Abstract
BackgroundNumerous studies associate adipokines with colorectal malignancy, but few data deal with patients suffering exclusively of rectal carcinoma (RC).AimsWe evaluated leptin and adiponectin levels in RC patients compared to healthy population and their dynamics after surgery.Material and methodsSerum leptin and adiponectin were evaluated before surgery in 59 RC consecutive patients (38 males and 21 females), and in age and weight matched healthy controls. Measurements were repeated at 24, 72 hours and 7 days after surgery.ResultsAdipokine levels were higher in women. Controls had higher leptin (32.±4.34 vs 9.51±1.73 ng/ml in women and 11±2.66 vs 2.54±0.39 ng/ml in men, p = 0.00048 and 0.0032) and lower adiponectin (9±0.64 vs 11.85±1.02 μg/ml in women and 7.39±0.51 vs 8.5±0.62 μg/ml in men, p = 0.017 and 0.019) than RC patients. Surgery caused an increase of leptin from 5.11±0.8 to 18.7±2.42 ng/ml, p = 6.85 x 10¨8, and a decrease of adiponectin from 9.71±0.58 to 7.87±0.47 μg/ml, p = 1.4 x 10¨10 for all RC patients and returned thereafter to the initial range at 7 days. Adipokines were correlated with body weight (BW). The significance of correlation persisted after surgery only in males, but disappeared in females. Adipokines were not modified by tumor position, presurgical chemoradiotherapy or surgical technique. Women with RC experiencing weight loss had higher adiponectin than women without weight modifications (p<0.05 at all time points).ConclusionsAdipokine levels of patients with RC differ from the healthy population, possibly reflecting an adaptation to disease. Adipokine modifications after surgery may be related to acute surgical stress. Whether leptin and adiponectin directly interact is not clear. Women have higher adipokine levels, more so after significant weight loss, but the strength of their correlation with BW decreases after surgery. These data suggest gender differences in the adipokine profile of RC patients which may find clinical applications.
Highlights
Adipose tissue performs an endocrine role, mediated by hormones which are secreted by the adipocytes [1]
We evaluated leptin and adiponectin levels in rectal carcinoma (RC) patients compared to healthy population and their dynamics after surgery
Surgery caused an increase of leptin from 5.11±0.8 to 18.7±2.42 ng/ml, p = 6.85 x 10 ̈8, and a decrease of adiponectin from 9.71±0.58 to 7.87±0.47 μg/ml, p = 1.4 x 10 ̈10 for all RC patients and returned thereafter to the initial range at 7 days
Summary
Adipose tissue performs an endocrine role, mediated by hormones (adipokines) which are secreted by the adipocytes [1]. Epidemiological data consistently show an association between weight gain and the risk of colorectal cancer in adults. This observation led to the evaluation of a possible linking role of adipokines with cancer pathogenesis [2,3,4]. Leptin is an adipokine which reflects fat mass, being involved in nutrition behavior, and is considered a proinflammatory and carcinogenic factor in various cancer types, stimulating carcinogenic angiogenesis [2,4,5,6]. Adiponectin is inversely related to fat mass and stimulates insulin secretion [1,2] and has an anti-inflammatory role, inhibiting angiogenesis and being considered protective against various cancer types [2,4,5]. Numerous studies associate adipokines with colorectal malignancy, but few data deal with patients suffering exclusively of rectal carcinoma (RC)
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