To study the association of serum biomarkers (leptin and adiponectin), anthropometry and insulin resistance with endometrial cancer.

This case–control study enrolled 40 women diagnosed with endometrial cancer, matched with an equal number age and BMI-matched controls. Serum leptin (ng/ml) and adiponectin (µg/ml) levels were measured using ELISA. Anthropometric measurements; waist circumference, waist/hip ratio and insulin resistance parameters, fasting insulin, and blood sugar, were assessed. Receiver operating characteristic curves were employed to evaluate the accuracy of serum biomarkers and metabolic syndrome parameters in predicting the risk of endometrial cancer, and optimal cutoff points were determined.

Baseline characteristics were similar between the two groups. The mean serum adiponectin level in cases was significantly lower (7.89 ± 2.80 µg/ml versus 11.23 ± 2.84 µg/ml; p < 0.001), whereas the mean serum leptin level and Leptin/Adiponectin (L/A) ratio were significantly higher in endometrial cancer patients compared to controls (28.18 ± 13.63 ng/ml versus 12.32 ± 7.96 ng/ml, p < 0.001, and 4.02 ± 2.29 versus 1.29 ± 1.05, p < 0.001, respectively). The optimal cutoff points were identified as > 14 ng/ml for serum leptin (sensitivity: 78.9%, specificity: 68.4%), < 9.73 µg/ml for serum adiponectin (sensitivity: 73.7%, specificity: 69.4%), and 1.37 for the L/A ratio (sensitivity: 94.7%, specificity: 76.3%) to differentiate cases from controls. Waist–hip ratio, waist circumference, hypertension, and fasting insulin levels were significantly elevated in cases compared to controls.

Elevated leptin levels and decreased adiponectin levels were observed in obese women with endometrial cancer. Anthropometric and biochemical indicators of insulin resistance were associated with an increased risk of endometrial cancer.