Circulating adiponectin levels in various malignancies: an updated meta-analysis of 107 studies

Abstract

Early detection of cancers is challenging for lack of specific biomarkers. Adiponectin is an adipokine predominantly derived from adipocytes and hypoadiponectinemia has been reported to associate with risk of many types of cancers. However, available evidence is controversial. Some studies show that increased adiponectin levels correlate with cancer risk. Therefore, we performed a meta-analysis of the association between circulating adiponectin levels and cancer development. A systematic search of PubMed, EMBASE, Wiley Online Library and Cochrane Library was conducted for eligible studies involving circulating adiponectin and malignancies from inception to August 8, 2015. Standard mean differences (SMDs) with 95% confidence intervals (95% CIs) were calculated by use of a random-effect model. Funnel plot and Egger's linear regression test were conducted to examine the risk of publication bias. 107 studies were included with 19,319 cases and 25,675 controls. The pooled analysis indicated that circulating adiponectin levels were lower in patients with various cancers than in controls, with a pooled SMD of -0.334 μg/ml (95% CI, -0.465 to -0.203, P = 0.000). No evidence of publication bias was observed. Circulating high molecular weight adiponectin levels were also lower in cancer patients than in controls, with a pooled SMD of -0.502 μg/ml (95% CI, -0.957 to -0.047, P = 0.000). This meta-analysis provides further evidence that decreased adiponectin levels is associated with risk of various cancers. Hypoadiponectinemia may represent a useful biomarker for early detection of cancers.

Keywords: adiponectin; biomarker; diagnosis; malignancy; meta-analysis.

Figure 1. Flow diagram of the included studies

Figure 2. Forest plot of studies in circulating total adiponectin and cancer risk

The combined SMD and 95% CIs were calculated through a random-effect model.

Figure 3. Forest plot of studies in circulating high molecular weight adiponectin and cancer risk

The combined SMD and 95% CIs were calculated through a random-effect model.

Figure 4. Funnel plot of lower adiponectin expression and cancer risk

Circles indicate included studies.

Figure 5. Egger's linear regression test for publication bias detection