脂联素、胰岛素抵抗与子宫内膜癌的发生发展

Research Progress in Adiponectin,Insulin Resistance and Endometrial Carcinoma

脂联素(adiponectin)为脂肪组织特异性分泌的一种内源性细胞因子,通过与脂联素受体(AdipoR)结合发挥特异的生物学效应。血清脂联素水平降低与肥胖、胰岛素抵抗(IR)有关,且与IR程度呈正相关。临床研究显示脂联素水平降低与子宫内膜癌发生相关。AdipoR的表达随着临床分期及组织学分级的升高、肌层浸润加重、淋巴结转移而明显下降,且与无进展生存时间及生存率呈负相关。脂联素与AdipoR结合,激活多种信号传导通路的下游,并可与胰岛素信号通路相互作用,抑制细胞增殖,诱导肿瘤细胞凋亡。因此,脂联素水平降低同时存在IR会促进子宫内膜癌发生,是其发病的危险因素。

Adiponectin is an endogenous peptide specifically secreted by adipose tissues. Adiponectin exerts its biological effects by binding to its receptor（AdipoR）. Low levels of plasma adiponectin was associated with obesity and insulin resistance,and its degree was associated parallel with insulin resistance. Clinical study showed the decrease of adiponectin level was associated with the occurrence of endometrial cancer. With increase of clinical stage and histological grade, muscular invasion, lymph node metastasis, the expression of AdipoR was significantly decreased, and it was negatively correlated with progression free survival time and survival rate. Adiponectin binding to AdipoR, following to activate downstream of a variety of signal transduction pathways, and also interact with the insulin signaling pathway, and directly led to inhibit proliferation and induce apoptosis. Therefore, the decreased adiponectin and insulin resistance may be the independent risk factors to promote endometrial cancer.