- 作者：Maria Dalamaga ; Konstantinos Karmaniolas ; John Chamberl ; Athina Nikolaidou ; Antigoni Lekka ; Amalia Dionyssiou-Asteriou ; Christos S. Mantzoros
- 关键词：AML ; Acute Myeloid Leukemia ; BMI ; Body Mass Index ; BM ; bone marrow ; CMML ; chronic myelomonocytic leukemia ; FAB ; French American British Classification ; FLI ; free leptin index ; HGF ; hepatocyte growth factor ; IL-6 ; interleukin-6 ; IPSS ; International Prognostic Scoring System ; IR ; insulin resistance ; LHC ; lymphohematopoietic cancer ; Mets ; metabolic syndrome ; MDS ; myelodysplastic syndrome ; RA ; refractory anemia ; RAEB ; refractory anemia with excess blasts ; RAEB-t ; refractory anemia with excess blasts
- 刊名：Metabolism
- 出版年：December, 2013
- 年：2013
- 卷：62
- 期：12
- 页码：1830-1839
- 全文大小：379 K
Objective
Excess body weight has been implicated in the pathogenesis of myelodysplastic syndrome (MDS). We thus explored the role of serum fetuin-A reflecting ectopic hepatic fat deposition when storage capacity of adipocytes has been exceeded, free leptin reflecting overall fat mass and adiponectin reflecting visceral fat mass, all potential mediators of the effects of obesity on insulin resistance and, consequently, to MDS risk.Materials & Methods
In a hospital-based case-control study, we studied 101 cases with incident, histologically confirmed primary MDS and 101 controls matched on gender, age and date of diagnosis, between 2004 and 2007. Serum fetuin-A, adiponectin, leptin, leptin receptor, free leptin and insulin were determined.
Results
Higher serum fetuin-A, lower adiponectin and lower free leptin were all individually and independently associated with higher risk of MDS before and after controlling for matching and risk factors, such as age, gender, date of diagnosis, body mass index (BMI), family history of lymphohematopoietic cancer, smoking history and serum insulin. Interestingly, we have shown that these associations were prominent among overweight/obese individuals and persisted after controlling for BMI and serum insulin indicating that their effects are above and beyond insulinemia only.
Conclusion
Elevated serum fetuin-A but lower adiponectin and free leptin are associated with higher risk of MDS particularly among overweight/obese individuals. These findings suggest that the association between excessive weight gain and the risk of MDS could be mediated by fetuin-A, adiponectin and free leptin, which may have potential clinical and preventive implications.