title: Perioperative Adiponectin Measurement is Useful for Prediction of Postoperative Infection in Patients with Colorectal Cancer.
abstract: BACKGROUND
  Adiponectin (ADN) is a key molecule associated with obesity and metabolic syndrome, and functions as an immunomodulator. We have shown that the ADN ratio (i.e., postoperative ADN/preoperative ADN) can predict infection after gastrectomy in patients with gastric cancer . In the present study, we evaluated whether the ADN ratio could reliably predict the incidence of postoperative infection in patients undergoing colorectal cancer surgery.
  
  
  METHODS
  We retrospectively analyzed 131 consecutive patients who underwent colorectal cancer surgery and measured their preoperative and postoperative ADN values. The outcome was postoperative infection, including surgical site and remote infections. The association between the ADN ratio and postoperative infection was assessed using logistic regression models. For the ADN ratio and other significant predictors, we conducted receiver operating characteristics (ROC) analyses.
  
  
  RESULTS
  Forty-nine patients (37.4 %) experienced postoperative infections. Logistic regression analysis indicated that the ADN ratio was most significantly associated with postoperative infection [odds ratio per one standard deviation (1 SD) decrease 0.36; 95 % confidence interval 0.18-0.71] even after adjustment for diabetes, type of surgery, blood loss, C-reactive protein level, and preoperative ADN level. History of type 2 diabetes mellitus also significantly predicted postoperative infection (odds ratio per 1 SD increase 2.93; 95 % confidence interval 1.03-8.38). When predicting postoperative infection, the area under the ROC curve for the ADN ratio (0.707) was comparable to that for blood loss (0.698; p = 0.975).
  
  
  CONCLUSIONS
  ADN ratio is a clinically useful predictor of postoperative infection in patients undergoing colorectal cancer.
authors.affiliation: Department of Surgery, Shiga University of Medical Science, Shiga, Japan. yhiroshi@belle.shiga-med.ac.jp.
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Yamamoto
authors.affiliation: Department of Metabolic Medicine, Osaka University Hospital, Osaka, Japan.
authors.forename: Kazuhisa
authors.initials: K
authors.lastname: Maeda
authors.affiliation: Department of Preventive Medicine and Public Health, Faculty of Medicine, Fukuoka University, Fukuoka, Japan.
authors.forename: Hisatomi
authors.initials: H
authors.lastname: Arima
authors.affiliation: Department of Surgery, Shiga University of Medical Science, Shiga, Japan.
authors.forename: Hiromichi
authors.initials: H
authors.lastname: Sonoda
authors.affiliation: Department of Surgery, Shiga University of Medical Science, Shiga, Japan.
authors.forename: Tomoharu
authors.initials: T
authors.lastname: Shimizu
authors.affiliation: Department of Comprehensive Surgery, Shiga University of Medical Science, Shiga, Japan.
authors.forename: Eiji
authors.initials: E
authors.lastname: Mekata
authors.affiliation: Department of Surgery, Shiga University of Medical Science, Shiga, Japan.
authors.forename: Sachiko
authors.initials: S
authors.lastname: Kaida
authors.affiliation: Department of Surgery, Shiga University of Medical Science, Shiga, Japan.
authors.forename: Tsuyoshi
authors.initials: T
authors.lastname: Yamaguchi
authors.affiliation: Department of Surgery, Shiga University of Medical Science, Shiga, Japan.
authors.forename: Satoshi
authors.initials: S
authors.lastname: Murata
authors.affiliation: Department of Public Health, Shiga University of Medical Science, Shiga, Japan.|Center for Epidemiologic Research in Asia, Shiga University of Medical Science, Shiga, Japan.
authors.forename: Katsuyuki
authors.initials: K
authors.lastname: Miura
authors.affiliation: Division of Gastrointestinal Pathophysiology, Department of Bioscience, Institute of Natural Medicine, University of Toyama, Toyama, Japan.
authors.forename: Makoto
authors.initials: M
authors.lastname: Kadowaki
authors.affiliation: Department of Surgery, Shiga University of Medical Science, Shiga, Japan.
authors.forename: Masaji
authors.initials: M
authors.lastname: Tani