title: Endometrial cancer associated biomarkers in bariatric surgery candidates: exploration of racial differences.
abstract: BACKGROUND
  Obesity is the main risk factor for endometrial cancer (EC), the most common gynecologic malignancy in the United States. A number of potential risk biomarkers have been associated with EC development, including altered proinflammatory cytokines, chemokines, and adipokines.
  
  
  OBJECTIVE
  The overarching aim of this research is to investigate racial differences in the expression of EC-associated biomarkers among bariatric surgery candidates.
  
  
  METHODS
  Tertiary academic medical center METHODS: Blood samples were collected from 175 women aged 18 to 72 (mean age: 42.93; standard deviation 11.66), before bariatric surgery. Levels of biomarkers associated with obesity and EC risk were measured using xMAP immunoassays. Wilcoxon rank sum and Fisher's exact tests were utilized to compare biomarker and demographic variables between African American and European American women. Linear regression models, adjusted for menopause status and diabetes, were utilized to identify factors associated with biomarker levels.
  
  
  RESULTS
  When the biomarker levels were compared by race, insulin-like growth factor-binding protein 1 and adiponectin were significantly lower in African American women (P<.05), whereas estradiol was significantly higher in African American women (P<.05). Linear regression models found that race significantly predicted insulin-like growth factor binding protein 1, adiponectin, resistin, and interleukin-1 receptor alpha expression levels, menopause status and diabetes status were significantly associated with adiponectin and leptin levels, whereas body mass index was significantly associated with leptin, adiponectin, interleukin-1 receptor alpha, and interleukin-6 levels.
  
  
  CONCLUSIONS
  As one of the first efforts to explore racial differences in EC-associated biomarkers in a cohort of women with severe obesity, this study found several significant differences that should be further explored in large-scale studies.
authors.affiliation: Magee-Womens Research Institute, Department of Obstetrics, Gynecology and Reproductive Sciences, University of Pittsburgh, Pittsburgh, Pennsylvania; Department of Epidemiology, University of Pittsburgh, Pittsburgh, Pennsylvania; University of Pittsburgh Cancer Institute, Pittsburgh, Pennsylvania. Electronic address: linkfy@mail.magee.edu.
authors.forename: Faina
authors.initials: F
authors.lastname: Linkov
authors.affiliation: Magee-Womens Research Institute, Department of Obstetrics, Gynecology and Reproductive Sciences, University of Pittsburgh, Pittsburgh, Pennsylvania.
authors.forename: Sharon L
authors.initials: SL
authors.lastname: Goughnour
authors.affiliation: Magee-Womens Research Institute, Department of Obstetrics, Gynecology and Reproductive Sciences, University of Pittsburgh, Pittsburgh, Pennsylvania; University of Pittsburgh Cancer Institute, Pittsburgh, Pennsylvania.
authors.forename: Robert P
authors.initials: RP
authors.lastname: Edwards
authors.affiliation: Department of Medicine, University of Pittsburgh, and the Luminex Core Laboratory, University of Pittsburgh Cancer Institute, Pittsburgh, Pennsylvania.
authors.forename: Anna
authors.initials: A
authors.lastname: Lokshin
authors.affiliation: Division of Minimally Invasive and Bariatric Surgery, University of Pittsburgh, Pittsburgh, Pennsylvania.
authors.forename: Ramesh C
authors.initials: RC
authors.lastname: Ramanathan
authors.affiliation: Division of Minimally Invasive and Bariatric Surgery, University of Pittsburgh, Pittsburgh, Pennsylvania.
authors.forename: Giselle G
authors.initials: GG
authors.lastname: Hamad
authors.affiliation: Division of Minimally Invasive and Bariatric Surgery, University of Pittsburgh, Pittsburgh, Pennsylvania.
authors.forename: Carol
authors.initials: C
authors.lastname: McCloskey
authors.affiliation: University of Pittsburgh Cancer Institute, Pittsburgh, Pennsylvania; Departments of Psychiatry, Psychology, and Behavioral & Community Health Sciences, University of Pittsburgh, Pittsburgh, Pennsylvania.
authors.forename: Dana H
authors.initials: DH
authors.lastname: Bovbjerg
mesh_terms: D054392:Adipokines / Q000378:metabolism; D000293:Adolescent; D000328:Adult; D001741:Black or African American / Q000208:ethnology*; D000368:Aged; D050110:Bariatric Surgery; D014408:Biomarkers, Tumor / Q000378:metabolism*; D018925:Chemokines / Q000378:metabolism; D016207:Cytokines / Q000378:metabolism; D016889:Endometrial Neoplasms / Q000097:blood / Q000208:ethnology*; D005260:Female; D006801:Humans; D010535:Laparoscopy; D008875:Middle Aged; D009767:Obesity, Morbid / Q000097:blood / Q000208:ethnology* / Q000601:surgery; D044465:White People / Q000208:ethnology*; D055815:Young Adult
chemical_list: D054392:Adipokines; D014408:Biomarkers, Tumor; D018925:Chemokines; D016207:Cytokines
keywords: Bariatric surgery; Biomarkers; Endometrial cancer; Inflammation; Racial differences