| Objective：Obesity has been associated with increased incidence ofhealth problems. Recent studies have linked obesity with an increasedmetabolic syndrome (MetS)(including insulin resistance, dyslipidemia,hypertension and T2DM ect) risk, and suggests that obesity has a majorimpact on the risk of some common forms of malignancy. Hepatocellularcarcinoma (HCC) is the most commonly occurring malignancy and representsthe major histological subtype of primary liver cancer (PLC). It has beenreported that obesity is associated with increased incidence and mortality ofHCC. Vaspin (visceral adipose tissue-derived serpin), a recently identifiedadipocytokine, has been suggested to improve glucose tolerance andinsulin-sensitizing, and decrease an obese and obesity-relatedcomplications．However, the relationships between vaspin, insulin regulation,and fat build-up remain controversial, and only a few studies have beenconducted which examines them in patients with cancer. The aim of this studywas to examine the relationships between vaspin, MetS and HCC.Methods：59patients were enrolled between March2013and September2013at the Hepatobiliary Surgery division of the Fourth Hospital of HebeiMedical University. The patients were divided into tumour group(n=44) andcontrol group(hepatolithiasis, n=15) based on diagnosis after surgery. Thetumour group was subdivided into hepatocellular carcinoma (HCC, n=33)group and hepatocellular carcinoma (HCC, n=11) group. The expression ofvaspin in visceral adipose tissue (VAT) was determined by quantitativereal-time RT-PCR. Fasting plasma glucose(FPG), fasting Insulin (FINS) andblood lipid profile were determined. According to the homeostasis modelassessment, FPG and FINS were used for the estimation of insulin resistance(HOMA-IR), β cell secretion (HOMA-β) and insulin sensitivity (HOMA-IS). Anthropometric measurements and blood pressure were measured. Body massindex (BMI) and waist to hip ratio (WHR) were calculated for all participants.The history of HBV infection, alcohol and tobacco use of all participants wasrecorded.Results：1General characteristics of subjects1.1There were no significant differences in gender, age, SBP, DBP,WHR, total cholesterol (TC), triglycerides (TG), LDL cholesterol (LDL-C),VLDL cholesterol (VLDL-C), HOMA-， the number of patients withhypertension and smoke habit between tumour group and control (P＞0.05).The higher HOMA-IS, more people with BMI＜24kg/m2, BMI≥24kg/m2,infecting HBV, drinking history were seen in tumor group than those incontrol group（P<0.05, P<0.01）, while WC, HC, BMI, BW, HDL cholesterol(HDL-C), FPG, FINS and HOMA-IR in tumour group were much lower thanthose in control group (P<0.01).1.2HCC subjects had significantly higher HOMA-IS and HOMA-β thansubjects had in control group（P<0.05, P<0.01）, and the patients with BMI＜24kg/m2, BMI≥24kg/m2, HBV or drinking history in HCC group weremore than patients in control group（P<0.01）. On the other hand, WC, HC,BMI, BW, HDL-C, FPG, FINS and HOMA-IR were significantly lower inHCC group than control group (P<0.01). The rest of the comparisons werenon-contributory (P＞0.05).1.3The patients with HH were much younger than those in control group(P<0.05). Compared with the control group, there were fewer patients withBMI≥24kg/m2in HH group (P<0.05) and more patients with BMI＜24kg/m2.1.4The levels of HDL-C, FPG, FINS and HOMA-IR in HCC groupswere significantly lower (P<0.01), but the age, the level of TC and HOMA-IS,patients with HBV and drinking history in HCC group were higher（P<0.05,P<0.01）than those in HH groups. gender, SBP, DBP, WC, HC, WHR, BMI,BW, TG, LDL-C, VLDL-C, HOMA-β and the the number of people with hypertension or tobaco consumption did not show any statistical differencebetween HCC and HH groups (P＞0.05).2Vaspin mRNA expression in VAT2.1Vaspin mRNA expression in VAT of four groupsThe vaspin mRNA expression both in tumor and HCC groups werehigher than the controls group(1.322±0.355for tumor group,1.440±0.302forHCC group and1.000for control group), and this difference was statisticallysignificant (P<0.01). The vaspin mRNA expression in HCC group was alsohigher than that (0.972±0.320) in HH group (P<0.05). The vaspin mRNAexpression did not show any statistical difference between HH and controlgroups (P＞0.05).2.2Vaspin mRNA expression in VAT of obese and non-obese groupsVaspin expression was significantly higher in HCC patients with BMI≥24kg/m2than that in patients with BMI<24kg/m2(1.692±0.187vs1.324±0.276, P<0.01). There was no significant differences in vaspinexpression between HH patients with BMI≥24kg/m2and HCC patients withBMI<24kg/m2(0.896±0.066vs.1.201±0.393, P＞0.05).2.3Vaspin mRNA expression inVAT of male and female groupsVaspin expression was significantly lower in male HCC patients thanfemale patients (1.334±0.284vs.1.674±0.297, P<0.05), while there was nodifferences in vaspin expression between male and female HH patients(0.940±0.082vs.1.266±0.441, P＞0.05).3Correlation of expression of vaspin mRNA with clinicopathologiccharacteristics in HCC and HH groupThe expression of vaspin mRNA in HCC group was positively correlatedwith WC (r=0.659, P=0.002), HC(r=0.665, P=0.002), BMI (r=0.659,P=0.002), HDL-C (r=0.484, P=0.036)（P＜0.05, P＜0.01）. A negativecorrelation was present between vaspin and SBP (r=－0.527, P=0.02, P＜0.05). The vaspin expression in HCC was not correlated with DBP, WHR, TC,LDL-C, FPG, FINS and HOMA-IR（P＞0.05）.Vaspin expression in VAT of HH group was not associated with age, SBP, DBP, HC, WHR, BMI, TC, TG, VLDL-C, FPG, FINS, HOMA-IR, HOMA-IS,but associated with HDL-C (r=0.817, P=0.002)（P＜0.01）and LDL-C(r=-0.767, P=0.006)（P＜0.01）.4Multivariate regression analysis of vaspin mRNA expressionMultivariate stepwise regression analysis revealed that SBP, WC, HC,BMI, HDL-C were independent determinants for vaspin mRNA expression ofHCC group, while HDL-C and LDL-C were independent determinants forvaspin mRNA expression of HH group.5Single-factor non-conditional logistic regression analyses revealed thatSBP, WC, HC, BMI, BW, HDL-C, FPG, FINS, HOMA-IR, a history ofalcohol consumption and vaspin expression in VAT were associated with HCCdevelopment.Conclusions：1The high level of vaspin expression in VAT of the HCC patients may beinvolved in HCC development, and vaspin may be a potential tissue biomarkerfor HCC.2Vaspin is closely correlated with the indicators of hypertension, fataccumulation and metabolism, and is a potentially MetS-related biomarker.3HCC could be a MetS-related malignancy.4There were no significantly interactional correlations between vaspinexpression in VAT and IR in HCC patients. Vaspin may not play a role inregulating the insulin sensitivity and stimulating insulin secretion of islet βcells. |
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