胰岛素抵抗与结直肠癌相关性的临床研究

Clinical study on insulin resistance associated with colorectal cancer

目的研究胰岛素抵抗与结直肠癌(CRC)临床特征、病理特征的关系及危险性。方法选择322例CRC患者和200例健康者作为CRC组和对照组,对比两组体质量指数(BMI)、腰臀比(WHR)、收缩压(SBP)、舒张压(DBP)、空腹血糖(FPG)、空腹胰岛素(FINS)、胰岛素抵抗指数(HOMA-IR)、总胆固醇(TC)、甘油三酯(TG)、高密度脂蛋白胆固醇(HDL-C)、低密度脂蛋白胆固醇(LDL-C)、脂联素,并分析CRC患病危险因素及胰岛素抵抗与CRC病理特征的关系。结果 CRC组WHR、SBP、FPG、FINS、HOMA-IR、TG值均显著高于对照组(P<0.05),HDLC、脂联素值显著低于对照组(P<0.05)。两组BMI、DBP、TC、LDL-C值比较,差异无统计学意义(P>0.05)。家族史、代谢综合征、FINS、HOMA-IR是CRC的危险因素(P<0.05)。胰岛素抵抗与TNM分期有关(P<0.05),与肿瘤部位、分化程度、淋巴结转移、远处转移无关(P>0.05)。结论胰岛素抵抗、家族史、代谢综合征与结直肠癌患病密切相关,胰岛素抵抗程度可能与结直肠癌进展有关。

Objective To study insulin resistance and colorectal cancer （CRC） clinical features, pathological characteristics and hazards. Methods A total of 322 cases of CRC patients and 200 healthy subjects divided into CRC group and control group, BMI, WHR, SBP, DBP, FPG, FINS, HOMA-IR, TC, TG, HDL-C, LDL-C, adiponectin of two groups were compared, and to analyze the risk factors of CRC and insulin resistance and pathological features of CRC. Results CRC group, WHR, SBP, FPG, FINS, HOMA-IR, TG values were significantly higher （P〈0.05）, HDL-C, adiponectin were significantly lower than the control group （P〈0.05）. Two BMI, DBP, TC, LDL-C values, the difference were not statistically significant （P〉 0.05）. Family history, metabolic syndrome, FINS, HOMA-IR were risk factors for CRC（P〈0.05）. Insulin resistance and TNM stage（P〈0.05）, and not related to tumor location, differentiation, lymph node metastasis, distant metastasis （P〉0.05）. Conclusion Insulin resistance, family history, prevalence of metabolic syndrome and colorectal cancer is closely related to the degree of insulin resistance may be associated with the progression of colorectal cancer.