scholarly journals Visceral Obesity and Metabolic Syndrome Are Associated with Well-Differentiated Gastroenteropancreatic Neuroendocrine Tumors

Cancers ◽  
2018 ◽  
Vol 10 (9) ◽  
pp. 293 ◽  
Author(s):  
Ana Santos ◽  
Ana Santos ◽  
Clara Castro ◽  
Luís Raposo ◽  
Sofia Pereira ◽  
...  

The determinants for gastroenteropancreatic neuroendocrine tumors (GEP-NET) recent burden are matters of debate. Obesity and metabolic syndrome (MetS) are well established risks for several cancers even though no link with GEP-NETs was yet established. Our aim in this study was to investigate whether well-differentiated GEP-NETs were associated with obesity and MetS. Patients with well-differentiated GEP-NETs (n = 96) were cross-matched for age, gender, and district of residence with a control group (n = 96) derived from the general population in a case-control study. Patients presented gastro-intestinal (75.0%) or pancreatic (22.9%) tumors, grade G1 (66.7%) or G2 (27.1%) with localized disease (31.3%), regional metastasis (16.7%) or distant metastasis (43.8%) at diagnosis, and 45.8% had clinical hormonal syndromes. MetS was defined according to Joint Interim Statement (JIS) criteria. Well-differentiated GEP-NETs were associated with MetS criteria as well as the individual components’ waist circumference, fasting triglycerides, and fasting plasma glucose (p = 0.003, p = 0.002, p = 0.011 and p < 0.001, respectively). The likelihood of the association was higher when the number of individual MetS components was greater than four. MetS and some individual MetS components including visceral obesity, dyslipidemia, and increased fasting glucose are associated with well-differentiated GEP-NET. This data provides a novel insight in unraveling the mechanisms leading to GEP-NET disease.

2021 ◽  
Vol 12 ◽  
Author(s):  
Luigi Barrea ◽  
Giovanna Muscogiuri ◽  
Roberta Modica ◽  
Barbara Altieri ◽  
Gabriella Pugliese ◽  
...  

BackgroundObesity, mainly visceral obesity, and metabolic syndrome (MetS) are major risk factors for the development of type 2 diabetes, cardiovascular diseases, and cancer. Data analyzing the association of obesity and MetS with gastroenteropancreatic neuroendocrine neoplasms (GEP-NEN) are lacking. Fatty liver index (FLI) is a non-invasive tool for identifying individuals with non-alcoholic fatty liver disease (NAFLD). Visceral adiposity index (VAI) has been suggested as a gender-specific indicator of adipose dysfunction. Both indexes have been proposed as early predictors of MetS. This study aimed to investigate the association of FLI VAI as early predictors of MetS with gastroenteropancreatic neuroendocrine tumors (GEP-NETs).MethodsA cross-sectional, case–control, observational study was carried out at the ENETS Centers of Excellence Multidisciplinary Group for Neuroendocrine Tumors, University “Federico II”. VAI and FLI were calculated.ResultsWe enrolled 109 patients with histologically confirmed G1/G2 GEP-NET (53 M; 57.06 ± 15.96 years), as well as 109 healthy subjects, age, sex- and body mass index-matched. Forty-four GEP-NET patients were G2, of which 21 were with progressive disease, and 27 patients had metastases. GEP-NET patients had a higher value of VAI (p &lt; 0.001) and FLI (p = 0.049) and higher MetS presence (p &lt; 0.001) compared with controls. VAI and FLI values and MetS presence were higher in G2 than in G1 patients (p &lt; 0.001), in patients with progressive disease, and in metastatic vs non-metastatic patients (p &lt; 0.001). In addition, higher values of VAI and FLI and higher MetS presence were significantly correlated with the worst clinical severity of NENs. The cut-off values for the FLI and MetS to predict high grading of GEP-NETs and the presence of metastasis were also provided.ConclusionsThis is the first study investigating an association between VAI and FLI as early predictors of MetS and GEP-NET. Our findings report that the worsening of clinicopathological characteristics in GEP-NET is associated with higher presence of MetS, NAFLD, evaluated by FLI, and visceral adiposity dysfunction, evaluated by VAI. Addressing the clinical evaluation of MetS presence, NAFLD, and visceral adiposity dysfunction might be of crucial relevance to establish targeted preventive and treatment interventions of NEN-related metabolic comorbidities.


2020 ◽  
Vol 6 (4) ◽  
pp. 382-390
Author(s):  
EN Adejumo ◽  
OA Adejumo ◽  
OA Ogundahunsi

Background: Inflammation is linked to the aetiopathogenesis of Metabolic syndrome (MetS). Objective: To assess the ability of high sensitivity C-Reactive Protein (hs-CRP), Tumour Necrosis Factor-alpha (TNFα) and Interleukin-6 (IL-6) to predict MetS. Methods: A case-control study involving 123 subjects with MetS (cases) and age-matched 123 subjects. without MetS (controls) was conducted. The levels of TNFα, IL-6, and hs-CRP between independent groups were compared. The Receiver Operative Characteristic Curve was used to assess the ability of inflammatory markers to discriminately identify MetS. Results: The mean age of the case and control groups was 49.9±0.9 years and 48.1±1.1 years (p = 0.274) respectively. The median levels of TNFα, IL-6 and hS-CRP were significantly higher among the cases than the control group in both genders (p <0.001). There was a significant increase in the serum values of the markers with increasing components of MetS (p <0.001). The Area Under the Curve of TNFα, IL-6 and hs-CRP was > 0.9 in both males and females. Conclusion: TNFα, IL-6, and hs-CRP identified MetS. There is a need for further studies to determine the inflammatory marker most predictive of MetS.


