Features of Endometrial Cancer in Patients With ‘Metabolically Healthy’ Versus ‘Standard’ Obesity: the Decreasing Frequency of Metabolically Healthy Obesity

Abstract

Background:As endometrial cancer (EC) prevalence increases with obesity, we aimed to determine whether EC characteristics depend upon obesity type: ‘standard’ (SO) or ‘metabolically healthy obesity’ (MHO).Patients & methods:258 EC patients were included. Data on anthropometry, blood hormones, lipids and glucose, and tumor features were collected.Results:EC clinicopathologic characteristics and clinical stage correlate differently with BMI and obesity type. BMI is related inversely with tumor grade while SO patients are characterized by a more advanced clinical stage than those with MHO. Besides typical insulin resistance signs, EC patients with SO often display a higher serum leptin/adiponectin ratio compared with MHO patients. Historical data suggest a gradual increase in EC patient height and weight, and a decrease in MHO prevalence.Conclusion:It is currently unknown whether the latter observation reflects the evolution of EC, or obesity alongside the current epidemic. Regardless, the reduced MHO prevalence demonstrates the need for more intensive preventive measures aimed at obesity and obesity-associated conditions, including different EC subtypes.

Features of omental adipose tissue in endometrial cancer patients with ‘standard’ or ‘metabolically healthy’ obesity: associations with tumor process characteristics

“…On the other hand, these are certainly not final and only arguments as, for example, there is also data on exactly opposed (antitumor like) influence exerted by UCP1 (Chen et al 2009). Besides, the fact of positive correlation between UCP1 expression level in omental fat and EC clinical stage, which is more evident—as was just mentioned—in MHO patients, cannot abolish our earlier data, according to which endometrial cancer clinical stage is more advanced in patients with “standard” (insulin resistance-associated) obesity (Berstein et al 2015). In addition to this, among other studied markers as rather logical seem opposite associations of macrophage lineage label CD68 with EC differentiation grade (low and high, respectively) in females with MHO and SO (Table 4).…”

“…Besides being the possible consequence of gradual changes in EC biology (Evans et al 2011; Berstein et al 2015), the latter ascertaining may also be related to another aspects of obesity problem and its study in uterine body cancer patients. In particular, we must to stress that obesity and high body mass index are not equivalent entities (Crosbie et al 2012) and that obesity draws attention not only due to the growing scale of its epidemics (Kelly et al 2008), but also by the fact of its heterogeneity (Berstein 2012).…”

“…In particular, we must to stress that obesity and high body mass index are not equivalent entities (Crosbie et al 2012) and that obesity draws attention not only due to the growing scale of its epidemics (Kelly et al 2008), but also by the fact of its heterogeneity (Berstein 2012). Due to this, obesity is not always univocal in its manifestations and consequences, justifying in the first place the distinguishing between “standard” (SO), or insulin resistance-associated, and “metabolically healthy” (MHO) obesity phenotypes (Sims 2001; Karelis 2008) and underlining the need in their comparative considering in cancer patients including patients with EC (Berstein et al 2015; Berstein 2012; Calori et al 2011). …”

Systemic Inflammation in Severe Obese Patients Undergoing Surgery for Obesity and Weight-Related Diseases

“…Another important result of our study was the negative correlation of the delta values of adiponectin with the delta of the BMI. As these markers improved their values after BS, we can infer that the inflammatory response reduced, which may lead to a decrease in the association between obesity and cardiovascular risk and cancers, especially those related to obesity such as endometrial cancer [ 46 ].…”

Letter to the editorial office of the journal "Problems of Endocrinology" in connection with the publication of an editorial by prof. P.O.Rumyantsev "Oncoendocrinology - an innovative interdisciplinary platform for personalized medicine"

“…Так, не стоит упускать из виду вопросы о стероидных (в частности, эстрогенах) и нестероидных (ожирение, сахарный диабет, преимущественно 2 типа, и др.) факторах риска опухолевого роста в гормонозависимых тканях [1][2][3][4][5][6], экзогенных агентах/воздействиях, включая алкоголь [7] и курение [8,9], механизмах гормонального канцерогенеза [10,11,12], проблемах резистентности к гормонотерапии [13,14], различиях между рецепторпозитивными и рецепторнегативными новообразованиями, взаимоотношениях заболеваемости опухолями гормонозависимых тканей с некоторыми другими основными неинфекционными заболеваниями и т.д.…”