Association of serum leptin with serum estradiol in relation to breast carcinogenesis: a comparative case-control study between pre- and postmenopausal women

Background/aim: The aims of this study were to observe the interhormonal relationship of serum leptin with serum estradiol and to compare pre- and postmenopausal women for possible implications in breast carcinogenesis. Materials and methods: This comparative case-control study encompasses 175 breast cancer patients and 175 age-, sex-, and BMI- matched healthy controls. For comparison, the subjects were divided into pre- and postmenopausal groups according to their menstrual history. Blood samples were analyzed for serum leptin and serum estradiol by the ELISA method. Results: Higher mean values of serum estrogen and leptin were observed in breast cancer cases among both the pre- and postmenopausal groups. While estimating the association of serum leptin with serum estradiol, a weak positive (r = 0.186) but statistically significant (P = 0.022) correlation was found among the premenopausal subjects, while a moderate positive association (r = 0.556) was found among the postmenopausal subjects, which had high statistical significance (P = 0.001). Furthermore, correlation coefficients (r) of the pre- and postmenopausal groups were compared using Fisher r-to-z transformation and found to have a statistically significant difference (z = 4.03, P = 0.0001). Conclusion: The findings of this study suggest the mitogenic effects of leptin on mammary tissue via augmenting peripheral estrogen production more significantly among postmenopausal subjects. Thus, the therapeutic modulation of leptin may be a potential adjuvant treatment for breast cancer patients with high levels of leptin along with high estrogen concentration as a consequence.

Serum Adiponectin Level Association with Breast Cancer Risk: Evidence from a Case-Control Study.

BACKGROUND: Adiponectin is a protein, synthesized by adipose tissue, which has a questionable role in breast cancer pathogenesis. This study focused on serum levels of adiponectin among cases and controls, and its possible association with breast cancer risk. MATERIALS AND METHODS: This case-control study covered 175 diagnosed breast cancer patients with positive histopathology from Breast Clinic, surgical unit-1, Civil Hospital, Karachi and 175 healthy controls from various screening programs. Blood samples were obtained after an overnight fast and later analyzed. RESULTS: Fasting blood glucose was significantly raised, while serum adiponectin was significantly decreased in breast cancer cases when compared to control subjects. To find the precise influence of serum adiponectin on the risk of breast cancer, subjects were divided in to quartiles based on serum levels of adiponectin. It is observed that risk of breast cancer decreased with rising quartile. Q2 (25th-50th) had the highest OR=1.76 (CI: 0.93-3.34), Q3 (50th-75th) has OR=0.89 (CI: 0.48-1.64), while subjects in the highest quartile Q4 (>75th) had significantly (p< 0.05) decreased risk of breast cancer having OR=0.06 (CI: 0.02-0.15), when compared to the lowest quartile. CONCLUSIONS: We demonstrated a statistically significant association of elevated serum adiponectin with decreased risk of breast cancer. This signifies a protective role of adiponectin via an intricate mechanism of masking mitogenic growth factors in breast carcinogenesis.

Elevated fasting blood glucose is associated with increased risk of breast cancer: outcome of case-control study conducted in Karachi, Pakistan.

BACKGROUND: There are several validated risk factors for breast cancer. However the legitimacy of elevated fasting blood glucose (FBG) is not well established. This study was designed to assess this parameter as a risk factor for breast cancer among pre- and post-menopausal women. MATERIALS AND METHODS: This case-control study was conducted at Department of Biochemistry, University of Karachi from June 2010 to August 2014. Simple random sampling technique was used to collect data of study subjects comprising 175 diagnosed breast cancer patients with positive histopathology from Breast Clinic, surgical unit-1, Civil Hospital, Karachi and 175 healthy controls from various screening programs. Blood samples were analyzed for FBG and serum insulin. RESULTS: FBG, HOMA-IR, systolic and diastolic blood pressure were significantly raised in breast cancer cases when compared to control subjects. Cases and controls were further categorized in to two groups using cutoff value of 110 mg/dl to distinguish subjects into normal fasting glucose (<110 mg/dl) and having impaired fasting glucose (≥110-≤125 mg/dl) or diabetes (≥126 mg/dl). Odds ratios were found to be 1.57, 2.15 and 1.17 in overall, pre-menopausal and post-menopausal groups, respectively. (all p<0.05). CONCLUSIONS: A statistically significant risk of breast cancer exists in women having elevated fasting blood glucose levels, corresponding to prediabetes and diabetes, among pre and postmenopausal ages, with comparatively greater effects in the premenopausal group.

