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Dalamaga M.,National and Kapodistrian University of Athens | Karmaniolas K.,NIMTS General Hospital | Chamberland J.,Beth Israel Deaconess Medical Center | Nikolaidou A.,National and Kapodistrian University of Athens | And 4 more authors.
Metabolism: Clinical and Experimental | Year: 2013

Objective Excess body weight has been implicated in the pathogenesis of myelodysplastic syndrome (MDS). We thus explored the role of serum fetuin-A reflecting ectopic hepatic fat deposition when storage capacity of adipocytes has been exceeded, free leptin reflecting overall fat mass and adiponectin reflecting visceral fat mass, all potential mediators of the effects of obesity on insulin resistance and, consequently, to MDS risk. Materials & Methods In a hospital-based case-control study, we studied 101 cases with incident, histologically confirmed primary MDS and 101 controls matched on gender, age and date of diagnosis, between 2004 and 2007. Serum fetuin-A, adiponectin, leptin, leptin receptor, free leptin and insulin were determined. Results Higher serum fetuin-A, lower adiponectin and lower free leptin were all individually and independently associated with higher risk of MDS before and after controlling for matching and risk factors, such as age, gender, date of diagnosis, body mass index (BMI), family history of lymphohematopoietic cancer, smoking history and serum insulin. Interestingly, we have shown that these associations were prominent among overweight/obese individuals and persisted after controlling for BMI and serum insulin indicating that their effects are above and beyond insulinemia only. Conclusion Elevated serum fetuin-A but lower adiponectin and free leptin are associated with higher risk of MDS particularly among overweight/obese individuals. These findings suggest that the association between excessive weight gain and the risk of MDS could be mediated by fetuin-A, adiponectin and free leptin, which may have potential clinical and preventive implications. © 2013 Elsevier Inc. Source


Dalamaga M.,Rimini Street | Archondakis S.,401 General Army Military Hospital | Sotiropoulos G.,Naval Hospital of Athens NNA | Karmaniolas K.,NIMTS General Hospital | And 2 more authors.
Maturitas | Year: 2012

Objective: Previous studies have shown that visfatin is significantly elevated in patients with gastric carcinoma and postmenopausal breast cancer (PBC). We thus explored whether serum visfatin could be used as a potential diagnostic and prognostic tool for PBC, taking into account clinicopathological features, serum tumor markers, anthropometric and metabolic parameters. Methods: Serum visfatin, tumor marker CA 15-3, carcinoembryonic antigen, metabolic and anthropometric parameters were determined in 103 postmenopausal women with pathologically confirmed, incident invasive breast cancer, 103 controls matched on age and time of diagnosis, and 51 patients with benign breast lesions (BBL). Results: Mean serum visfatin was significantly higher in cases than in controls and patients with BBL (p < 0.001). In cases, visfatin was significantly associated with CA 15-3 (p = 0.03), hormone-receptor status (p < 0.001), lymph node invasion (p = 0.06) but not with metabolic and anthropometric variables (p > 0.05). Multivariable regression analysis revealed that absence of estrogen and progesterone receptors (ER-PR-) was the strongest significant determinant of serum visfatin (p < 0.001) in cases adjusting for demographic, metabolic and clinicopathological features. Based upon receiver operator characteristic analysis, serum visfatin outperformed CA 15-3 only in discriminating between PBC cases with early cancer stage than those with late stage, and in differentiating particularly patients with ER-PR- breast tumors. Conclusion: Further prospective and longitudinal studies are needed to determine whether serum visfatin could be used as a prognostic tool in the armamentarium of PBC monitoring and management in conjunction with other biomarkers. © 2011 Elsevier Ireland Ltd. All rights reserved. Source


Tsibouris P.,NIMTS General Hospital | Tsibouris P.,Gastro Unit | Hendrickse M.T.,Gastro Unit | Kalantzis C.,NIMTS General Hospital | Isaacs P.E.T.,Gastro Unit
Hepato-Gastroenterology | Year: 2012

