Do Alterations In Serum Leptin, Adiponectin, Resistin, C Peptide, Il-10, Il-22 And Visfatin Levels Have An Impact On Survival In Patients With Advanced Stage Gastric And Colon Cancer?

Can Özlü; Gamze Gokoz Dogu; Ayşegül Kargı; Hakan Akça; Aydın Demiray; Burcu Yapar Taşköylü; Atike Gökçen Demiray; Serkan Değirmencioğlu; Arzu Yaren; Ahmet Ergin

Clinical Research

Serum Leptin, Adiponektin, Resistin, C Peptid, IL-10, IL-22 Ve Visfatin Düzeylerinin İleri Evre Mide Ve Kolon Kanserli Hastalarda Sağkalıma Etkisi Var Mı?

Year 2023, Volume: 13 Issue: 3, 451 - 458, 31.05.2023

Can Özlü Gamze Gokoz Dogu Ayşegül Kargı Hakan Akça Aydın Demiray Burcu Yapar Taşköylü Atike Gökçen Demiray Serkan Değirmencioğlu Arzu Yaren Ahmet Ergin

Abstract

Öz
Amaç: Kanser kaşeksisinin patogenezi henüz tam olarak anlaşılamamıştır; ancak adipositokinlerin bu bağlamda önemli olduğu düşünülmektedir. Bu çalışmada kanser kaşeksi belirteçlerinden sayılan leptin, adiponektin, resistin, c-peptid, IL-10, IL-22, visfatin değerlendirildi.
Gereç ve Yöntem: Bu çalışmaya 53 hasta (34 erkek, 19 kadın) ve 20 sağlıklı kişi kontrol grubu olarak dahil edildi. Kan örnekleri -70 ºC'de derin dondurucuda saklandı ve tüm örnekler uygun biyokimya kiti ile analiz edildi. Hasta ve kontrol grubunda demografik veriler ve laboratuvar test sonuçları ile birlikte 3 farklı zaman diliminde serum adiponektin, leptin, IL-10, IL-22, C peptid, resistin, visfatin düzeyleri ölçüldü. İstatistiksel veriler SPSS v22 ile değerlendirildi.
Bulgular: Adipositokin düzeyleri ile progresyonsuz sağkalım arasında istatistiksel olarak anlamlı bir ilişki yoktu. Daha yüksek resistin ve IL-10 seviyeleri, daha kısa genel sağkalım ile ilişkilendirildi (sırasıyla p=0.035, p=0.14). Diğer sitokinler ile genel sağkalım arasında anlamlı bir ilişki yoktu. Çok değişkenli analiz, daha yüksek serum Ca 19.9 düzeylerinin (OR 0.226, P=0.005), daha düşük BMI (OR 5.726, p= 0.007), daha yüksek serum IL-10 düzeylerinin (OR 0.329, p= 0.042) progresyonsuz sağkalıma etki gösteren faktörler olduğunu göstermiştir. Daha düşük serum albümin seviyeleri (OR 0.282, p=0.013), daha yüksek serum LDH seviyeleri (OR 0.338, p=0.012), tanı anında düşük BMI (OR 5.19, P<0.0005) genel sağkalımı etkileyen faktörlerdi.
Sonuç: Çalışmamız, resistin, adipositokin ve IL10 düzeyi ile genel sağkalım arasında bir ilişki saptadı.