Serum estrogen and interleukin-6 levels in postmenopausal female osteoarthritis patients.

The objective of the present study is to determine whether the levels of endogenous estrogen and interleukin-6 (IL-6) are associated with osteoarthritis (OA) in postmenopausal women. Forty-three patients who were suffering from osteoarthritis were studied and twenty control normal subjects having no symptoms of osteoarthritis disease, were also included in the study. The estrogen hormone and interleukin-6 were measured in the serum by Enzyme linked immunosorbent assay technique. Interleukin-6 and estrogen both were detected in serum. In osteoarthritis patients IL-6 levels were high as compared to control subjects (P<0.001) and estrogen levels in OA postmenopausal females was decreased significantly (p<0.01) when compared with control subjects. There was a minimal inverse correlation between IL-6 and estrogen (P<0.05) in the sera of postmenopausal osteoarthritic women. These results indicate that estrogen deficiency after menopause may cause alterations of IL-6 in postmenopausal osteoarthritic patients.

Risk profile for breast carcinoma and tumour histopathology of medical uninsured patients in Pakistan.

BACKGROUND: Breast carcinoma is an unpredictable disease in the sense that some patients may die at early disease stage due to wide-spread metastasis within six months to one year, while others may survive longer. This study was aimed to evaluate the risk factors for breast carcinoma occurrence and histopathological features of breast carcinoma developed in the social and economical conditions of Pakistan. METHODS: A total of 224 female breast cancer diagnosed patients with uncovered medical insurance visiting at the Oncology clinic of a teaching hospital at Karachi, Pakistan were selected for the study. Two hundred and twenty-four (224) healthy female subjects free of any cancer diagnosis were selected as control from different areas of the city. Information on stress, occupation, life history, and life style was obtained through personal interviews. Breast tumour pathology was evaluated for histological grade, lymph node metastasis and hormone receptor status by using standard methods. Student's t-test, Chi-square test and ANOVA were used for comparison. RESULTS: Breast cancer patients in significantly high percentage reported early marriages, abortion occurrence, stressful life style, family cancer history and past disease suffering from diabetes and hypertension. Life style including aerosol chewing and fat rich food intake was significantly high among the patients (p<0.05). On histopathological analysis, patients at the age of 40 years and below were identified in significantly high percentage with tumour grade III, 1-3 lymph node metastasis and hormone receptor negative type. Increasing age was associated with low tumour grade and less percentage of lymph node metastasis. Significantly high percentage of patients were presented with hormone receptor positive tumour (p<0.05). CONCLUSION: The contributing factors for breast carcinoma occurrence were related to life history and life-style of the patients. Medical insurance uncovered patients at initial diagnosis were presented in significantly high percentage with advanced disease including high tumour grade and lymph node metastasis due to less use of preventive and screening service which delays the diagnosis, effecting both survival and treatment cost.

Evaluation of toxicities induced by chemotherapy in breast cancer patients.

The study includes the breast cancer female patients who had received chemotherapy (CMF, tamoxifen) and the newly diagnosed breast cancer patients, who had not received any chemotherapy. The patients who had received six cycles of CMF had shown low RBC, WBC and platelet count, elevated levels of SGPT, alkaline phosphatase and lactate dehydrogenase as compared to newly diagnosed breast cancer patients. The RBC count is increased in patients who had received CMF and tamoxifen as compared to the patients received only CMF, the alkaline phosphatase level is also declined in patients who had received CMF and tamoxifen as compared to the patients received CMF only.