Abstract
Purpose: To elucidate the possible diagnostic utility of adipokines and insulin growth factor binding proteins in hepatocellular carcinoma (HCC) diabetic subjects. Methods: Seventy five patients were divided equally into 3 groups as follows: healthy normal control (NC), non-diabetic hepatocellular carcinoma (HCC) and diabetic hepatocellular carcinoma (HCC-DM). Serum levels of leptin, insulin growth factor binding protein-2 (IGFBP-2) and alpha fetoprotein (AFP) were measured. Correlation and receiver operating characteristics (ROC) analysis was carried out. Results: HCC and HCC-DM groups showed changes in body mass index (BMI, p > 0.05 and p < 0.001 respectively), glucose, insulin, homeostatic model assessment-insulin resistance (HOMA-IR), liver function tests and AFP (p < 0.001). Leptin levels increased significantly in both HCC and HCC-DM (p < 0.001). Furthermore, IGFBP-2 showed significant increase in both groups (p < 0.001). Both leptin and insulin-like growth factor binding protein-2 (IGFBP-2) displayed significant positive correlation with AFP (p < 0.001). ROC analysis indicate different diagnostic accuracies for the tested markers for the various groups. Conclusion: Leptin and IGFBP-2 demonstrate significant potentials as diagnostic tools for HCC patients, especially diabetic cases, with IGFBP-2 displaying the highest diagnostic accuracy for HCC and HCC-DM groups. Keywords: Hepatocellular carcinoma, Diabetes mellitus, Leptin, Insulin-like growth factor-binding proteins-2, Adipokines
Highlights
Obesity and type 2 diabetes mellitus may have a positive association with both the risk of cancer and cancer-related mortality
Leptin and insulin growth factor binding protein-2 (IGFBP-2) in hepatocellular carcinoma (HCC) diabetic and nondiabetic patients compared to corresponding healthy controls
Diabetic patients recently-diagnosed with biochemicallyproven HCC who had not yet received treatment were included
Summary
Obesity and type 2 diabetes mellitus may have a positive association with both the risk of cancer and cancer-related mortality. A more detailed molecular and mechanistic understanding is required to interpret existing data Understanding these mechanisms may lead to novel diagnostic and prognostic strategies for HCC [3]. The insulin-like growth factor (IGF) system has a highly conserved function in mammals and plays a critical role in energy metabolism and cell renewal in response to nutrients. IGF pathway is involved in cell growth in tissue culture, but it is involved in cellular proliferation, migration and malignant transformation. It comprises IGF-I and IGF-II, type I and type II receptors, and a family of IGF binding proteins (IGFBPs) that bind IGFs. The IGF pathway revolves around 4 essential components [7]. Leptin and IGFBP-2 in HCC diabetic and nondiabetic patients compared to corresponding healthy controls
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