Keywords

Cancer cachexia, Cancer cachexia, Adipocytokines, Adipocytokines, Adiponectin, Gastric cancer, Colon cancer

Supporting Institution

Pamukkale Üniversitesi

Project Number

Pamukkale Üniversitesi Bilimsel Araştırma Projeleri Komisyonunun 07/03/2013 tarih ve 01 sayılı toplantısında 2011TPF009 numaralı proje onayı ile

References

1. Deans C, Wigmore SJ. Systemic inflamation, cachexia and prognosis in patients with cancer. Curr Opin Clin Nutr Metab Care. 2005;8:265-269.
2. Hopkinson JB, Wright DNM, Foster C. Management of weigt loss and anorexia. Ann Oncol. 2008;19:289-293.
3. Bosaeus I. Nutritional support in multimodal therapy for cancer cachexia. Support Care Cancer. 2008;16(5):447-51.
4. Fearon KCH, Moses AGW. Cancer cachexia. International Journal of Cardiology. 2002;85:73–81.
5. Johnson G, Salle A, Lorimier G, Laccourreye L, Enon B, Blin V, et al. Cancer cachexia: measured and predicted resting energy expenditures for nutritional needs evaluation. Nutrition. 2008;24:443-450.
6. Yavuzsen T, Walsh D, Mellar P, Kirkova DJ, Jin T, LeGrand S et all. Components of the anorexia–cachexia syndrome: gastrointestinal symptom correlates of cancer anorexia. Support Care Cancer. 2009;17:1531–1541.
7. Seelaender M, Batista M Jr, Lira F, Silverio R, Rossi-Fanelli F. Inflammation in cancer cachexia: to resolve or not to resolve (is that the question?). Clin Nutr. 2012;31(4):562-6.
8. Hopkinson J, Corner J. Helping patients with advanced cancer live with concerns about eating: a challenge for palliative care professionals. J Pain Symptom Manage. 2006;31(4):293-305.
9. Bennani-Baiti N, Davis MP. Cytokines and cancer anorexia cachexia syndrome. Am J Hosp Palliat Care. 2008;25(5):407-11.
10. Rydén M, Arner P. Fat loss in cachexia--is there a role for adipocyte lipolysis? Clin Nutr. 2007;26(1):1-6.
11. Adya R, Tan BK, Chen J, Randeva HS. Visfatin and endothelial angiogenesis Cardiovasc Res. 2012;96(2): 223-226.
12. Jenab M, Riboli E, Cleveland RJ, Norat T, Rinaldi S, Nieters A, et al. Serum C-peptide, IGFBP-1 and IGFBP-2 and risk of colon and rectal cancers in the European prospective investigation into cancer and nutrition. Int J Cancer. 2007;121:368–376.
13. Otani T, Iwasaki M, Sasazuki S, Inoue M, Tsugane S; Japan Public Health Center-based Prospective Study Group. Plasma C-peptide, insulin-like growth factor-I, insulin-like growth factor binding proteins and risk of colorectal cancer in a nested case-control study: the Japan public health center-based prospective study. Int J Cancer. 2007;120: 2007–2012.
14. Wei EK, Ma J, Pollak MN, Rifai N, Fuchs CS, Hankinson SE, et al. A prospective study of C-peptide, insulinlike growth factor-I, insulin-like growth factor binding protein-1, and the risk of colorectal cancer in women. Cancer Epidemiol Biomarkers Prev. 2005;14: 850–855.
15. Won HH, Kim JW, Kim MJ, Kim S, Park JH, Lee KA. Interleukin 10 polymorphisms differentially influence the risk of gastric cancer in East Asians and Caucasians. Cytokine. 2010;51(1):73-7.
16. Thompson CL, Plummer SJ, Tucker TC, Casey G, Li L. Interleukin-22 genetic polymorphisms and risk of colon cancer Cancer Causes Control. 2010;21: 1165–1170.
17. Fortunati N, Manti R, Birocco N, Pugliese M, Brignardello E, Ciuffreda L, et al. Pro-inflammatory cytokines and oxidative stress/antioxidant parameters characterize the bio-humoral profile of early cachexia in lung cancer patients. Oncol Rep. 2007;18(6):1521-7.
18. World Health Organization (WHO). Obesity: Preventing and Managing the Global Epidemic. Report of a WHO consultation: 2000 WHO Techinical Report Series no.894.Geneva.
19. Davies M. Nutrional screening and assessment in cancer-associated malnutrition. Eur J Oncol. 2005;9:64-73.
20. http://globocan.iarc.fr/Pages/fact_sheets_population.aspx
21. Persson C, Sjödén PO, Glimelius B. The Swedish version of the patient-generated subjective global assessment of nutritional status: gastrointestinal vs urological cancers. Clin Nutr. 1999;18(2):71-7.
22. Ryan AM, Healy LA, Power DG, Rowley SP, Reynolds JV. Short-term nutritional implications of total gastrectomy for malignancy, and the impact of parenteral nutritional support. Clin Nutr. 2007;26(6):718-27.
