Insulin-like growth factor-I and insulin are associated with the presence and advancement of adenomatous polyps
Insulin-like growth factor-I and insulin are associated with the presence and advancement of adenomatous polyps
复制标题
DOI：
10.1053/j.gastro.2005.05.051
复制
发表时间：
2005-08-01
期刊：
影响因子：
29.4
通讯作者：
Rosen, CJ
中科院分区：
文献类型：
--
作者：
Schoen, RE;Weissfeld, JL;Rosen, CJ
背景与目的：胰岛素和胰岛素样生长因子- i （IGF-I）影响结直肠癌的增殖、分化和凋亡，是结直肠癌的潜在危险因素。内脏型肥胖，可能与高胰岛素血症有关，也与结直肠癌风险有关。我们评估了胰岛素、igf - 1、胰岛素样生长因子结合蛋白（IGFBP） 3和内脏脂肪组织（VAT）在腺瘤性息肉患者中的关系，腺瘤性息肉是结直肠癌的前兆病变。方法：参与者是在前列腺、肺、结直肠和卵巢（PLCO）癌症筛查试验中接受柔性乙状结肠镜（FSG）筛查的无症状受试者。受试者接受单片计算机断层扫描，测量VAT和血清空腹胰岛素、IGF-I和IGFBP-3的测量。结果：共纳入458例受试者，其中202例为腺瘤，其中70例为晚期腺瘤。与对照组相比，腺瘤组IGF-I （P = 0.02）、IGF-I/IGFBP-3比值（P = 0.003）和胰岛素（P = 0.02）均显著升高。在使用性别特异性四分位数切点进行的未经调整的logistic回归分析中，与四分位数1相比，四分位数4的受试者（优势比[OR] = 1.7; [95% CI: 1.0-2.9], Ptrend = 0.03）、IGF-I/IGFBP-3比值（OR = 1.9 [95% CI: 1.1-3.3], Ptrend = 0.01）和胰岛素（OR = 2.1 [95% CI: 1.2-3.6], Ptrend = 0.04）患腺瘤的风险增加。当将病例组限制为晚期腺瘤时，效果更为明显：IGF-I (OR = 2.8 [95% CI: 1.3-6.2], Ptrend = 0.006)， IGF-I/IGFBP-3比值（OR 2.3, [95% CI: 1.0-5.2], Ptrend = 0.04）和胰岛素（OR 2.3 [95% CI: 1.1-4.9], Ptrend = 0.14）。内脏脂肪组织与腺瘤风险无关。结论：IGF-I水平、IGF-I/IGFBP-3比值和胰岛素与腺瘤相关，与晚期腺瘤关系更密切。这些数据支持了胰岛素和igf - 1可能促进性腺瘤性息肉的发展和进展的假设。
Background & Aims: Insulin and insulin-like growth factor-I (IGF-I) affect proliferation, differentiation, and apoptosis and are potential risk factors for colorectal cancer (CRC). Visceral obesity, possibly via hyperinsulinemia, has also been linked to CRC risk. We evaluated the relationship of insulin, IGF-I, insulin-like growth factor binding protein (IGFBP) 3, and visceral adipose tissue (VAT) in subjects with adenomatous polyps, the precursor lesion of colorectal cancer. Methods: Participants were asymptomatic subjects who underwent screening flexible sigmoidoscopy (FSG) within the Prostate, Lung, Colorectal, and Ovarian (PLCO) Cancer Screening Trial. Subjects underwent single-slice, computerized tomography scanning to measure VAT and serum fasting insulin, IGF-I, and IGFBP-3 measurements. Results: Four hundred fifty-eight subjects were enrolled, of which 202 subjects had an adenoma, 70 of which were an advanced adenoma. IGF-I (P = .02), IGF-I/IGFBP-3 ratio (P = .003), and insulin (P = .02) were significantly increased in subjects with adenomas compared with controls. In an unadjusted logistic regression analysis using sex-specific quartile cut points, subjects in quartile 4 'in comparison with quartile 1 of IGF-I (odds ratio [OR] = 1.7; [95% CI: 1.0-2.9], Ptrend =.03), IGF-I/IGFBP-3 ratio (OR = 1.9 [95% CI: 1.1-3.3], Ptrend = .01), and insulin (OR = 2.1 [95% CI: 1.2-3.6], Ptrend =.04) were at increased risk of adenoma. When limiting the case group to advanced adenomas, the effect was more pronounced: IGF-I (OR = 2.8 [95% CI: 1.3-6.2], Ptrend =.006), IGF-I/IGFBP-3 ratio (OR 2.3, [95% CI: 1.0-5.2], Ptrend =.04), and insulin (OR 2.3 [95% CI: 1.1-4.9], Ptrend = .14). Visceral adipose tissue was not associated with adenoma risk. Conclusions: Levels of IGF-I, ratio of IGF-I/IGFBP-3, and insulin are associated with adenomas and even more so with advanced adenomas. These data support the hypothesis that insulin and IGF-I may contribute to the development and advancement of adenomatous polyps.