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Original research
Metabolic profile of patients with endometrial adenocarcinoma and association with tumor grade
  1. João Paulo Andrade Fernandes1,
  2. Alex Oliveira da Camara2,3,
  3. Fernando Trevisan Frajacomo4,
  4. Claudia Bessa Pereira Chaves5,
  5. Avany Fernandes Pereira1 and
  6. Gabriela Villaça Chaves3
  1. 1 Nutrition Institute, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil
  2. 2 National School of Public Health, Fundação Oswaldo Cruz, Fundação Oswaldo Cruz, Rio de Janeiro, Brazil
  3. 3 Nutrition Department, Cancer Hospital II, Brazilian National Cancer Institute, Rio de Janeiro, Brazil
  4. 4 Program of Molecular Carcinogenesis, Brazilian National Cancer Institute, Rio de Janeiro, Brazil
  5. 5 Gynecologic Oncology Department, Cancer Hospital II, Brazilian National Cancer Institute, Rio de Janeiro, Brazil
  1. Correspondence to Dr Gabriela Villaça Chaves, Nutrition Department, Cancer Hospital II, Brazilian National Cancer Institute, Rio de Janeiro, RJ 20220-410, Brazil; gabrielavc{at}gmail.com

Abstract

Objective To describe the prevalence of metabolic syndrome and other metabolic indicators in patients with endometrial cancer and its association with tumor grade.

Methods This is a cross-sectional study of patients with endometrial cancer referred to the Brazilian National Cancer Institute. We collected data on sociodemographic variables, smoking, co-morbidities, physical activity level, menopausal status, and tumor characteristics (histological subtype, stage, and tumor grade). In addition, weight, height, and waist circumference were measured. Laboratory evaluation included lipid profile, fasting blood glucose and insulin, and C-reactive protein. Insulin resistance was estimated by the Homeostasis Model Assessment of Insulin Resistance (HOMA-IR). Characterization of metabolic syndrome and cardiovascular risk profile was performed. Binary logistic regression models were used to test the association between metabolic syndrome and its metabolic parameters, HOMA-IR, and C-reactive protein with tumor grade.

Results We included a total of 313 patients, 245 (78.3%) aged <65 years, 262 (83.7%) with endometrioid adenocarcinoma, 193 (61.7%) early stage, and 201 (64.2%) with lower tumor grade (G1 and G2). Metabolic syndrome, insulin resistance, and low levels of leisure-time physical activity were highly prevalent (90.7%). In binary logistic regression models, an association was observed between HOMA-IR and lower tumor grade (p<0.05), while high-grade tumors were associated with the highest C-reactive protein values (p<0.05).

Conclusion The main finding of this study was the association between insulin resistance and low-grade tumors, and the association between high C-reactive protein levels and high-grade tumors.

  • endometrial neoplasms

Data availability statement

Data are available upon reasonable request. All data relevant to the study are included in the article or uploaded as supplementary information.

https://doi.org/10.1136/ijgc-2021-003245

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    Data availability statement

    Data are available upon reasonable request. All data relevant to the study are included in the article or uploaded as supplementary information.

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    Footnotes

    • Contributors JPAF, FTF, CBPC: Data curation, Investigation, formal analysis, visualization, writing - original draft and approved the final version. AOdC: Data curation, Investigation, formal analysis, writing - original draft and approved the final version. AFP: Formal analysis, writing - original draft and approved the final version. GVC: Conceptualization, data curation, formal analysis, investigation, methodology, project administration, supervision, visualization, writing - original draft and approved the final version, and is the guarantor of the manuscript. All authors approved the final version and submission of the study.

    • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

    • Competing interests None declared.

    • Provenance and peer review Not commissioned; externally peer reviewed.

    • Supplemental material This content has been supplied by the author(s). It has not been vetted by BMJ Publishing Group Limited (BMJ) and may not have been peer-reviewed. Any opinions or recommendations discussed are solely those of the author(s) and are not endorsed by BMJ. BMJ disclaims all liability and responsibility arising from any reliance placed on the content. Where the content includes any translated material, BMJ does not warrant the accuracy and reliability of the translations (including but not limited to local regulations, clinical guidelines, terminology, drug names and drug dosages), and is not responsible for any error and/or omissions arising from translation and adaptation or otherwise.