Changes in inflammatory endometrial cancer risk biomarkers in individuals undergoing surgical weight loss

DOI

10.1016/j.ygyno.2017.07.144

Document Type

Journal Article

Publication Date

10-1-2017

Publication Title

Gynecologic Oncology

Volume

147

Issue

1

First Page

133

Last Page

138

ISSN

908258

Keywords

Bariatric surgery, Biomarkers, Endometrial cancer, Obesity, Weight loss

Abstract

Objective Obesity has been strongly linked to endometrial cancer (EC) risk. A number of potential EC risk biomarkers have been proposed, including heightened pro-inflammatory cytokines and adipokines. To evaluate if bariatric surgery can serve as a means for altering levels of such EC risk biomarkers, we investigated changes in these biomarkers after weight loss. Methods Blood samples were collected pre-operatively and 6 months post-operatively in 107 female bariatric surgery patients aged 18–72 years. Wilcoxon signed-rank tests were used to compare biomarker levels (measured using xMAP immunoassays) pre- and post-surgery. Normative comparisons were implemented to contrast 6-month post-surgery biomarker levels to levels in a sample of 74 age-matched non-obese women. Linear regression was used to evaluate the relationship between biomarker expression at baseline and 6 months post-surgery and the relationship between race and biomarker levels. Results On average, participants lost 30.15 kg (SD: 12.26) after the bariatric intervention. Levels of C-peptide, insulin, CRP, leptin, IL-1Rα, and IL-6 significantly decreased, while levels of SHBG, IGFBP1, and adiponectin significantly increased with weight loss. Normative comparisons showed the levels of SHBG, C-peptide, insulin, IGFBP1, adiponectin, CRP, and TNFα after bariatric intervention approached the level of markers in comparison group. Multiple regression analyses revealed significant relationships between changes in BMI and changes in biomarker levels. The changes in IL-1Rα were significantly associated with race. Conclusions Our findings demonstrate that normalization of EC risk biomarkers can be achieved with bariatric surgery. Improved understanding of biological mechanisms associated with weight loss may inform preventive strategies for EC.

Open Access

Green Accepted

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