title: The level of fasting serum insulin, but not adiponectin, is associated with the prognosis of early stage hepatocellular carcinoma.
abstract: Impaired glucose tolerance influences the prognosis of hepatocellular carcinoma (HCC), but this mechanism is still not fully understood. We investigated the impact of the fasting serum levels of insulin and adiponectin on the prognosis of HCC and its recurrence. One hundred and forty patients with newly diagnosed HCC were enrolled in the prognosis study. Their fasting serum levels of insulin and adiponectin were determined. Of 140 patients, 59 patients who underwent curative treatment were subjected to analysis of the recurrence-free survival. The 140 patients were divided into two groups by the 50th percentile value of insulin (7.73 microIU/ ml) or total adiponectin (6.95 microg/ml). Kaplan-Meier analysis indicated that high insulin group (>7.73 microIU/ml) exhibited a significantly poorer prognosis than low insulin group (<7.73 microIU/ml) in early stage HCC (P=0.018). In contrast, the level of total adiponectin had no impact on the prognosis of HCC. Multivariate analysis indicated that fasting hyper-insulinemia was an independent risk factor for a poorer prognosis in early stage HCC (P=0.044). Likewise, Kaplan-Meier analysis indicated that the recurrence-free survival of high insulin group was significantly lower than that of low insulin group (P=0.017). The level of total adiponectin had no impact on the recurrence-free survival of HCC. Multivariate analysis indicated that fasting hyperinsulinemia was an independent risk factor for the lower recurrence-free survival of HCC (P=0.049). In conclusion, our study suggests that the fasting insulin level affects the clinical course of early stage HCC.
authors.affiliation: Department of Gastroenterology and Hepatology Graduate School of Biomedical Sciences, Nagasaki University, Nagasaki, Japan. miuma-gi@umin.net
authors.forename: Satoshi
authors.initials: S
authors.lastname: Miuma
authors.forename: Tatsuki
authors.initials: T
authors.lastname: Ichikawa
authors.forename: Naota
authors.initials: N
authors.lastname: Taura
authors.forename: Hidetaka
authors.initials: H
authors.lastname: Shibata
authors.forename: Shigeyuki
authors.initials: S
authors.lastname: Takeshita
authors.forename: Motohisa
authors.initials: M
authors.lastname: Akiyama
authors.forename: Yasuhide
authors.initials: Y
authors.lastname: Motoyoshi
authors.forename: Eisuke
authors.initials: E
authors.lastname: Ozawa
authors.forename: Masumi
authors.initials: M
authors.lastname: Fujimoto
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Kawashimo
authors.forename: Hisamitsu
authors.initials: H
authors.lastname: Miyaaki
authors.forename: Katsumi
authors.initials: K
authors.lastname: Eguchi
authors.forename: Kazuhiko
authors.initials: K
authors.lastname: Nakao
mesh_terms: D052242:Adiponectin / Q000097:blood*; D017668:Age of Onset; D000368:Aged; D015992:Body Mass Index; D006528:Carcinoma, Hepatocellular / Q000097:blood* / Q000175:diagnosis; D005260:Female; D006801:Humans; D007328:Insulin / Q000097:blood*; D008113:Liver Neoplasms / Q000097:blood* / Q000175:diagnosis; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D011379:Prognosis; D012307:Risk Factors; D013997:Time Factors
chemical_list: D052242:Adiponectin; D007328:Insulin