23. Wakahara T, Shiraki M, Murase K, Fukushima H, Matsuura K, Fukao A, et al. Nutritional screening with subjective global assessment predicts hospital stay in patients with digestive diseases. Nutrition. 2007;23(9):634-9.
24. Andreyev HJ, Norman AR, Oates J, Cunningham D. Why do patients with weight loss have a worse outcome when undergoing chemotherapy for gastrointestinal malignancies? Eur J Cancer. 1998;34(4):503-9.
25. DeWys WD, Begg C, Lavin PT, Bennett JM, Bertino JR, Cohen MH, et al. Prognostic effect of weight loss prior to chemotherapy in cancer patients. Am J Med. 1980;69(4):491-7.
26. Dülger H, Alici S, Sekeroğlu MR, Erkog R, Ozbek H, Noyan T, et al. Serum levels of leptin and proinflammatory cytokines in patients with gastrointestinal cancer. Int J Clin Pract. 2004;58: 545-549.
27. Brown DR, Berkowitz DE, Breslow MJ. Weight loss is not associated with hyperleptinemia in humans with pancreatic cancer. J Clin Endocrinol Metab. 2001;86(1):162-6.
28. Bolukbas FF, Kilic H, Bolukbas C. Serum leptin concentration and advanced gastrointestinal cancers: a case-controlled study. BMC Cancer. 2004;4: 29-33.
29. Karapanagiotou EM, Tsochatzis EA, Dilana KD, Tourkantonis I, Gratsias I, Syrigos KN. The significance of leptin, adiponectin, and resistin serum levels in non-small cell lung cancer (NSCLC). Lung Cancer. 2008;61(3):391-7.
30. Nakajima TE, Yamada Y, Hamano T, Furuta K, Gotoda T, Katai H, et al. Adipocytokine levels in gastric cancer patients: resistin and visfatin as biomarkers of gastric cancer. J Gastroenterol. 2009;44(7):685-90.
31. Berg AH, Scherer PE. Adipose tissue, inflammation, and cardiovascular disease. Circ Res. 2005; 13;96(9):939-49.
32. Salmenniemi U, Ruotsalainen E, Pihlajamäki J, Vauhkonen I, Kainulainen S, Punnonen K, et al. Multiple abnormalities in glucose and energy metabolism and coordinated changes in levels of adiponectin, cytokines, and adhesion molecules in subjects with metabolic syndrome. Circulation. 2004;110: 3842-3848.
33. Wolf I, Sadetzki S, Kanety H, Kundel Y, Pariente C, Epstein N, et al. Adiponectin, ghrelin, and leptin in cancer cachexia in breast and colon cancer patients. Cancer. 2006;106: 966-973.
34. Mantzoros CS, Moschos S, Avramopoulos I, Kaklamani V, Liolios A, Doulgerakis DE, et al. Leptin concentrations in relation to body mass index and the tumor necrosis factor-alpha system in humans. J Clin Endocrinol Metab. 1997;82(10):3408-13.
35. McTernan PG, Kusminski CM, Kumar S. Resistin. Curr Opin Lipidol. 2006;17(2):170-5.
36. Kerem M, Ferahkose Z, Yilmaz UT, Pasaoglu H, Ofluoglu E, Bedirli A,et al. Adipokines and ghrelin in gastric cancer cachexia. World J Gastroenterol. 2008;14(23):3633-41.
37. Nakajima TE1, Yamada Y, Hamano T, Furuta K, Matsuda T, Fujita S, et al. Adipocytokines as new promising markers of colorectal tumors: adiponectin for colorectal adenoma, and resistin and visfatin for colorectal cancer. Cancer Sci. 2010;101(5):1286-91.
38. Argilés JM, Busquets S, García-Martínez C, López-Soriano FJ. Mediators involved in the cancer anorexia–cachexia syndrome: past, present, and future. Nutrition. 2005;21(9):977-85.
39. Shibata M, Nezu T, Takekawa M, Takizawa H, Ando K, Miyake H, et al. Serum levels of interleukin- 10 and interleukin-12 in patients with colo-rectal cancer. Ann N Y Acad Sci. 1996;795:410-2.
40. Stanilov N, Miteva L, Deliysky T, Jovchev J, Stanilova S. Advanced Colorectal Cancer Is Associated With Enhanced IL-23 and IL-10 Serum Levels. Labmed. 2010;41:3.
41. De Vita F, Orditura M, Galizia G, Romano C, Infusino S, Auriemma A, et al. Serum interleukin-10 levels in patients with advanced gastrointestinal malignancies. Cancer. 1999;86(10):1936-43.
42. Witte E, Witte K, Warszawska K, Sabat R, Wolk K. Interleukin-22: A cytokine produced by T, NK and NKT cell subsets, with importance in the innate immune defense and tissue protection. Cytokine Growth Factor Rev. 2010;21(5):365-79.
43. Bi TQ, Che XM. Nampt/PBEF/visfatin and cancer. Cancer Biol Ther. 2010;10(2):119-25.
44. Moschen AR, Kaser A, Enrich B, Mosheimer B, Theurl M, Niederegger H et al. Visfatin, an adipocytokine with proinflammatory and immunomodulating properties. J Immunol. 2007;178:1748– 1758

