Circulating levels of adiponectin may provide a novel marker for identifying individuals who are at an increased risk for pancreatic cancer, report researchers.
In a prospective study of data pooled from five large US cohorts, Ying Bao (Harvard Medical School, Boston, Massachusetts, USA) and colleagues found that low prediagnostic adiponectin is associated with a significantly increased risk for pancreatic cancer.
"Our data provide additional evidence for a biological link between obesity, insulin resistance, and pancreatic cancer risk and also suggest an independent role of adiponectin in the development of pancreatic cancer," write the researchers in the Journal of the National Cancer Institute.
On comparing follow-up data (available for up to 26 years since blood collection) for 468 individuals with pancreatic cancer and 1080 matched controls, the team found that the median baseline level of adiponectin was significantly lower in individuals who developed pancreatic cancer than in the healthy controls, at 6.2 µg/mL versus 6.8 µg/mL, respectively.
A significant inverse relationship between plasma adiponectin and risk for pancreatic cancer was observed. Compared with individuals in the lowest quintile for circulating adiponectin (<4.4 µg/mL), those in quintiles 2-5 (4.4-5.8, 5.9-7.8, 2.9-10.8, and ≥10.9 µg/mL) had a reduction in risk for pancreatic cancer of 39%, 42%, 41%, and 34%, respectively, after adjustment for race, multivitamin use, vitamin D level, diabetes, body mass index, physical activity, and plasma C-peptide.
Multivariate regression analysis showed that the adjusted odds ratios for pancreatic cancer declined significantly with increasing levels of adiponectin up to 5 µg/mL, and then plateaued.
"Adiponectin has a central role in the regulation of glucose and lipid metabolism," note the researchers. "Because impaired glucose processing, obesity, and Type 2 diabetes have been linked to incident pancreatic cancer, adiponectin may decrease pancreatic cancer risk by favorably modulating insulin resistance."
In an accompanying editorial, Jianliang Zhang (Roswell Park Cancer Institute, New York, USA) notes: "Currently most cases of pancreatic cancer are diagnosed at a late stage, contributing to high mortality rates. Adiponectin assessment may be used to prescreen patients with metabolic disorders such as diabetes for the detection of pancreatic cancer at an early stage."
Such detection has the potential to improve the survival rates of patients with tumors of the pancreas, he adds.
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