High Leptin and Low Adiponectin Levels in The Metabolic Syndrome Patients with Malignancy

Ria Ambarwati, Damai Santosa, Eko Adhi Pangarsa, Budi Setiawan, Mika Lumban Tobing, Muchlis Achsan Udji Sofro, Dharminto Dharminto, Tjokorda Gde Dalem Pemayun, Catharina Suharti


BACKGROUND: Metabolic syndrome (MetS), which is characterized by insulin resistance, adipocyte accumulation, and obesity, has been linked to malignancy development. Both leptin, an adipose tissue-produced cytokine-like hormone, and adiponectin, a hormone secreted by adipose tissue, play roles in the progression of MetS. However, the presence of leptin and adiponectin is also assumed to be associated with cancer proliferation. Therefore, it is necessary to investigate the profile of leptin and adiponectin levels in MetS patients with malignancy and non-malignancy.

METHODS: This was a cross-sectional study involving 80 MetS subjects with and without malignancy. Leptin and adiponectin levels of subjects were analyzed by using the enzyme-linked immunosorbent assay (ELISA) method. Mann-Whitney tests were used to compare leptin and adiponectin levels between groups.

RESULTS: Leptin levels were significantly higher in MetS patients with malignancy (32.99±22.47 ng/mL) than those without malignancy (6.17±7.46 ng/mL). Conversely, adiponectin levels were lower in the malignancy group (10.11±7.66 µg/mL) compared to the non-malignancy group (13.44±8.29 µg/mL), with both differences being statistically significant (p<0.001 for leptin, p=0.023 for adiponectin).

CONCLUSION: Leptin levels were found to be higher while adiponectin levels were found to be lower in MetS patients with malignancy compared to those without malignancy. Therefore, it is suggested that leptin and adiponectin levels might be used as malignancy markers in MetS patients.

KEYWORDS: adiponectin, leptin, metabolic syndrome, malignancy

Full Text:



UpToDate [Internet]. Meigs JB. Metabolic Syndrome (Insulin Resistance Syndrome or Syndrome X) [updated 2021; cited 2022 Oct 22]. Available from: https://www.uptodate.com/.

Ford E, Giles W, Dietz W. Prevalence of the metabolic syndrome among US adults: Findings from the Third National Health and Nutrition Examination Survey. JAMA. 2002; 287(3): 356-9, CrossRef.

Hirode G, Wong R. Trends in the prevalence of metabolic syndrome in the United States, 2011-2016. JAMA. 2020; 323(24): 2526-8, CrossRef.

Dutta D, Ghosh S, Pandit K, Mukhopadhyay P, Chowdhury S. Leptin and cancer: Pathogenesis and modulation. Indian J Endocrinol Metab. 2012; 16(9): 596, CrossRef.

Febriza A, Ridwan R, As'ad S, Kasim VN, Idrus HH. Adiponectin and its role in inflammatory process of obesity. Mol Cell Biomed Sci. 2019; 3(2): 60-6, CrossRef.

Sulistiowati E, Sihombing M. NCEP-ATP III and IDF criteria for metabolic syndrome predict type 2 diabetes mellitus. Universa Medicina. 2016; 35(1): 46-55, CrossRef.

Cook MB, Dawsey SM, Freedman ND, Inskip PD, Wichner SM, Quraishi SM, et al. Sex disparities in cancer incidence by period and age. Cancer Epidemiol Biomarkers Prev. 2009; 18(4): 1174-82, CrossRef.

Ali I, Högberg J, Hsieh JH, Auerbach S, Korhonen A, Stenius U, et al. Gender differences in cancer susceptibility: Role of oxidative stress. Carcinogenesis. 2016; 37(10): 985-92, CrossRef.

Botta L, Dal Maso L, Guzzinati S, Panato C, Gatta G, Trama A, et al. Changes in life expectancy for cancer patients over time since diagnosis. J Adv Res. 2019; 20: 153-9, CrossRef.

Busti F, Marchi G, Ugolini S, Castagna A, Girelli D. Anemia and iron deficiency in cancer patients: Role of iron replacement therapy. Pharmaceuticals. 2018; 11(4): 94, CrossRef.

Liberti MV, Locasale JW. The Warburg effect: How does it benefit cancer cells? Trends Biochem Sci. 2016; 41(3): 211-8, CrossRef.

