血清胰岛素和IGFBP3水平与子宫内膜癌相关性研究

A study on the association among serum insulin,IGFBP3,and endometrial cancer risk in Chinese women

目的 探讨血清胰岛素和胰岛素样生长因子结合蛋白3（IGFBP3）水平与子宫内膜癌风险的相关性。方法检测206例子宫内膜癌患者（病例组）和310名健康体检妇女（对照组）的血清胰岛素和IGFBP3水平,采用多因素Logistic回归分析校正体质指数（BMI）、血糖和血脂等因素后,分析血清胰岛素和IGFBP3与子宫内膜癌发生风险的关系。结果 病例组血清胰岛素水平为（14.84±16.72）uU/mL,高于对照组的（8.13±9.40）uU/mL（P〈0.01）,两组IGFBP3水平差异无统计学意义（P〉0.05）。分别以本次全部研究对象血清胰岛素和IGFBP3值的≤33.33%分位数（T1）为基准参考,未校正OR模型显示,血清胰岛素水平在T3的妇女患子宫内膜癌风险增加（P〈0.01）,而血清IGFBP3水平在T2和T3的妇女患子宫内膜癌风险均下降（P〈0.01）。但经多因素Logistic回归分析校正BMI、血糖和血脂等因素后,提示血清胰岛素在T2和T3水平的妇女,其子宫内膜癌发生的风险增高（ORT2=2.32,95%CI：1.37~3.39;ORT3=2.34,95%CI：1.32~4.14）;而血清IGFBP3在T3水平的妇女与子宫内膜癌的发生未见统计关联性（P〉0.05）。结论 血清胰岛素增高是代谢综合征妇女子宫内膜癌高发的重要因素,血清IGFBP3增高对子宫内膜癌发生的作用尚需进一步验证。

Objective To explore the association among serum insulin, IGFBP3, and endometrial cancer risk in Chinese women. Methods Serum insulin and IGFBP3 were detected by ELISA method in 206 patients with endometrial carcinoma and 310 healthy women. Using logistic regression analysis after explore the association among the two indicators and the risk of adjustments for BMI, serum glucose and triglycerides to endometrial carcinoma. Results Increased insulin were found in the women with endometrial carcinomas as compared with that of controls·Mean ±SD ： insulin （ 14.84 ±16.72 ） uU · mL-1 in women with cancer versus （8.13 ±9.40） uU · mL-1 in controls, P 〈0.01 ]. However, serum IGFBP3 was not significantly higher in women with endometrial cancer [ Mean ±SD ： IGFBP3 （ 1.76 ±2.44 ） mg · L- 1 in women with cancer versus （ 1.57 ±1.80） mg· L-lin controls, P 〉 0.05 ]. The risk for endometrial cancer was significantly higher in the upper quartile relevant to the lowest quartile of serum insulin, and lower in the upper quartile of serum IGFBP3 （ P 〈 0.05 ）. Logistic regression analysis showed that serum insulin was the risk factor of endometrial carcinoma （ OR = 2.34, 95% CI：I. 32 -4.14）, after adjusting obesity/over-weight status, HDL- C. Conclusion Hyperinsulinemia was an independent risk sdent glucose, total cholesterol, total glyceride, and factor for endometrial carcinomas in Chinese women. However, the protective role of increased serum IGFBP3 should be validated further.