Do Alterations In Serum Leptin, Adiponectin, Resistin, C Peptide, Il-10, Il-22 And Visfatin Levels Have An Impact On Survival In Patients With Advanced Stage Gastric And Colon Cancer?

Year 2023, Volume: 13 Issue: 3, 451 - 458, 31.05.2023

Can Özlü Gamze Gokoz Dogu Ayşegül Kargı Hakan Akça Aydın Demiray Burcu Yapar Taşköylü Atike Gökçen Demiray Serkan Değirmencioğlu Arzu Yaren Ahmet Ergin

Abstract

Abstract
Background/Aims: Pathogenesis of cancer cachexia is not fully understood yet; however, adipocytokines are considered necessary in this context. In this study, leptin, adiponectin, resistin, c-peptid, IL-10, IL-22, visfatin which are considered to be among markers of cancer cachexia were assessed.
Methods: Fifty-three patients (34 male, 19 female) and 20 healthy people as a control group were included into this study. Blood samples were stored in deep freeze at -70 ºC and all of the samples were analyzed with appropriate biochemistry kit. Along with demographic data and laboratory tests results serum adiponectin, leptin, IL-10, IL-22, C peptide, resistin, visfatin levels were measured in 3 different time period both in patient and control group. Statistical data were evaluated by SPSS v22.
Results: There was no statistically significant relationship between adipocytokine levels and progression-free survival. Higher resistin and IL-10 levels were associated with shorter overall survival (p=0.035, p=0.14, respectively). There was no significant relationship between other cytokines and overall survival. Multivariate analysis has shown that higher serum Ca 19.9 levels (OR 0.226, P=0.005), lower BMI (OR 5.726, p= 0.007), higher serum IL-10 levels (OR 0.329, p= 0.042) were factors showing an impact on progression-free survival; lower serum albumin levels (OR 0.282, p=0.013), higher serum LDH levels (OR 0,338, p=0.012), low BMI at diagnosis (OR 5.19, P<0.0005) were factors having an impact on overall survival.
Conclusions: Our study detected an association between resistin, adipocytokine, and IL10 level and overall survival.

