title: Serum adiponectin is associated with worsened overall survival in a prospective cohort of hepatocellular carcinoma patients.
abstract: BACKGROUND
  Hepatocellular carcinoma (HCC) is the third leading cause of cancer deaths worldwide. The rise in metabolic syndrome has contributed to this trend. Adipokines, such as adiponectin, are associated with prognosis in several cancers, but have not been well studied in HCC.
  
  
  METHODS
  We prospectively enrolled 140 patients with newly diagnosed or recurrent HCC with Child-Pugh (CP) class A or B cirrhosis. We examined associations between serum adipokines, clinicopathological features of HCC, and time to death. We also examined a subset of tumors with available pathology for tissue adiponectin receptor (AR) expression by immunohistochemistry.
  
  
  RESULTS
  The median age of subjects was 62 years; 79% were men, 59% had underlying hepatitis C, and 36% were diabetic. Adiponectin remained a significant predictor of time to death (hazard ratio 1.90; 95% confidence interval 1.05-3.45; p = 0.03) in a multivariable adjusted model that included age, alcohol history, CP class, stage, and serum α-fetoprotein level. Cytoplasmic AR expression (AR1 and AR2) in tumors trended higher in those with higher serum adiponectin levels and in those with diabetes mellitus, but the association was not statistically significant.
  
  
  CONCLUSIONS
  In this hypothesis-generating study, we found the serum adiponectin level to be an independent predictor of overall survival in a diverse cohort of HCC patients.
  
  
  CONCLUSIONS
  Understanding how adipokines affect the HCC outcome may help develop novel treatment and prevention strategies.
authors.affiliation: Department of Medicine, Columbia University Medical Center, New York, N.Y., USA.
authors.forename: Abby B
authors.initials: AB
authors.lastname: Siegel
authors.forename: Abhishek
authors.initials: A
authors.lastname: Goyal
authors.forename: Marcela
authors.initials: M
authors.lastname: Salomao
authors.forename: Shuang
authors.initials: S
authors.lastname: Wang
authors.forename: Valerie
authors.initials: V
authors.lastname: Lee
authors.forename: Christine
authors.initials: C
authors.lastname: Hsu
authors.forename: Rosa
authors.initials: R
authors.lastname: Rodriguez
authors.forename: Dawn L
authors.initials: DL
authors.lastname: Hershman
authors.forename: Robert S
authors.initials: RS
authors.lastname: Brown
authors.forename: Alfred I
authors.initials: AI
authors.lastname: Neugut
authors.forename: Jean
authors.initials: J
authors.lastname: Emond
authors.forename: Tomoaki
authors.initials: T
authors.lastname: Kato
authors.forename: Benjamin
authors.initials: B
authors.lastname: Samstein
authors.forename: David
authors.initials: D
authors.lastname: Faleck
authors.forename: Raffi
authors.initials: R
authors.lastname: Karagozian
mesh_terms: D052242:Adiponectin / Q000097:blood*; D000328:Adult; D000368:Aged; D006528:Carcinoma, Hepatocellular / Q000097:blood / Q000401:mortality*; D015331:Cohort Studies; D005260:Female; D006801:Humans; D007333:Insulin Resistance; D020738:Leptin / Q000097:blood; D008113:Liver Neoplasms / Q000097:blood / Q000401:mortality*; D008297:Male; D008875:Middle Aged; D016016:Proportional Hazards Models; D011446:Prospective Studies; D054419:Receptors, Adiponectin / Q000032:analysis
chemical_list: D052242:Adiponectin; D020738:Leptin; D054419:Receptors, Adiponectin