The relationship between serum adropin levels, body mass index and blood pressure values in endometrial carcinoma

Öz

Aim: Adropin is a protein that has been found in the brain, liver, and peripheral tissues in terms of energy homeostasis. Serum adropin levels were lower in hypertension, diabetes mellitus, and metabolic syndrome. This study aimed to investigate the relationship between adropin levels, body mass index (BMI), and blood pressure values in endometrial carcinoma (EC). Material and Methods: Fourty healthy and 50 EC patients’ demographic information, including characteristics of obstetric history, diabetes mellitus (DM), hypertension (HT), and family history were recorded. Fasting insulin, homeostasis model assessment for insulin resistance (HOMA-IR), high-density lipoprotein (HDL), low-density lipoprotein (LDL), total cholesterol (TC), triglyceride (TG), and adropin levels were obtained from venous blood samples. Results: We found no statistically significant difference between the control and EC groups at the serum adropin level. However, adropin was found to be significantly lower in type 2 EC (OR=0.350; 95%CI 0.156-0.783; p=0.011). Optimal cut-off value was calculated in ROC curve analysis as 0.4 ng/mL for adropin (63.6% sensitivity, 64.7% specificity). Positive Likelihood ratio (LR+) was 1.8 and the negative Likelihood ratio (LR-) was 0.56. Conclusion: Adropin may be a promising marker for the differential diagnosis of type 1 and type 2 endometrial carcinoma before surgery and needs to be confirmed by further studies.

Anahtar Kelimeler

• Adropin
• Body Mass Index
• Blood Pressure
• Endometrial Carcinoma

Destekleyen Kurum

None.

Etik Beyan

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards. The study was approved by the Ethics Committee of University of Health Sciences Turkey, Sisli Hamidiye Etfal Education and Research Hospital (Date: 03/10/2017 No: 1704/866).

Teşekkür

The authors would like to thank the study participants for their contribution.

Endometrial karsinomda serum adropin düzeyleri, vücut kitle indeksi ve kan basıncı değerleri arasındaki ilişki

Öz

Amaç: Adropin, enerji homeostazı açısından beyin, karaciğer ve periferik dokularda bulunan bir proteindir. Serum adropin düzeyleri hipertansiyon, diabetes mellitus ve metabolik sendromda daha düşük bulunmuştur. Bu çalışmanın amacı endometriyal karsinomlu (EC) hastalarda adropin düzeyleri, vücut kitle indeksi (VKİ) ve kan basıncı değerleri arasındaki ilişkiyi araştırmaktır. Gereç ve Yöntemler: Toplam 40 sağlıklı ve 50 EC hastanın obstetrik öykü, diabetes mellitus (DM), hipertansiyon (HT) ve aile öyküsü özelliklerini içeren demografik bilgileri kaydedildi. Venöz kan örneklerinden açlık insülini, insülin direnci için homeostaz modeli değerlendirmesi (HOMA-IR), yüksek yoğunluklu lipoprotein (HDL), düşük yoğunluklu lipoprotein (LDL), total kolesterol (TK), trigliserit (TG) ve adropin düzeyleri elde edildi. Bulgular: Kontrol ve EC grupları arasında serum adropin düzeyi açısından istatistiksel olarak anlamlı bir fark bulunmamıştır. Ancak tip 2 EC’de adropin anlamlı derecede düşük bulunmuştur (OR=0,350; %95CI 0,156-0,783; p=0,011). ROC eğrisi analizinde adropin için optimum cut-off değeri 0,4 ng/mL olarak hesaplanmıştır (%63,6 duyarlılık, %64,7 özgüllük). Pozitif Olabilirlik oranı (LR+) 1,8 ve negatif Olabilirlik oranı (LR-) 0,56 olarak hesaplanmıştır. Sonuç: Adropin, cerrahi öncesi tip 1 ve tip 2 endometriyal karsinomun ayırıcı tanısı için umut verici bir belirteç olabilir ve daha ileri çalışmalarla doğrulanması gerekmektedir.