Keywords

Cancer cachexia, Adipocytokines, Adiponectin, Gastric cancer, Colon cancer

Project Number

Pamukkale Üniversitesi Bilimsel Araştırma Projeleri Komisyonunun 07/03/2013 tarih ve 01 sayılı toplantısında 2011TPF009 numaralı proje onayı ile

References

1. Deans C, Wigmore SJ. Systemic inflamation, cachexia and prognosis in patients with cancer. Curr Opin Clin Nutr Metab Care. 2005;8:265-269.
2. Hopkinson JB, Wright DNM, Foster C. Management of weigt loss and anorexia. Ann Oncol. 2008;19:289-293.
3. Bosaeus I. Nutritional support in multimodal therapy for cancer cachexia. Support Care Cancer. 2008;16(5):447-51.
4. Fearon KCH, Moses AGW. Cancer cachexia. International Journal of Cardiology. 2002;85:73–81.
5. Johnson G, Salle A, Lorimier G, Laccourreye L, Enon B, Blin V, et al. Cancer cachexia: measured and predicted resting energy expenditures for nutritional needs evaluation. Nutrition. 2008;24:443-450.
6. Yavuzsen T, Walsh D, Mellar P, Kirkova DJ, Jin T, LeGrand S et all. Components of the anorexia–cachexia syndrome: gastrointestinal symptom correlates of cancer anorexia. Support Care Cancer. 2009;17:1531–1541.
7. Seelaender M, Batista M Jr, Lira F, Silverio R, Rossi-Fanelli F. Inflammation in cancer cachexia: to resolve or not to resolve (is that the question?). Clin Nutr. 2012;31(4):562-6.
8. Hopkinson J, Corner J. Helping patients with advanced cancer live with concerns about eating: a challenge for palliative care professionals. J Pain Symptom Manage. 2006;31(4):293-305.
9. Bennani-Baiti N, Davis MP. Cytokines and cancer anorexia cachexia syndrome. Am J Hosp Palliat Care. 2008;25(5):407-11.
10. Rydén M, Arner P. Fat loss in cachexia--is there a role for adipocyte lipolysis? Clin Nutr. 2007;26(1):1-6.
11. Adya R, Tan BK, Chen J, Randeva HS. Visfatin and endothelial angiogenesis Cardiovasc Res. 2012;96(2): 223-226.
12. Jenab M, Riboli E, Cleveland RJ, Norat T, Rinaldi S, Nieters A, et al. Serum C-peptide, IGFBP-1 and IGFBP-2 and risk of colon and rectal cancers in the European prospective investigation into cancer and nutrition. Int J Cancer. 2007;121:368–376.
13. Otani T, Iwasaki M, Sasazuki S, Inoue M, Tsugane S; Japan Public Health Center-based Prospective Study Group. Plasma C-peptide, insulin-like growth factor-I, insulin-like growth factor binding proteins and risk of colorectal cancer in a nested case-control study: the Japan public health center-based prospective study. Int J Cancer. 2007;120: 2007–2012.
14. Wei EK, Ma J, Pollak MN, Rifai N, Fuchs CS, Hankinson SE, et al. A prospective study of C-peptide, insulinlike growth factor-I, insulin-like growth factor binding protein-1, and the risk of colorectal cancer in women. Cancer Epidemiol Biomarkers Prev. 2005;14: 850–855.
15. Won HH, Kim JW, Kim MJ, Kim S, Park JH, Lee KA. Interleukin 10 polymorphisms differentially influence the risk of gastric cancer in East Asians and Caucasians. Cytokine. 2010;51(1):73-7.
16. Thompson CL, Plummer SJ, Tucker TC, Casey G, Li L. Interleukin-22 genetic polymorphisms and risk of colon cancer Cancer Causes Control. 2010;21: 1165–1170.
17. Fortunati N, Manti R, Birocco N, Pugliese M, Brignardello E, Ciuffreda L, et al. Pro-inflammatory cytokines and oxidative stress/antioxidant parameters characterize the bio-humoral profile of early cachexia in lung cancer patients. Oncol Rep. 2007;18(6):1521-7.
18. World Health Organization (WHO). Obesity: Preventing and Managing the Global Epidemic. Report of a WHO consultation: 2000 WHO Techinical Report Series no.894.Geneva.
19. Davies M. Nutrional screening and assessment in cancer-associated malnutrition. Eur J Oncol. 2005;9:64-73.
20. http://globocan.iarc.fr/Pages/fact_sheets_population.aspx
21. Persson C, Sjödén PO, Glimelius B. The Swedish version of the patient-generated subjective global assessment of nutritional status: gastrointestinal vs urological cancers. Clin Nutr. 1999;18(2):71-7.
22. Ryan AM, Healy LA, Power DG, Rowley SP, Reynolds JV. Short-term nutritional implications of total gastrectomy for malignancy, and the impact of parenteral nutritional support. Clin Nutr. 2007;26(6):718-27.
