Soliman PT et al. (2006) Association between adiponectin, insulin resistance and endometrial cancer. Cancer 106: 2376–2381

A study by Soliman et al. reports that low levels of adiponectin are a risk factor for endometrial cancer. Levels of this protein, which is secreted by adipose cells, show a negative correlation with the prediabetic state of insulin resistance and hyperinsulinemia; these conditions might therefore contribute to endometrial cancer development.

Serum adiponectin levels were measured in 117 women with endometrial cancer (cases) and 238 women with no cancer history (controls), and their association with endometrial cancer determined. Mean serum adiponectin levels were significantly lower in cases than in controls (88.8 ± 63.3 ng/ml and 148.2 ± 68.3 ng/ml, respectively; P <0.001), a difference that remained after adjustment for age, BMI, diabetes, and hypertension. As expected from previous studies, age, BMI and hypertension were all independently associated with endometrial cancer, but serum adiponectin level showed the strongest association, with cases over 10 times more likely to have adiponectin levels in the lowest tertile, and nearly 3 times more likely to have adiponectin levels in the intermediate tertile, than controls (P <0.001 and P = 0.05, respectively). Obesity is widely regarded as the strongest risk factor for endometrial cancer; this study showed a strong association between adiponectin level and endometrial cancer even in the subset of non-overweight (BMI <25 kg/m2) women, and indicates that insulin resistance is independently associated with this cancer.

Soliman et al. comment that data concerning other potential risk factors in their patients were lacking, and state that their results need confirmation in a prospective longitudinal study that calculates the relative risk associated with insulin resistance and developing endometrial cancer.