Abstract
Some studies have observed a lower circulating level of adiponectin in cancer patients, but whether this observation is causal remains unresolved. We therefore undertook a meta-analysis implementing Mendelian randomization to exploit the causal relevance of circulating adiponectin with cancer by using multiple polymorphisms in adiponectin encoded gene ADIPOQ as instrumental variables. Eligible articles were identified from PubMed and Embase. Data and study quality were assessed in duplicate. Total 26 articles including 31 study groups were analyzed. Overall allelic association with cancer was significant for rs822396 (odds ratio (OR) = 0.91; P = 0.045) and rs1501299 (OR = 0.89; P = 0.051), with low or moderate heterogeneity. Carriers of rs2241766 GG genotype (weighted mean difference (WMD) = 0.86; P = 0.037) or G allele (WMD = 0.68; P = 0.047) had significantly higher circulating adiponectin than the TT genotype carriers, without heterogeneity. Using rs2241766 as an instrument in Mendelian randomization analysis, an increment of 1 mg/L in circulating adiponectin was significantly associated with a 43–50 % reduced risk for lung cancer, but with a 20–40 % increased risk of colorectal cancer, respectively. There was no observable publication bias. Genetically elevated circulating adiponectin might confer a protective effect against lung cancer, yet a risky effect for colorectal cancer. Further validation is urgently required.
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References
Dalamaga M, Diakopoulos KN, Mantzoros CS. The role of adiponectin in cancer: a review of current evidence. Endocr Rev. 2012;33:547–94.
Hebbard L, Ranscht B. Multifaceted roles of adiponectin in cancer. Best Pract Res Clin Endocrinol Metab. 2014;28:59–69.
Smith GD, Ebrahim S. Mendelian randomization: prospects, potentials, and limitations. Int J Epidemiol. 2004;33:30–42.
Al-Harithy RN, Al-Zahrani MH. The adiponectin gene, ADIPOQ, and genetic susceptibility to colon cancer. Oncol Lett. 2012;3:176–80.
Dastani Z, Hivert MF, Timpson N, Perry JR, Yuan X, Scott RA, et al. Novel loci for adiponectin levels and their influence on type 2 diabetes and metabolic traits: a multi-ethnic meta-analysis of 45,891 individuals. PLoS Genet. 2012;8:e1002607.
Moher D, Liberati A, Tetzlaff J, Altman DG. Preferred reporting items for systematic reviews and meta-analyses: the PRISMA statement. PLoS Med. 2009;6:e1000097.
Higgins JP, Thompson SG, Deeks JJ, Altman DG. Measuring inconsistency in meta-analyses. BMJ. 2003;327:557–60.
Bowden J, Tierney JF, Copas AJ, Burdett S. Quantifying, displaying and accounting for heterogeneity in the meta-analysis of RCTs using standard and generalised Q statistics. BMC Med Res Methodol. 2011;11:41.
Doecke JD, Zhao ZZ, Stark MS, Green AC, Hayward NK, Montgomery GW, et al. Single nucleotide polymorphisms in obesity-related genes and the risk of esophageal cancers. Cancer Epidemiol Biomarkers Prev. 2008;17:1007–12.
Kaklamani VG, Sadim M, Hsi A, Offit K, Oddoux C, Ostrer H, et al. Variants of the adiponectin and adiponectin receptor 1 genes and breast cancer risk. Cancer Res. 2008;68:3178–84.
Kaklamani VG, Wisinski KB, Sadim M, Gulden C, Do A, Offit K, et al. Variants of the adiponectin (ADIPOQ) and adiponectin receptor 1 (ADIPOR1) genes and colorectal cancer risk. JAMA. 2008;300:1523–31.
Wong VW, Wong GL, Tsang SW, Hui AY, Chan AW, Choi PC, et al. Genetic polymorphisms of adiponectin and tumor necrosis factor-alpha and nonalcoholic fatty liver disease in Chinese people. J Gastroenterol Hepatol. 2008;23:914–21.
Moore SC, Leitzmann MF, Albanes D, Weinstein SJ, Snyder K, Virtamo J, et al. Adipokine genes and prostate cancer risk. Int J Cancer. 2009;124:869–76.
Pechlivanis S, Bermejo JL, Pardini B, Naccarati A, Vodickova L, Novotny J, et al. Genetic variation in adipokine genes and risk of colorectal cancer. Euro J Endocrinol. 2009;160:933–40.