Ghahremanfard F, Mirmohammadkhani M, Shahnazari B, Gholami G, Mehdizadeh J. The valuable role of measuring serum lipid profile in cancer progression. Oman Med J. 2015; 3(5): 353-7, CrossRef.

Tu H, McQuade JL, Davies MA, Huang M, Xie K, Ye Y, et al. Body mass index and survival after cancer diagnosis: A pan-cancer cohort study of 114 430 patients with cancer. Innov. 2022; 3(6): 100344, CrossRef.

Esposito K, Chiodini P, Colao A, Lenzi A, Giugliano D. Metabolic syndrome and risk of cancer. Diabetes Care. 2012; 35(11): 2402-11, CrossRef.

Trevisan M, Liu J, Muti P, Misciagna G, Menotti A, Fucci F. Markers of insulin resistance and colorectal cancer mortality. Cancer Epidemiol Biomarkers Prev. 2001; 10(9): 937-41, PMID.

Rodrigo C, Tennekoon KH, Karunanayake EH, De Silva K, Amarasinghe I, Wijayasiri A. Circulating leptin, soluble leptin receptor, free leptin index, visfatin and selected leptin and leptin receptor gene polymorphisms in sporadic breast cancer. Endocr J. 2017; 64(4): 393-401, CrossRef.

Candra N, Wijaya A, As'ad S. Correlation between adiponectin, tumor necrosis factor-alpha, insulin resistance and atherogenic dyslipidemia in non-diabetic central obese males. Indones Biomed J. 2010; 2(1): 73-9, CrossRef.

Isidori AM, Strollo F, Morè M, Caprio M, Aversa A, Moretti C, et al. Leptin and aging: Correlation with endocrine changes in male and female healthy adult populations of different body weights. J Clin Endocrinol Metab. 2000; 85(5): 1954-62, CrossRef.

Balaskó M, Soós S, Székely M, Pétervári E. Leptin and aging: Review and questions with particular emphasis on its role in the central regulation of energy balance. J Chem Neuroanat. 2014; 61-62: 248-55, CrossRef.

Shankar A, Xiao J. Positive relationship between plasma leptin level and hypertension. Hypertension. 2010; 56(4): 623-8, CrossRef.

Guadagni F, Roselli M, Martini F, Spila A, Riondino S, D'Alessandro R, et al. Prognostic significance of serum adipokine levels in colorectal cancer patients. Anticancer Res. 2009; 29(8): 3321-7, PMID.

Gonullu G, Kahraman H, Bedir A, Bektas A, Yücel I. Association between adiponectin, resistin, insulin resistance, and colorectal tumors. Int J Colorectal Dis. 2010; 25(2): 205-12, CrossRef.

Michalakis K, Williams CJ, Mitsiades N, Blakeman J, Balafouta-Tselenis S, Giannopoulos A, et al. Serum adiponectin concentrations and tissue expression of adiponectin receptors are reduced in patients with prostate cancer: A case control study. Cancer Epidemiol Biomarkers Prev. 2007; 16(2): 308-13, CrossRef.

Petridou ET, Sergentanis TN, Antonopoulos CN, Dessypris N, Matsoukis IL, Aronis K, et al. Insulin resistance: An independent risk factor for lung cancer? Metabolism. 2011; 60(8): 1100-6, CrossRef.

White MC, Holman DM, Boehm JE, Peipins LA, Grossman M, Jane Henley S. Age and cancer risk. Am J Prev Med. 2014; 46(3): S7-15, CrossRef.

Wan S, Lai Y, Myers RE, Li B, Palazzo JP, Burkart AL, et al. Post-diagnosis hemoglobin change associates with overall survival of multiple malignancies – Results from a 14-year hospital-based cohort of lung, breast, colorectal, and liver cancers. BMC Cancer. 2013; 13(1): 340, CrossRef.

Retnowardani A, Kresno SB, Arif M. Association of obesity and breast cancer risk: The role of estrogen, tumor necrosis factor-alpha, and adiponectin as risk factors (preliminary study). Indones Biomed J. 2009; 1(1): 45-52, CrossRef.

Colt JS, Schwartz K, Graubard BI, Davis F, Ruterbusch J, DiGaetano R, et al. Hypertension and risk of renal cell carcinoma among white and black americans. Epidemiology. 2011; 22(6): 797-804, CrossRef.

DOI: https://doi.org/10.18585/inabj.v15i5.2567

Copyright (c) 2023 The Prodia Education and Research Institute

Creative Commons License
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.


Indexed by:






The Prodia Education and Research Institute