Endometrial cancer: association with serum adipokines, specialized pro-resolving mediators, clinical and morphological characteristics of the tumour with hyperglycemia and obesity

Background. Endometrial cancer (EC) is closely associated with carbohydrate and lipid metabolism disorders, which are triggers for obesity and decreased sensitivity of insulin-dependent tissues to insulin (insulin resistance), which in turn leads to hormonal imbalance, increased estrogen levels and the presence of a chronic low-intensity inflammatory reaction. Important mediators that regulate inflammatory reactions and indirectly affect carbohydrate metabolism are adipokines and specialized pro-resolving mediators (SpRM). Aim. To study the relationship between the content of SpRM and adipokines in blood serum of patients with EC and dysmetabolic disorders and clinical / morphological characteristics of the tumor. Materials and methods. A single-center, non-interventional, cross-sectional comparative study included 45 patients with EC (endometrioid adenocarcinoma, T1–2N0M0). The study assessed the serum levels of adipokines (adiponectin and visfatin), SpRM (maresin-1 and protectin D1) in comparison with carbohydrate metabolism indices, body mass index, clinical and morphological characteristics of the tumor (tumor size, presence of myometrial invasion and tumor grade). Results. In EC patients with dysmetabolic disorders, a significant decrease in the level of adiponectin was revealed (1.4-fold decrease in the case of hyperglycemia (p = 0.048) and a 1.45-fold decrease in the case of body mass index ≥30 kg / m2 (p = 0.041). A 2.25-fold decrease in the level of visfatin was found in cases with impaired tissue sensitivity to insulin (p = 0.011). Carbohydrate metabolism disorders in EC are accompanied by loss of correlation relationships between the studied parameters. The present study was the first to demonstrate results concerning the content of SpRM (maresin-1 and protectin D1) in EC. In EC patients with normal blood glucose concentration, statistically significant differences in the levels of adiponectin were found between patients with different depth of myometrial invasion. Conclusion. The revealed changes in the levels of adipokines and SpRM are not specific to the tumor process; however, they affect the clinical and morphological characteristics of the tumor. These biologically active components have a regulatory effect on various metabolic pathways, which must be taken into account during EC treatment.