Circulating Leptin, Adiponectin, and Tumor Necrosis Factor-Alpha in Patients Undergoing Surgery Due to Colorectal Cancer

Abstract

Background: Adipocytokines have been proposed as factors mediating associations between obesity and inflammation in patients with colorectal cancer (CRC). Thus, the aim of this study was to determine the clinical relationships between blood concentrations of leptin (LEP), adiponectin (ADP), and tumor necrosis factor alpha (TNF-alpha) and the outcomes measured in patients with CRC undergoing surgery. Patients and Methods: History, body composition, and blood concentrations of LEP, ADP, and TNF-alpha were determined in 107 patients undergoing surgery due to CRC. The patients were followed up for 619.72 ± 371.65 days. Results: Compared to patients with stage II CRC, individuals with clinical stage I CRC had significantly lower ADP and higher TNF-alpha blood concentrations. We found significant correlations between the clinical stage of CRC (early vs. localized vs. metastatic) and the following: crude blood ADP concentration (R = 0.25; p = 0.015), ADP-to-TNF-alpha ratio (R = 0.31; p = 0.002), and ADP when indexed to body surface area (R = 0.25; p = 0.008) and to fat mass (R = 0.25; p = 0.016). The risk of death during the long-term follow-up period was independently related to the clinical stage of CRC, impairment of the patient’s functional status, and higher blood carcinoembryonic antigen concentration. In Kaplan-Meier survival analysis, patients with blood LEP concentrations adjusted to a visceral adipose tissue score of ≥0.47 had a significantly better likelihood of surviving than their counterparts. Conclusions: In patients with CRC undergoing surgery, blood ADP and TNF-alpha concentrations were associated with the clinical stage of the cancer, likelihood of radical tumor excision, occurrence of nonsurgical postoperative complications, and long-term survival, which suggests the role of dysregulation in the endocrine function of adipose tissue in response to the neoplasmatic process.

Effects of Aerobic Exercise on Rats with Hyperandrogenic Polycystic Ovarian Syndrome

“…e ADP/LP ratio is considered to be a functional biomarker of adipose tissue inflammation from recent studies, and a reduced ADP/LP ratio was suggestive of dysfunctional adipose tissue and elevated systemic inflammation [59]. Our correlation analysis results showed that LP was negatively correlated with ADP and positively correlated with proinflammatory factors such as TNF-α, IL-6, and FFA, and this is consistent with previous results and supports the contention that high LP levels are closely related to inflammation [60,61]. An attenuation in inflammation can upregulate the levels of ADP, thus inhibiting the synthesis of androstenedione, reducing the levels of serum androgen, and alleviating hyperandrogenism.…”

Correlation and prognostic implications of intratumor and tumor draining lymph node Foxp3+ T regulatory cells in colorectal cancer

“…Some of these cytokines would have a profound effect on the control of the development of CRC. For example, it was found that high concentration of IL-35 in CRC could inhibit the cancer cell migration, invasion and proliferation, more importantly, suppress the cancer stem cells [ 54 ]; also, the concentration of TNF-α was found to be negatively correlated with the stage in CRC [ 55 ]. In addition, it was long-time established that TNF-α and INF-γ have a strong effect in inhibiting colon cancer cell proliferation [ 56 ], and a combination of these cytokines could resulted in 30–40% more growth inhibition in CRC cell lines [ 57 ].…”

Nutritional and functional status as indices of short- and long-term prognosis in patients undergoing surgery due to colorectal cancer

“…However, the association is complex. On the one hand, overweight and obesity are linked to longer survival of CRC patients after treatment, which is mostly interpreted as the presence of the "obesity paradox" [6][7][8][9]. On the other, there is strong evidence that both malnutrition [10][11][12][13][14] and excess body fat, visceral adiposity, and sarcopenia (reduced skeletal muscle mass, strength and functional performance), especially when it coexists with obesity (sarcopenic obesity), contribute to worse short-, medium-and long-term outcomes of CRC treatment [1, 2, 6-8, 11-13, 15, 16].…”

“…On the other, there is strong evidence that both malnutrition [10][11][12][13][14] and excess body fat, visceral adiposity, and sarcopenia (reduced skeletal muscle mass, strength and functional performance), especially when it coexists with obesity (sarcopenic obesity), contribute to worse short-, medium-and long-term outcomes of CRC treatment [1, 2, 6-8, 11-13, 15, 16]. Numerous explanations for associations between CRC surgery outcomes and patients' baseline nutritional status are proposed, including (a) the effect of adipocytokines (hormonal substances secreted by adipocytes and that induce insulin and insulin-like growth factor-1 [IGF-1] secretion), changes in appetite and energy expenditure, promotion of colonic www.journals.viamedica.pl/medical_research_journal cell proliferation, immune response, and angiogenesis [8,[17][18][19][20][21][22]; (b) possibility to perform of radical operation [1,2,4]; (c) the risk of perioperative complications [1,2]; (d) the response to chemotherapy [23] and the risk of chemotherapy-associated hepatotoxicity due to liver steatosis [4]; and (e) the risk of post-surgery neoplasmatic cachexia and frailty [14,24].…”