Anahtar Kelimeler

• Adropin
• Vücut Kitle İndeksi
• Kan Basıncı
• Endometriyal Karsinom

Kaynakça

1. Siegel RL, Miller KD, Jemal A. Cancer Statistics, 2017. CA Cancer J Clin. 2017;67(1):7-30.
2. Dinkelspiel HE, Wright JD, Lewin SN, Herzog TJ. Contemporary clinical management of endometrial cancer. Obstet Gyne-col Int. 2013;2013:583891.
3. Zeimet AG, Reimer D, Huszar M, Winterhoff B, Puistola U, Abdel Azim S, et al. L1CAM in early-stage type I endometrial cancer: results of a large multicenter evaluation. Journal of the National Cancer Institute. 2013;105(15):1142-50.
4. Gao S, McMillan RP, Jacas J, Zhu Q, Li X, Kumar GK, et al. Regulation of substrate oxidation preferences in muscle by the peptide hormone adropin. Diabetes. 2014;63(10):3242-52.
5. Kuloglu T, Aydin S. Immunohistochemical expressions of adropin and ınducible nitric oxide synthase in renal tissues of rats with streptozotocin-ınduced experimental diabetes. Biotech Histochem. 2014;89(2):104-10.
6. Topuz M, Celik A, Aslantas T, Demir AK, Aydin S, Aydin S. Plasma adropin levels predict endothelial dysfunction like flow-mediated dilatation in patients with type 2 diabetes mellitus. J Investig Med. 2013;61(8):1161-4.
7. Zheng J, Liu M, Chen L, Yin F, Zhu X, Gou J, et al. Association between serum adropin level and coronary artery disease: a systematic review and meta-analysis. Cardiovasc Diagn Ther. 2019;9(1):1-7.
8. Choi HN, Yim JE. Plasma Adropin as a Potential Marker Predicting Obesity and Obesity-associated Cancer in Korean Pati-ents With Type 2 Diabetes Mellitus. J Cancer Prev. 2018;23(4):191-6.

9. Prystupa A, Kiciński P, Luchowska-Kocot D, Sak J, Prystupa T, Chen KH, et al. Afamin and adropin in patients with alcohol-induced liver cirrhosis. Ann Agric Environ Med. 2018;25(3):527-31.
10. Sarac M, Bakal U, Kuloglu T, Tartar T, Aydin S, Yardim M, et al. Effects of Carnosine and Vitamin E on Nucleobindin 2 (NUCB2)/nesfatin-1, Ghrelin, Adropin, and Irisin in Experimentally Induced Ovarian Torsion. Ann Clin Lab Sci. 2018;48(3):345-54.
11. Bozic J, Borovac JA, Galic T, Kurir TT, Supe-Domic D, Dogas Z. Adropin and Inflammation Biomarker Levels in Male Patients With Obstructive Sleep Apnea: A Link With Glucose Metabolism and Sleep Parameters. J Clin Sleep Med. 2018;14(7):1109-18.
12. Nergiz S, Altinkaya SO, Kurt Ömürlü İ, Yuksel H, Küçük M, Demircan Sezer S. Circulating adropin levels in patients with en-dometrium cancer. Gynecol Endocrinol. 2015;31(9):730-5.
13. Gutch M, Kumar S, Razi SM, Gupta KK, Gupta A. Assessment of insulin sensitivity/resistance. Indian journal of endocrino-logy and metabolism. 2015;19(1):160-4.
14. Constantine GD, Kessler G, Graham S, Goldstein SR. Increased Incidence of Endometrial Cancer Following the Women’s Health Initiative: An Assessment of Risk Factors. J Womens Health (Larchmt). 2019;28(2):237-43.
15. NCD Risk Factor Collaboration (NCD-RisC). Worldwide trends in body-mass index, underweight, overweight, and obesity from 1975 to 2016: a pooled analysis of 2416 population-based measurement studies in 128·9 million children, adoles-cents, and adults. Lancet. 2017;390(10113):2627-42.
16. Sung H, Siegel RL, Torre LA, Pearson-Stuttard J, Islami F, Fedewa SA, et al. Global patterns in excess body weight and the associated cancer burden. CA Cancer J Clin. 2019;69(2):88-112.
17. Grandi G, Perrone AM, Chiossi G, Friso S, Toss A, Sammarini M, et al. Increasing BMI is associated with both endometrioid and serous histotypes among endometrial rather than ovarian cancers: a case-to-case study. Gynecol Oncol. 2019;154(1):163-8.
18. Heidari F, Rabizadeh S, Mansournia MA, Mirmiranpoor H, Salehi SS, Akhavan S, et al. Inflammatory, oxidative stress and anti-oxidative markers in patients with endometrial carcinoma and diabetes. Cytokine. 2019;120:186-90.
19. Oruc CU, Akpinar YE, Dervisoglu E, Amikishiyev S, Salmaslıoglu A, Gurdol F, et al. Low concentrations of adropin are asso-ciated with endothelial dysfunction as assessed by flow-mediated dilatation in patients with metabolic syndrome. Clin Chem Lab Med. 2017;55(1):139-44.
20. Zang H, Jiang F, Cheng X, Xu H, Hu X. Serum adropin levels are decreased in Chinese type 2 diabetic patients and negati-vely correlated with body mass index. Endocr J. 2018;65(7):685-91.
21. Celik A, Balin M, Kobat MA, Erdem K, Baydas A, Bulut M, et al. Deficiency of a new protein associated with cardiac synd-rome X; called adropin. Cardiovasc Ther. 2013;31(3):174-8.
22. Kandoth C, Schultz N, Cherniack AD, Akbani R, Liu Y, Shen H, et al. Integrated genomic characterization of endometrial carcinoma. Nature. 2013;497(7447):67-73.