Gong Ting-Ting, Wu Qi-Jun, Wang Yong-Lai, Ma Xiao-Xin
Department of Obstetrics and Gynecology, Shengjing Hospital of China Medical University, Shenyang, Liaoning, People's Republic of China.
Division of Clinical Epidemiology, Shengjing Hospital of China Medical University, Shenyang, Liaoning, People's Republic of China.
Int J Cancer. 2015 Oct 15;137(8):1967-78. doi: 10.1002/ijc.29561. Epub 2015 Apr 22.
We performed this meta-analysis of epidemiologic studies to investigate the associations between circulating adiponectin, leptin and adiponectin-leptin (A/L) ratio and endometrial cancer risk. Relevant manuscripts were identified by searching PubMed and ISI Web of Science databases as well as by manual searching the references cited in retrieved manuscripts. Random-effects models were used to estimate summary odds ratio (SOR) and 95% confidence intervals (CIs) for aforementioned associations. Fourteen manuscripts with 13 studies (five nested case-control and eight case-control studies) cumulatively involving a total of 1,963 endometrial cancer cases and 3,503 noncases were included in the analyses. Overall, comparing persons with circulating concentrations of adiponectin, leptin and A/L ratio in the top tertile with persons with concentrations of these biomarkers in the bottom tertile yielded SORs of 0.47 (95% CI: 0.34-0.65; I(2) = 63.7%; n = 13), 2.19 (95% CI: 1.44-3.31; I(2) = 64.2%; n = 7),and 0.45 (95% CI: 0.24-0.86; I(2) = 90.1%; n = 5), respectively. Notably, there was an 18% reduction in risk for per each 5 μg/mL increment in circulating adiponectin concentrations (SOR = 0.82; 95% CI: 0.74-0.90; I(2) = 49%; n = 8). Stratifying by study characteristics and whether these studies considered or adjusted for potential confounders, the findings were robust in the analyses of circulating adiponectin and leptin. No evidence of publication bias was detected. In conclusion, the findings from this meta-analysis suggest that increased circulating adiponectin and A/L ratio or decreased leptin concentrations were associated with reduced risk of endometrial cancer. Further prospective designed studies are warranted to confirm our findings.
我们进行了这项流行病学研究的荟萃分析，以调查循环脂联素、瘦素及脂联素 - 瘦素（A/L）比值与子宫内膜癌风险之间的关联。通过检索PubMed和ISI科学网数据库以及手动检索所检索手稿中引用的参考文献来识别相关手稿。采用随机效应模型来估计上述关联的汇总比值比（SOR）和95%置信区间（CI）。分析纳入了14篇手稿中的13项研究（5项巢式病例对照研究和8项病例对照研究），累计共涉及1963例子宫内膜癌病例和3503例非病例。总体而言，将循环脂联素、瘦素和A/L比值处于最高三分位数的人群与处于最低三分位数的人群进行比较，得出的SOR分别为0.47（95%CI：0.34 - 0.65；I(2) = 63.7%；n = 13）、2.19（95%CI：1.44 - 3.31；I(2) = 64.2%；n = 7）和0.45（95%CI：0.24 - 0.86；I(2) = 90.1%；n = 5）。值得注意的是，循环脂联素浓度每增加5μg/mL，风险降低18%（SOR = 0.82；95%CI：0.74 - 0.90；I(2) = 49%；n = 8）。按研究特征以及这些研究是否考虑或调整潜在混杂因素进行分层后，循环脂联素和瘦素的分析结果依然稳健。未检测到发表偏倚的证据。总之，这项荟萃分析的结果表明，循环脂联素和A/L比值升高或瘦素浓度降低与子宫内膜癌风险降低相关。需要进一步开展前瞻性设计研究来证实我们的发现。
