title: 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).
  
  
  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.
  
  
  CONCLUSIONS
  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.
authors.affiliation: Laboratory of Oncoendocrinology, N.N. Petrov Research Institute of Oncology, St Petersburg 197758, Russia; Laboratory of Oncoendocrinology, N.N. Petrov Research Institute of Oncology, St Petersburg 197758, Russia.
authors.forename: Lev M
authors.initials: LM
authors.lastname: Berstein
authors.affiliation: Laboratory of Oncoendocrinology, N.N. Petrov Research Institute of Oncology, St Petersburg 197758, Russia; Laboratory of Oncoendocrinology, N.N. Petrov Research Institute of Oncology, St Petersburg 197758, Russia.
authors.forename: Tatyana E
authors.initials: TE
authors.lastname: Poroshina
authors.affiliation: Department of Tumor Morphology, N.N. Petrov Research Institute of Oncology, St Petersburg 197758, Russia; Department of Tumor Morphology, N.N. Petrov Research Institute of Oncology, St Petersburg 197758, Russia.
authors.forename: Elena A
authors.initials: EA
authors.lastname: Turkevich
authors.affiliation: Laboratory of Oncoendocrinology, N.N. Petrov Research Institute of Oncology, St Petersburg 197758, Russia; Laboratory of Oncoendocrinology, N.N. Petrov Research Institute of Oncology, St Petersburg 197758, Russia.
authors.forename: Dmitry A
authors.initials: DA
authors.lastname: Vasilyev
authors.affiliation: Division of Oncogynecology, N.N. Petrov Research Institute of Oncology, St Petersburg 197758, Russia; Division of Oncogynecology, N.N. Petrov Research Institute of Oncology, St Petersburg 197758, Russia.
authors.forename: Alexandra N
authors.initials: AN
authors.lastname: Baltrukova
authors.affiliation: Laboratory of Oncoendocrinology, N.N. Petrov Research Institute of Oncology, St Petersburg 197758, Russia; Laboratory of Oncoendocrinology, N.N. Petrov Research Institute of Oncology, St Petersburg 197758, Russia.
authors.forename: Irina M
authors.initials: IM
authors.lastname: Kovalenko
authors.affiliation: Division of Oncogynecology, N.N. Petrov Research Institute of Oncology, St Petersburg 197758, Russia; Division of Oncogynecology, N.N. Petrov Research Institute of Oncology, St Petersburg 197758, Russia.
authors.forename: Igor V
authors.initials: IV
authors.lastname: Berlev
keywords: endometrial cancer; metabolically healthy obese; obesity types; tumor features and subtypes