Chin Med J 2007;120(18):1592-1596
Adipocytokines and breast cancer risk
HOU Wei-kai, XU Yu-xin, YU Ting, ZHANG Li, ZHANG Wen-wen, FU Chun-li, SUN Yu, WU Qing and CHEN Li
Keywords: obesity; cytokines; breast neoplasms
Background Many researches suggested that obesity increased the risk of breast cancer, but the mechanism was
currently unknown. Adipocytokines might mediate the relationship. Our study was aimed to investigate the relationship
between serum levels of resistin, adiponectin and leptin and the onset, invasion and metastasis of breast cancer.
Methods Blood samples were collected from 80 newly diagnosed, histologically confirmed breast cancer patients and
50 age-matched healthy controls. Serum levels of resistin, adiponectin and leptin were determined by enzyme-linked
immunosorbent assays (ELISA); fasting blood glucose (FBG), lipids, body mass index (BMI), and waist circumference
(WC) were assayed simultaneously.
Results Serum levels of adiponectin ((8.60±2.92) mg/L vs (10.37±2.81) mg/L, P=0.001) and HDL-c were significantly
decreased in breast cancer patients in comparison to controls. Serum levels of resistin ((26.35±5.36) μg/L vs (23.32±4.75)
μg/L, P=0.000), leptin ((1.35±0.42) μg/L vs (1.06±0.39) μg/L, P=0.003), FBG and triglyceride (TG) in breast cancer
patients were increased in contrast to controls, respectively. However, we did not find the significant difference of the
serum levels of resistin, adiponectin and leptin between premenopausal breast cancer patients and healthy controls (P＝
0.091, 0.109 and 0.084, respectively). The serum levels of resistin, adiponectin and leptin were significantly different
between patients with lymph node metastasis (LNM) and those without LNM (P=0.001, 0.000 and 0.006, respectively).
The stepwise regression analysis indicated that the tumor size had the close correlation with leptin (R2=0.414, P=0.000)
and FBG (R2=0.602, P=0.000). Logistic regression analysis showed that reduced serum levels of adiponectin (OR: 0.805;
95%CI: 0.704–0.921; P＝0.001), HDL (OR: 0.087; 95%CI: 0.011–0.691, P＝0.021), elevated leptin (OR: 2.235;
95%CI:1.898–4.526; P＝0.004) and resistin (OR: 1.335; 95%CI: 1.114–2.354; P＝0.012) increased the risk for breast
cancer; Reduced serum levels of adiponectin (OR: 0.742; 95%CI: 0.504–0.921; P=0.003) and elevated leptin (OR: 2.134;
95%CI:1.725–3.921; P= 0.001) were associated with lymph node metastasis of breast cancer.
Conclusions The decreased serum adiponectin levels and increased serum resistin and leptin levels are risk factors of
breast cancer. The low serum adiponectin levels and high serum leptin levels are independent risk factors for metastasis
of cancer. The association between obesity and breast cancer risk might be explained by adipocytokines.
Chin Med J 2007;120(18):1592-1596
reast cancer is a malignant tumor which severely
harms the female health. Researches have shown that
obesity possibly correlates with risk for breast cancer,
especially with onset and prognosis of postmenopausal
breast cancer, but the concrete mechanism is in nubibus.
Recent researches indicate adipose tissue as an endocrine
organ, which secretes adiponectin, resistin, leptin and
other cytokines.1 Although many recent researches find
that some adipocytokines may play an important role in
the onset of breast cancer in obese people, the
relationship between adipocytokines and breast cancer
need further study. We measured serum levels of
adiponectin, resistin, leptin and obesity-related metabolic
factors of Chinese breast cancer patients, in order to
investigate the correlation between adipocytokines and
onset, development and metastasis of breast cancer.
We selected eighty women who were newly diagnosed as
having breast cancer and treated surgically at Qilu
Hospital of Shandong University from January 2005 to
January 2006. Of whom forty-three were premenopausal
and thirty-seven postmenopausal. The median age was 48
years (19–87 years). Diagnosis of breast cancer was
confirmed histologically in each case (Infiltrating ductal
carcinomas, 46 cases; Infiltrating lobular carcinoma, 24;
Medullary carcinomas or other types of carcinoma,10).
Of the 80 patients, 49 were estrogen receptor
(ER)-positive and 41 were progesterone (PR)-positive;
The staging of breast cancer was determined according to
the TNM system. The distribution of the TNM staging
was 13 patients in TNM I, 43 in TNM II, 24 in TNM III.
All patients had never accepted radiotherapy or
chemotherapy before operation.
We chose 50 healthy women (26 premenopausal women
and 24 postmenopausal women) as controls, who attended
Department of Endocrinology, Qilu Hospital of Shandong
University, Jinan 250012, China (Hou WK, Xu YX, Yu T, Zhang L,
Zhang WW, Fu CL, Sun Y and Chen L)
Department of Breast Surgery, Qilu Hospital of Shandong
University, Jinan 250012, China (Wu Q)
Correspondence to: Dr. CHEN Li, Department of Endocrinology,
Qilu Hospital of Shandong University, Jinan 250012, China
(86-531-82169452. Email: firstname.lastname@example.org)