2型糖尿病患者血清IGF-1、IGFBP-3及胰岛素水平的变化与结直肠癌关系的研究

Study of serum IGF-1,IGFBP-3 and insulin levels in patients with type 2 diabetes mellitus and their relationship with colorectal cancer

目的研究结直肠癌(CRC)和/或2型糖尿病(T2DM)患者胰岛素样生长因子1(IGF-1)、胰岛素样生长因子结合蛋白3(IGFBP-3)及胰岛素(Ins)水平,并探讨其与结直肠癌发病的关系。方法结直肠癌合并2型糖尿病患者24例为C&D组,2型糖尿病患者排除结直肠癌31例为DM组,结直肠癌患者排除2型糖尿病28例为CRC组,健康自愿者28人为正常对照组(NC组)。检测各组收缩压(SBP)、舒张压(DBP)、空腹血糖(FPG)、餐后血糖(PPG)、空腹胰岛素(Fins)、糖化血红蛋白(HbA1C)、甘油三脂(TG)、总胆固醇(TC)、低密度脂蛋白(LDL-C)及高密度脂蛋白(HDL-C);采用酶联免疫吸附法检测胰岛素样生长因子1(IGF-1)和胰岛素样生长因子结合蛋白(IGFBP3)水平,同时计算体质指数(BMI)、腰臀比(WHR)、胰岛素抵抗指数(HOMA-IRI)及IGF-1/IGFBP-3比值。结果 C&D组FPG、PPG、HbA1C、Fins及HOMA-IRI与CRC组比较差异有统计学意义(P<0.01)。C&D组PPG、TC及HOMA-IRI与DM组比较差异有统计学意义(P<0.05)。C&D组IGF-1和IGF-1/IGFBP-3与DM组比较差异有统计学意义(P<0.01)。多元线性逐步回归分析显示,TC、PPG、IGF-1/IGFBP-3及HOMA-IRI对结直肠癌有影响。结论 CRC患者存在IGF-1和IGF-1/IGFBP-3水平变化;高胆固醇血症、餐后血糖升高和胰岛素抵抗可能参与CRC的发生。

Objective To investigate the levels of serum insulin-like growth factor-1 （IGF-1）,IGF binding protein-3 （IGFBP-3） and insulin in patients with colorectal cancer （CRC） and/or type 2 diabetes mellitus （T2DM）;and to establish the relationship between the levels of IGF-1,IGFBP-3,insulin and colorectal cancer.Methods 24 patients with CRC and T2DM were recruited as C＆D group,another 31 patients with T2DM as DM group.28 patients with CRC as CRC group and 28 normal subjects were selected as the control group （NC）.The systolic blood pressure （SBP）,diastolic blood pressure （DBP）,fasting plasma glucose （FPG）,2-hour postprandial glucose （PPG）,fasting serum insulin （Fins）,hemoglobinA1C （HbA1C）,triglyceride （TG）,total cholesterol （TC）,low density lipoprotein （LDL-C） and high density lipoprotein （HDL-C） were measured.IGF-1 and IGFBP-3 levels were determined using the enzyme-linked immunosorbent assay method.The body mass index （BMI）,waist/hip ratio （WHR）,homeostasis model assessment-insulin resistant index （HOMA-IRI） and IGF-1/IGFBP-3 ratio were calculated.Results The FPG,PPG,HbA1C,Fins and HOMA-IRI were different between C＆D and CRC group,while PPG,TC and HOMA-IRI were different between C＆D and DM group.There were statistically significant difference between C＆D and DM group in IGF-1 and IGF-1/IGFBP-3.Multiple linear stepwise regression analysis showed that TC,PPG,IGF-1/IGFBP-3 and HOMA-IRI have a correlation with CRC.Conclusion The results suggest that IGF-1 and IGF-1/IGFBP-3 are different in patients with CRC.TC,PPG,IGF1/IGFBP-3 and HOMA-IRI are independent risk factors of CRC patients.