23. Wakahara T, Shiraki M, Murase K, Fukushima H, Matsuura K, Fukao A, et al. Nutritional screening with subjective global assessment predicts hospital stay in patients with digestive diseases. Nutrition. 2007;23(9):634-9.
24. Andreyev HJ, Norman AR, Oates J, Cunningham D. Why do patients with weight loss have a worse outcome when undergoing chemotherapy for gastrointestinal malignancies? Eur J Cancer. 1998;34(4):503-9.
25. DeWys WD, Begg C, Lavin PT, Bennett JM, Bertino JR, Cohen MH, et al. Prognostic effect of weight loss prior to chemotherapy in cancer patients. Am J Med. 1980;69(4):491-7.
26. Dülger H, Alici S, Sekeroğlu MR, Erkog R, Ozbek H, Noyan T, et al. Serum levels of leptin and proinflammatory cytokines in patients with gastrointestinal cancer. Int J Clin Pract. 2004;58: 545-549.
27. Brown DR, Berkowitz DE, Breslow MJ. Weight loss is not associated with hyperleptinemia in humans with pancreatic cancer. J Clin Endocrinol Metab. 2001;86(1):162-6.
28. Bolukbas FF, Kilic H, Bolukbas C. Serum leptin concentration and advanced gastrointestinal cancers: a case-controlled study. BMC Cancer. 2004;4: 29-33.
29. Karapanagiotou EM, Tsochatzis EA, Dilana KD, Tourkantonis I, Gratsias I, Syrigos KN. The significance of leptin, adiponectin, and resistin serum levels in non-small cell lung cancer (NSCLC). Lung Cancer. 2008;61(3):391-7.
30. Nakajima TE, Yamada Y, Hamano T, Furuta K, Gotoda T, Katai H, et al. Adipocytokine levels in gastric cancer patients: resistin and visfatin as biomarkers of gastric cancer. J Gastroenterol. 2009;44(7):685-90.
31. Berg AH, Scherer PE. Adipose tissue, inflammation, and cardiovascular disease. Circ Res. 2005; 13;96(9):939-49.
32. Salmenniemi U, Ruotsalainen E, Pihlajamäki J, Vauhkonen I, Kainulainen S, Punnonen K, et al. Multiple abnormalities in glucose and energy metabolism and coordinated changes in levels of adiponectin, cytokines, and adhesion molecules in subjects with metabolic syndrome. Circulation. 2004;110: 3842-3848.
33. Wolf I, Sadetzki S, Kanety H, Kundel Y, Pariente C, Epstein N, et al. Adiponectin, ghrelin, and leptin in cancer cachexia in breast and colon cancer patients. Cancer. 2006;106: 966-973.
34. Mantzoros CS, Moschos S, Avramopoulos I, Kaklamani V, Liolios A, Doulgerakis DE, et al. Leptin concentrations in relation to body mass index and the tumor necrosis factor-alpha system in humans. J Clin Endocrinol Metab. 1997;82(10):3408-13.
35. McTernan PG, Kusminski CM, Kumar S. Resistin. Curr Opin Lipidol. 2006;17(2):170-5.
36. Kerem M, Ferahkose Z, Yilmaz UT, Pasaoglu H, Ofluoglu E, Bedirli A,et al. Adipokines and ghrelin in gastric cancer cachexia. World J Gastroenterol. 2008;14(23):3633-41.
37. Nakajima TE1, Yamada Y, Hamano T, Furuta K, Matsuda T, Fujita S, et al. Adipocytokines as new promising markers of colorectal tumors: adiponectin for colorectal adenoma, and resistin and visfatin for colorectal cancer. Cancer Sci. 2010;101(5):1286-91.
38. Argilés JM, Busquets S, García-Martínez C, López-Soriano FJ. Mediators involved in the cancer anorexia–cachexia syndrome: past, present, and future. Nutrition. 2005;21(9):977-85.
39. Shibata M, Nezu T, Takekawa M, Takizawa H, Ando K, Miyake H, et al. Serum levels of interleukin- 10 and interleukin-12 in patients with colo-rectal cancer. Ann N Y Acad Sci. 1996;795:410-2.
40. Stanilov N, Miteva L, Deliysky T, Jovchev J, Stanilova S. Advanced Colorectal Cancer Is Associated With Enhanced IL-23 and IL-10 Serum Levels. Labmed. 2010;41:3.
41. De Vita F, Orditura M, Galizia G, Romano C, Infusino S, Auriemma A, et al. Serum interleukin-10 levels in patients with advanced gastrointestinal malignancies. Cancer. 1999;86(10):1936-43.
42. Witte E, Witte K, Warszawska K, Sabat R, Wolk K. Interleukin-22: A cytokine produced by T, NK and NKT cell subsets, with importance in the innate immune defense and tissue protection. Cytokine Growth Factor Rev. 2010;21(5):365-79.
43. Bi TQ, Che XM. Nampt/PBEF/visfatin and cancer. Cancer Biol Ther. 2010;10(2):119-25.
44. Moschen AR, Kaser A, Enrich B, Mosheimer B, Theurl M, Niederegger H et al. Visfatin, an adipocytokine with proinflammatory and immunomodulating properties. J Immunol. 2007;178:1748– 1758