Teras LR, Goodman M, Patel AV, Bouzyk M, Tang W, Diver WR, et al. No association between polymorphisms in LEP, LEPR, ADIPOQ, ADIPOR1, or ADIPOR2 and postmenopausal breast cancer risk. Cancer Epidemiol Biomarkers Prev. 2009;18:2553–7.
Tsilidis KK, Helzlsouer KJ, Smith MW, Grinberg V, Hoffman-Bolton J, Clipp SL, et al. Association of common polymorphisms in IL10, and in other genes related to inflammatory response and obesity with colorectal cancer. Cancer Causes Control. 2009;20:1739–51.
Wang MH, Helzlsouer KJ, Smith MW, Hoffman-Bolton JA, Clipp SL, Grinberg V, et al. Association of IL10 and other immune response- and obesity-related genes with prostate cancer in CLUE II. Prostate. 2009;69:874–85.
Beebe-Dimmer JL, Zuhlke KA, Ray AM, Lange EM, Cooney KA. Genetic variation in adiponectin (ADIPOQ) and the type 1 receptor (ADIPOR1), obesity and prostate cancer in African Americans. Prostate Cancer Prostatic Dis. 2010;13:362–8.
Partida-Perez M, de la Ayala-Madrigal LM, Peregrina-Sandoval J, Macias-Gomez N, Moreno-Ortiz J, Leal-Ugarte E, et al. Association of LEP and ADIPOQ common variants with colorectal cancer in Mexican patients. Cancer Biomark. 2010;7:117–21.
Al Khaldi RM, Al Mulla F, Al Awadhi S, Kapila K, Mojiminiyi OA. Associations of single nucleotide polymorphisms in the adiponectin gene with adiponectin levels and cardio-metabolic risk factors in patients with cancer. Dis Markers. 2011;30:197–212.
Cui E, Deng A, Wang X, Wang B, Mao W, Feng X, et al. The role of adiponectin (ADIPOQ) gene polymorphisms in the susceptibility and prognosis of non-small cell lung cancer. Biochem Cell Biol. 2011;89:308–13.
Dhillon PK, Penney KL, Schumacher F, Rider JR, Sesso HD, Pollak M, et al. Common polymorphisms in the adiponectin and its receptor genes, adiponectin levels and the risk of prostate cancer. Cancer Epidemiol Biomarkers Prev. 2011;20:2618–27.
Gornick MC, Rennert G, Moreno V, Gruber SB. Adiponectin gene and risk of colorectal cancer. Br J Cancer. 2011;105:562–4.
He B, Pan Y, Zhang Y, Bao Q, Chen L, Nie Z, et al. Effects of genetic variations in the adiponectin pathway genes on the risk of colorectal cancer in the Chinese population. BMC Med Genet. 2011;12:94.
Kaklamani V, Yi N, Zhang K, Sadim M, Offit K, Oddoux C, et al. Polymorphisms of ADIPOQ and ADIPOR1 and prostate cancer risk. Metab Clin Exp. 2011;60:1234–43.
Tang H, Dong X, Hassan M, Abbruzzese JL, Li D. Body mass index and obesity- and diabetes-associated genotypes and risk for pancreatic cancer. Cancer Epidemiol Biomarkers Prev. 2011;20:779–92.
Keku TO, Vidal A, Oliver S, Hoyo C, Hall IJ, Omofoye O, et al. Genetic variants in IGF-I, IGF-II, IGFBP-3, and adiponectin genes and colon cancer risk in African Americans and Whites. Cancer Causes Control. 2012;23:1127–38.
Chornokur G, Amankwah EK, Davis SN, Phelan CM, Park JY, Pow-Sang J, et al. Variation in HNF1B and obesity may influence prostate cancer risk in African American men: a pilot study. Prostate Cancer. 2013;2013:384594.
Hu X, Yuan P, Yan J, Feng F, Li X, Liu W, et al. Gene polymorphisms of +45 T>G, −866 G>A, and Ala54Thr on the risk of colorectal cancer: a matched case-control study. PLoS One. 2013;8:e67275.
Kaklamani VG, Hoffmann TJ, Thornton TA, Hayes G, Chlebowski R, Van Horn L, et al. Adiponectin pathway polymorphisms and risk of breast cancer in African Americans and Hispanics in the Women’s Health Initiative. Breast Cancer Res Treat. 2013;139:461–8.
Ye L, Zhang ZY, Du WD, Schneider ME, Qiu Y, Zhou Y, et al. Genetic analysis of ADIPOQ variants and gastric cancer risk: a hospital-based case-control study in china. Med Oncol. 2013;30:658.