2017 ◽  
Vol 39 (11) ◽  
pp. 2146-2157 ◽  
Author(s):  
Gurleen Pasricha ◽  
Parikshit Padhi ◽  
Nour Daboul ◽  
Dulabh K. Monga

Blood ◽  
2010 ◽  
Vol 116 (21) ◽  
pp. 3177-3177
Author(s):  
Francesco Dentali ◽  
Cihan Ay ◽  
Moon Jang ◽  
Matteo di Minno ◽  
Ingrid Pabinger ◽  
...  

Abstract Abstract 3177 Background: The metabolic syndrome (MS) is a cluster of interrelated risk factors that identify patients at increased risk of cardiovascular events. Recent studies also suggested an association between MS and venous thromboembolism (VTE). However, the role of the individual features of MS and whether MS and its features are more important than obesity alone to predict VTE remain to be established. Methods: We performed an individual patient level meta-analysis of case-control studies comparing the prevalence of MS in patients with unprovoked VTE and in controls. MEDLINE, EMBASE databases, and abstract books were searched up to January 2010. Odds ratios (OR) and 95% confidence intervals of pooled results were calculated. The influence of individual variables (age, sex, BMI and MS) on the likelihood of VTE was compared using logistic regression analysis. Multivariate analysis was subsequently performed including the individual components of MS in the place of MS. The impact of increasing number of individual components of MS on the risk of VTE was investigated. Results: Four studies were identified and analyzed, for a total of 1332 patients (479 cases and 833 controls). Mean age was 53.3 and 52.7, respectively (p=n.s.), 49.5% cases and 42.4% controls were males (p=0.0003), 38.8% and 30.0% were obese (p=0.0001). MS was significantly associated with VTE (OR 1.97, 1.57–2.47), and the association linearly increased with the number of MS features (p for trend <0.001). At multivariate analysis, MS but not obesity remained associated with VTE (OR 1.92, 1.50–2.46 and 1.14, 0.88–1.47, respectively). All individual features of MS, but HDL cholesterol, were independently associated with VTE. Conclusions: The results of this meta-analysis confirm the association between MS and VTE and suggest that MS (and visceral obesity defined by increased waist circumference) could be a more important predictor of VTE than obesity defined by BMI. Disclosures: No relevant conflicts of interest to declare.


2020 ◽  
Author(s):  
zhemin Shen ◽  
Xueqiao Wang ◽  
Zili Zhen ◽  
Yao Wang ◽  
Peilong Sun

Abstract Background: Acute pancreatitis (AP) is a common inflammatory disorder of pancreas. Recent evidence has shown that metabolic syndrome was positively correlated with the severity of AP. However, only few studies have revealed the relationship between metabolic syndrome and the occurrence of AP. We therefore elucidated the association between the metabolic syndrome components and the incidence rate of AP. Methods: A hospital-based case-control study was conducted. 705 patients admitted to our hospital from January 2016 to December 2018 were included in the study. Subjects were divided into case and control group according to their diagnosis: (1) According to the revised Atlanta classification from 2012, patients diagnosed as AP were enrolled into case group. (2) Patients without history of AP or any disease related to metabolic syndrome were allocated into control group. Controls were matched to cases individually by sex and age (control/case ratio=1). Risk factors were determined by univariate and multivariate logistic regression analyses. Results: The incidence rate of metabolic syndrome with AP patients was 30.9%, which was more frequent than controls (13.2%) (OR=2.975; 95%CI 1.947-4.548, p<0.001). In multivariate regression analysis, histories of smoking or alcohol drinking, biliary stone were important predictors of AP. Besides, occurrence of AP was significantly associated with total cholesterol (TC) (OR=1.831; 95%CI 1.137-2.948, p=0.013), triglyceride (TG) (OR=2.058; 95%CI 1.332-3.179, p=0.001), fasting plasma glucose (FPG) (OR =2.345; 95%CI 1.395-3.940, p=0.001), as well as low values of apolipoprotein A (Apo A) (OR =0.247; 95%CI 0.146-0.416, p<0.001). Conclusion: Metabolic syndrome and its components portend high risks of occurrence of AP.


