血清C肽和胰岛素样生长因子结合蛋白3与乳腺癌患者死亡风险相关性分析

Correlation between serum C peptide and insulin-like growth factor binding protein 3 and the risk of breast cancer patient death

目的探讨血清C肽和胰岛素样生长因子结合蛋白3(IGFBP-3)与乳腺癌患者死亡风险的相关性。方法选取乳腺癌患者339例,随访2~4年。收集所有患者的一般临床资料(年龄、性别、体力活动、吸烟史、饮酒史、身高、体质量、腰围),计算体质量指数(BMI),检测C肽、空腹胰岛素(FINS)、空腹血糖(FBG)、血清肌酐(SCr)和IGFBP-3水平。采用Cox回归分析评估各项指标与乳腺癌患者死亡风险的关系。结果死亡组BMI、腰围及血清C肽、IGFBP-3水平均显著高于生存组(P<0.05),其他指标2个组之间差异均无统计学意义(P>0.05)。根据C肽的四分位数对乳腺癌患者进行分组,与C肽≤0.39 nmol/L组比较,C肽0.40~0.62 nmol/L组、C肽0.63~1.02 nmol/L组、C肽≥1.03 nmol/L组血清IGFBP-3水平均显著升高(P<0.05),且趋势P<0.0001,表明IGFBP-3与C肽有关。根据FINS的四分位数将乳腺癌患者分为4组,4组之间血清IGFBP-3水平差异均无统计学意义(P>0.05),且趋势P>0.05,表明IGFBP-3与FINS水平无关。Cox回归分析结果显示,充分校正混杂因素后,C肽和IGFBP-3与乳腺癌患者死亡风险有关[风险比(HR)值分别为1.58、1.02,95%可信区间(CI)分别为1.09~2.66、1.01~1.91,P值分别为0.02、0.01]。结论C肽和IGFBP-3与乳腺癌患者死亡风险有关。

Objective To investigate the correlation between serum C peptide and insulin-like growth factor binding protein 3(IGFBP-3)and the risk of breast cancer patient death.Methods Totally,339 patients with breast cancer were enrolled and followed up for 2-4 years.The general clinical data(age,sex,physical activity,smoking history,drinking history,height,body mass and waist circumference)of all the patients were collected,the body mass index(BMI)was calculated,and the levels of C peptide,fasting insulin(FINS),fasting blood glucose(FBG),serum creatinine(SCr)and IGFBP-3 were determined.Cox regression analysis was used to assess the relationship between the indicators and the risk of breast cancer patient death.Results BMI,waist circumference,C peptide and IGFBP-3 levels in death group were higher than those in survival group(P<0.05).There was no statistical significance in the other indicators between the 2 groups(P>0.05).According to the four percentiles of C peptide,the patients were classified into 4 groups.Compared with those of C peptide≤0.39 nmol/L,serum IGFBP-3 levels of C peptide 0.40-0.62 nmol/L group,C peptide 0.63-1.02 nmol/L group,C peptide≥1.03 nmol/L group were increased(P<0.05)with the trend of P<0.0001,indicating that it was related to C peptide.According to FINS’s four percentiles,4 subgroups of breast cancer patients were grouped.There was no statistical significance in serum IGFBP-3 level among the 4 groups(P>0.05)with the trend of P>0.05,indicating that serum IGFBP-3 had no relation with FINS level.Cox regression analysis showed that C peptide and IGFBP-3 were related to the risk of breast cancer patient death after fully correcting the confounding factors.The hazard ratios(HR)were 1.58 and 1.02,respectively,the 95%confidence intervals(CI)ranged from 1.09 to 2.66 and from 1.01 to 1.91,and the P values were 0.02 and 0.01.Conclusions C peptide and serum IGFBP-3 are related to the risk of breast cancer patient death.