There are 44 citations in total.

Details

Primary Language	English
Subjects	Health Care Administration
Journal Section	Original Research
Authors	Can Özlü 0000-0002-9573-1177 Gamze Gokoz Dogu 0000-0001-8142-0362 Ayşegül Kargı 0000-0003-4797-7313 Hakan Akça 0000-0001-9138-0755 Aydın Demiray 0000-0002-3343-0184 Burcu Yapar Taşköylü 0000-0003-4755-2753 Atike Gökçen Demiray 0000-0003-4397-5468 Serkan Değirmencioğlu 0000-0002-1213-2778 Arzu Yaren 0000-0003-1436-8650 Ahmet Ergin 0000-0001-5236-7507
Project Number	Pamukkale Üniversitesi Bilimsel Araştırma Projeleri Komisyonunun 07/03/2013 tarih ve 01 sayılı toplantısında 2011TPF009 numaralı proje onayı ile
Publication Date	May 31, 2023
Acceptance Date	March 28, 2023
Published in Issue	Year 2023 Volume: 13 Issue: 3

Cite

AMA	Özlü C, Gokoz Dogu G, Kargı A, Akça H, Demiray A, Yapar Taşköylü B, Demiray AG, Değirmencioğlu S, Yaren A, Ergin A. Do Alterations In Serum Leptin, Adiponectin, Resistin, C Peptide, Il-10, Il-22 And Visfatin Levels Have An Impact On Survival In Patients With Advanced Stage Gastric And Colon Cancer?. J Contemp Med. May 2023;13(3):451-458.

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