Cai X, Gan Y, Fan Y, Hu J, Jin Y, Chen F, et al. The adiponectin gene single-nucleotide polymorphism rs1501299 is associated with hepatocellular carcinoma risk. Clin Translational Oncol. 2014;16:166–72.
Llanos AA, Brasky TM, Mathew J, Makambi KH, Marian C, Dumitrescu RG, Freudenheim JL, Shields PG. Genetic variation in adipokine genes and associations with adiponectin and leptin concentrations in plasma and breast tissues. Cancer Epidemiol Biomarkers Prev. 2014;23(8):1559–68. doi:10.1158/1055-9965.
Li Q, Ma Y, Sang W, Cui W, Li X, Liu X, et al. Five common haplotype-tagging variants of adiponectin (ADIPOQ) and cancer susceptibility: a meta-analysis. Genet Test Mol Biomarkers. 2014;18:417–24.
Zhou W, Liu Y, Zhong DW. Adiponectin (ADIPOQ) rs2241766 G/T polymorphism is associated with risk of cancer: evidence from a meta-analysis. Tumour Biol. 2013;34:493–504.
Ye C, Wang J, Tan S, Zhang J, Li M, Sun P. Meta-analysis of adiponectin polymorphisms and colorectal cancer risk. Int J Med Sci. 2013;10:1113–20.
Yang Y, Zhang F, Ding R, Skrip L, Wang Y, Lei H, et al. ADIPOQ gene polymorphisms and cancer risk: a meta-analysis. Cytokine. 2013;61:565–71.
Fan HJ, Wen ZF, Xu BL, Wu JJ, Jia YX, Gao M, et al. Three adiponectin rs1501299G/T, rs822395A/C, and rs822396A/G polymorphisms and risk of cancer development: a meta-analysis. Tumour Biol. 2013;34:769–78.
Ye J, Jia J, Dong S, Zhang C, Yu S, Li L, et al. Circulating adiponectin levels and the risk of breast cancer: a meta-analysis. Eur J Cancer Prev. 2014;23:158–65.
Macis D, Guerrieri-Gonzaga A, Gandini S. Circulating adiponectin and breast cancer risk: a systematic review and meta-analysis. Int J Epidemiol. 2014;43(4):1226–36. doi:10.1093/ije/dyu088.
Liu LY, Wang M, Ma ZB, Yu LX, Zhang Q, Gao DZ, et al. The role of adiponectin in breast cancer: a meta-analysis. PLoS One. 2013;8:e73183.
An W, Bai Y, Deng SX, Gao J, Ben QW, Cai QC, et al. Adiponectin levels in patients with colorectal cancer and adenoma: a meta-analysis. Eur J Cancer Prev. 2012;21:126–33.
Xu XT, Xu Q, Tong JL, Zhu MM, Huang ML, Ran ZH, et al. Meta-analysis: circulating adiponectin levels and risk of colorectal cancer and adenoma. J Dig Dis. 2011;12:234–44.
Vanderweele TJ, Tchetgen Tchetgen EJ, Cornelis M, Kraft P. Methodological challenges in Mendelian randomization. Epidemiology. 2014;25:427–35.
Goktas S, Yilmaz MI, Caglar K, Sonmez A, Kilic S, Bedir S. Prostate cancer and adiponectin. Urology. 2005;65:1168–72.
Ishikawa M, Kitayama J, Kazama S, Hiramatsu T, Hatano K, Nagawa H. Plasma adiponectin and gastric cancer. Clin Cancer Res. 2005;11:466–72.
Bianchini F, Kaaks R, Vainio H. Overweight, obesity, and cancer risk. Lancet Oncol. 2002;3:565–74.
Chen DC, Chung YF, Yeh YT, Chaung HC, Kuo FC, Fu OY, et al. Serum adiponectin and leptin levels in Taiwanese breast cancer patients. Cancer Lett. 2006;237:109–14.
Petridou E, Mantzoros C, Dessypris N, Koukoulomatis P, Addy C, Voulgaris Z, et al. Plasma adiponectin concentrations in relation to endometrial cancer: a case-control study in Greece. J Clin Endocrinol Metab. 2003;88:993–7.
Cardon LR, Bell JI. Association study designs for complex diseases. Nat Rev Genet. 2001;2:91–9.
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Yuan Pei and Yue Xu, the first two authors, contributed equally to this work.
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Pei, Y., Xu, Y. & Niu, W. Causal relevance of circulating adiponectin with cancer: a meta-analysis implementing Mendelian randomization. Tumor Biol. 36, 585–594 (2015). https://doi.org/10.1007/s13277-014-2654-x
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DOI: https://doi.org/10.1007/s13277-014-2654-x