2020 ◽  
Author(s):  
Zhemin Shen ◽  
Xueqiao Wang ◽  
Zili Zhen ◽  
Yao Wang ◽  
Peilong Sun

Abstract Background: Acute pancreatitis (AP) is a common inflammatory disorder of the pancreas. Recent evidence has shown that metabolic syndrome is positively correlated with the severity of AP. However, only a few studies have revealed the relationship between metabolic syndrome and the occurrence of AP. We therefore elucidated the association between metabolic syndrome and the occurrence of AP. Methods: A hospital-based case-control study was conducted. A total of 705 patients admitted to our hospital from January 2016 to December 2018 were included in the study. Subjects were divided into case and control groups according to their diagnosis: (1) According to the revised Atlanta classification from 2012, patients diagnosed with AP were enrolled in the case group. (2) Patients without a history of AP or any disease related to metabolic syndrome were allocated into the control group. Controls were matched to cases individually by sex and age (control/case ratio=1). Results: The incidence rate of metabolic syndrome in AP patients was 30.9%, which was more frequent than that in controls (13.2%) (OR=2.837; 95% CI 1.873-4.298, p<0.001). In the multivariate regression analysis, a history of smoking or alcohol consumption and biliary stones were significantly associated with AP (OR=2.441; 95% CI 1.865-5.172, p<0.001; OR=1.777; 95% CI 1.060-2.977, p=0.029; OR=28.995; 95% CI 13.253-63.435, p<0.001). In addition, the occurrence of AP was significantly associated with total cholesterol (TC) (OR=1.992; 95% CI 1.246-3.183, p=0.004), triglyceride (TG) (OR=2.134; 95% CI 1.403-3.245, p<0.001), hyperglycaemia (OR=2.261; 95% CI 1.367-3.742, p=0.001), and apolipoprotein A (Apo A) (OR=0.270; 95% CI 0.163-0.447, p<0.001). Conclusions: Metabolic syndrome and its components were associated with AP occurrence.


Author(s):  
Nadira Mamoon ◽  
Hania Naveed ◽  
Mariam Abid ◽  
Humaira Nasir ◽  
Imran Nazir Ahmad ◽  
...  

Abstract Objective: Clinicopathological features of gastroenteropancreatic neuroendocrine tumors (GEP-NETs) have rarely been studied in the Pakistani population. We investigated the clinical characteristics of these tumors according to the updated World Health Organization (WHO) 2010 classification. Methods: The data of Shifa International Hospital, Islamabad was retrospectively analysed for pathologically confirmed GEP-NETs from January 2013 to March 2018. Results: One hundred and eighteen patients (mean age, 52.2 years; male, 55.1%) were identified. 83.1% of the patients were symptomatic including5.1% functional tumors. Pancreas (28%) was the most frequent primary site noted. The most common histologic type was well differentiated neuroendocrine tumor (WDNET) in 81.4% followed by neuroendocrine carcinoma (NEC) in 16.1%. 45.8% cases of WDNET were grade 1, 27.1% were grade 2, and 8.5% were grade 3.15.3% had distant metastasis at the time of diagnosis with liver (77.7%) as the most common metastatic site. Synaptophysin positivity was seen in 96.8% of grade 1 & grade 2 WDNET, 100% of grade 3 WDNET and 92.3% of NEC and chromogranin was positive in 94.2% of grade 1 &grade 2 WDNET, 83.3% of grade 3 WDNET and 45.4% of NEC. Conclusion: GEP-NETs showed a wide clinicopathological spectrum. Pancreas is the most site of involvement by the GEP-NET however grade 3 WDNET had a predilection for the colon. Small cell carcinomas were commonly observed in esophagus. Keywords: Gastroenteropancreatic neuroendocrine tu­mor, well differentiated neuroendocrine tumor, neuroendocrine carcinoma. Continuous...


2019 ◽  
Vol 8 (9) ◽  
pp. 1479
Author(s):  
Santos ◽  
Castro ◽  
Antunes ◽  
Henrique ◽  
Cardoso ◽  
...  

The association of well-differentiated gastro-entero-pancreatic neuroendocrine tumors (WD GEP-NETs) with metabolic syndrome (MetS), abdominal obesity, and fasting glucose abnormalities was recently described. The aim of this study was to evaluate whether the presence of MetS or any MetS individual component was also influenced by GEP-NET characteristics at diagnosis. A cohort of patients with WD GEP-NETs (n = 134), classified according to primary tumor location (gastrointestinal or pancreatic), pathological grading (G1 (Ki67 ≤ 2%) and G2 (>3 ≤ 20%) (WHO 2010), disease extension (localized, loco-regional, and metastatic), and presence of hormonal secretion syndrome (functioning/non-functioning), was evaluated for the presence of MetS criteria. After adjustment for age and gender, the odds of having MetS was significantly higher for patients with WD GEP-NET grade G1 (OR 4.35 95%CI 1.30–14.53) and disseminated disease (OR 4.52 95%CI 1.44–14.15). GEP-NET primary tumor location or secretory syndrome did not influence the risk for MetS. None of the tumor characteristics evaluated were associated with body mass index, fasting plasma glucose category, or any of the individual MetS components. Patients with GEP-NET and MetS depicted a higher risk of presenting a lower tumor grade and disseminated disease. The positive association between MetS and GEP-NET characteristics further highlights the potential link between the two conditions.


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