponectin, leptin, and the ratio between the two. Adiponectin is generally associated with anti-diabetic and anti-inflammatory actions, while leptin contributes to cell proliferation and metastasis. In this study, the authors collected the existing literature on adiponectin, leptin, and endometrial cancer risk, and analyzed the combined data. They conclude that increased circulating adiponectin or decreased leptin, or a higher A/L ratio, corresponds to a reduced risk of endometrial cancer.