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Adipocyte and Cell Biology

Systemic adiponectin levels in colorectal cancer and adenoma: a systematic review and meta-analysis

International Journal of Obesity volume 47, pages 911–921 (2023)Cite this article

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Abstract

Background

Obesity is a well-established risk factor in the development of colorectal cancer; however, the mechanism mediating this relationship is not well understood. The adipokine, adiponectin, has an inverse relationship with obesity. Experimental studies have shown adiponectin to have dichotomous inflammatory and tumorigenic roles. Its role in the development of colorectal cancer, including the potential effect of its increase following bariatric surgery, is not yet clear. There are conflicting results from studies evaluating this relationship. This study sought to provide a systematic review and meta-analysis to examine the association between systemic adiponectin levels in patients with colorectal cancer and adenoma.

Methods

An electronic literature search was performed using PubMed, EMBASE, Web of Science as well as gray literature. Articles were screened for inclusion criteria and assessed for quality using the Newcastle–Ottawa Scale. Pooled mean differences were calculated using a random effects model. Subgroup and meta-regression analyses were performed to identify potential sources of heterogeneity.

Results

Thirty-two observational studies comparing systemic adiponectin in colorectal cancer vs healthy controls were included. Colorectal cancer cases had lower systemic adiponectin levels (overall pooled mean difference = −1.05 μg/ml [95% CI: −1.99; −0.12] p = 0.03); however, significant heterogeneity was present (I2 = 95% p < 0.01). Subgroup and meta- regression analyses results could not identify a source of the significant heterogeneity across the studies.

Conclusions

Studies suggest a trend towards lower systemic adiponectin levels in colorectal cancer patients, but the heterogeneity observed showed current evidence is not sufficient to definitively draw any conclusions. These data, however, suggest rising adiponectin is unlikely to account for the reported observation of increased CRC following bariatric surgery. Further studies with prospective age, race, and BMI-matched cohorts, and standardized adiponectin measurements may provide a better understanding of this relationship.

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Fig. 1: PRISMA flow chart of study screening and selection of studies.
Fig. 2: Forest plot of studies (n = 32) of adiponectin in CRC vs controls.
Fig. 3: Funnel plot of studies included in meta-analysis on the difference in adiponectin in colorectal cancer or adenoma vs normal control.

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Data availability

All data included and analyzed is available via contacting corresponding author.

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Funding

This work is supported indirectly by the John W. Price and Barbara Thruston Atwood Price Trust. Funding source had no role in the design and conduct of the study or the collection, analysis and interpretation of the data.

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Authors and Affiliations

  1. Price Institute of Surgical Research, Department of Surgery, University of Louisville School of Medicine, Louisville, KY, USA

    Anne Macleod, Katharina M. Scheurlen, James F. Burton, Mary Alex Parks & Susan Galandiuk

  2. Department of Bioinformatics and Biostatistics, University of Louisville, Louisville, KY, USA

    Mst Sharmin Akter Sumy & Jeremy T. Gaskins

  3. Hiram C. Polk Jr. MD Department of Surgery, University of Louisville, Louisville, KY, USA

    Susan Galandiuk

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Contributions

AM contributed to design; data acquisition, analysis, and interpretation; manuscript writing. KMS contributed conception and design, data interpretation and manuscript revision. JFB and MAP contributed to data acquisition, analysis, and manuscript revision. SS contributed to data acquisition, analysis, and interpretation. JTG contributed to data analysis and interpretation, and manuscript revision. SG contributed to conception and design, data interpretation, and manuscript revision.

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Correspondence to Susan Galandiuk.

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Competing interests

SG is the Editor-in-Chief of the journal Diseases of the Colon and Rectum, is the Director of the Price Institute of Surgical Research, and receives support from AbbVie for clinical research not related to this work. All other authors have no competing interests or conflicts of interest to declare.

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Macleod, A., Scheurlen, K.M., Burton, J.F. et al. Systemic adiponectin levels in colorectal cancer and adenoma: a systematic review and meta-analysis. Int J Obes 47, 911–921 (2023). https://doi.org/10.1038/s41366-023-01358-6

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