Background/Aims: Duodenogastric reflux is a possible risk factor for esophageal adenocarcinoma (CA) development. Gastric surgery that destroys or distorts the pylorus is a good model to study the effects of duodenogastric reflux. To define the consequences of gastrectomy in patients with Barrett esophagus (BE). Methodology: Records of all BE/CA patients examined in Blackpool-Wyre-Fylde area were reviewed. All surviving patients completed validated questionnaires. Results: Gastrectomy was more prevalent in CA patients (14 (3.6%) BE vs. 15 (13.3%) CA, p=0.0002). Partial gastrectomy was more prevalent in CA patients, (7 (1.8%) BE vs. 10 (8.8%) CA, p=0.0004), while there was no difference in total gastrectomy between the two groups. Persistence of H. pylori infection after gastrectomy and smoking were more frequent among CA patients with gastrectomy. Mean follow-up time in patients with prior gastrectomy was 78 (SD=76.4) months for BE patients and 119.3 (SD=72.9) months for CA patients (p=0.07). In logistic regression analysis gastrectomy, in addition to old age, long-term reflux, absence of hiatal hernia and H. pylori infection were risk factors for CA. Conclusions: Gastrectomy and especially partial gastrectomy was more prevalent in CA patients. © H.G.E. Update Medical Publishing S.A. Source


Dalamaga M.,Rimini Street | Sotiropoulos G.,Naval Hospital of Athens NNA | Karmaniolas K.,NIMTS General Hospital | Pelekanos N.,Rimini Street | Papadavid E.,Rimini Street
Clinical Biochemistry | Year: 2013

Objective: Previous few studies have shown that resistin is significantly elevated in breast cancer (BC) patients. Therefore, we investigated whether serum resistin could be used as a potential diagnostic and prognostic tool for postmenopausal BC (PBC), taking into account clinicopathological features, serum tumor markers, anthropometric, metabolic, and, for the first time, inflammatory parameters. Methods: Serum resistin, tumor markers (CA 15-3 and CEA), metabolic, anthropometric and inflammatory parameters (TNF-α, IL-6, hsCRP) were determined in 103 postmenopausal women with incident, pathologically confirmed, invasive BC, 103 controls matched on age and time of diagnosis, and 51 patients with benign breast lesions (BBL). Results: Mean serum resistin was significantly higher in cases than in controls and patients with BBL (p<. 0.001). In patients, resistin was significantly associated with tumor and inflammatory markers, cancer stage, tumor size, grade and lymph node invasion but not with anthropometric, metabolic parameters and hormone receptor status. Multivariable regression analysis revealed that serum IL-6 (p= 0.02) and cancer stage (p= 0.048) were the strongest determinants of serum resistin in cases adjusting for demographic, metabolic and clinicopathological features. Although resistin's diagnostic performance was low based on ROC curve analysis [0.72, 95% CI: 0.64-0.79], it could, however, represent a BC biomarker reflecting advanced disease stage and inflammatory state. Conclusion: Further prospective and longitudinal studies are needed to evaluate whether serum resistin could be used as a prognostic tool in BC monitoring and management. More research is essential to elucidate resistin's ontological role in the association between obesity, representing a chronic low-grade subclinical inflammation, and PBC. © 2013 The Canadian Society of Clinical Chemists. Source


Dalamaga M.,Rimini Street | Crotty B.H.,Beth Israel Deaconess Medical Center | Fargnoli J.,Beth Israel Deaconess Medical Center | Papadavid E.,Rimini Street | And 4 more authors.
Cancer Causes and Control | Year: 2010

Aim: Leptin and adiponectin are two well-studied adipokines in relation to malignancies. In this study, we examined the association between leptin/adiponectin and risk of B-cell chronic lymphocytic leukemia (B-CLL), as well as the relationships between adipokines and several established prognostic factors of B-CLL. Methods: Ninety-five patients with incident B-CLL and 95 hospital controls matched on age and gender were studied between 2001 and 2007, and blood samples were collected. Leptin, total and high molecular weight adiponectin, and prognostic markers of B-CLL were determined. Results: Cases had a higher body mass index (BMI) than controls (p = 0.01) and lower levels of leptin (p < 0.01). Significantly more cases than controls presented a family history of lymphohematopoietic cancer (LHC) (p = 0.01). Higher serum leptin levels were associated with lower risk of B-CLL adjusting for age, gender, family history of LHC, BMI and serum adiponectin; the multivariate odds ratio comparing highest to lowest tertile was 0.05 (95% CI 0.01-0.29, p trend < 0.001); Adiponectin was not significantly different between cases and controls. Conclusion: Leptin was found to be inversely associated with risk of CLL but in contrast to prior studies of CLL and hematologic malignancies, this study found no significant association between CLL and adiponectin. © 2010 Springer Science+Business Media B.V. Source

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