胃癌合并糖尿病患者血清IGF-1和IGFBP-3水平的变化及意义

Changes and clinical significance of serum IGF-1 and IGFBP-3 in patients with gastric cancer complicated with diabetes

目的探讨胃癌合并糖尿病患者血清胰岛素样生长因子-1(IGF-1)和胰岛素样生长因子结合蛋白-3(IGFBP-3)的变化及其临床意义。方法选取2017年3月至2018年12月间收治的100例胃癌患者,按照是否合并糖尿病进行分组,其中,合并糖尿病的55例患者纳入糖尿病合并胃癌组,未合并糖尿病的45例患者纳入单纯胃癌组,比较两组患者的血清IGF-1和IGFBP-3水平。结果糖尿病合并胃癌组IGF-1和IGFBP-3阳性率显著较单纯胃癌组高,差异均有统计学意义(均P <0. 05)。糖尿病合并胃癌组IGF-1和IGF-1/IGFBP-3水平显著高于单纯胃癌组,差异均有统计学意义(均P <0. 05),两组患者IGFBP-3组间比较,差异无统计学意义(P> 0. 05)。糖尿病合并胃癌组空腹血糖、餐后2h血糖和糖化血红蛋白显著高于单纯胃癌组,差异均有统计学意义(均P <0. 05)。IGF-1与IGFBP-3呈正相关,差异有统计学意义(P <0. 05)。将以上影响因素纳入多因素分析,结果表明,IGF-1、IGFBP-3、IGF-1/IGFBP-3、空腹血糖和糖化血红蛋白是糖尿病合并胃癌发生的危险因素,差异均有统计学意义(均P <0. 05),餐后2h血糖对糖尿病合并胃癌发生无明显影响,差异无统计学意义(P> 0. 05)。结论 IGF-1和IGFBP-3均参与糖尿病合并胃癌疾病发生过程,其值对于预测病情发展具有一定作用。

Objective To investigate the changes and clinical significance of serum insulin-like growth factor-1(IGF-1)and insulin-like growth factor binding protein-3(IGFBP-3)levels in patients gastric cancer(GC)complicated with diabetes mellitus(DM).Methods A total of 100 patients with gastric cancer who received treatment at Sun Simiao Hospital,Beijing University of Traditional Chinese Medicine from March 2017 to December 2018 were selected as research subjects.They were divided into the single gastric cancer group(55 patients)and gastric cancer complicated with diabetes mellitus group(45 patients)according to whether they had diabetes mellitus.Serum IGF-1 and IGFBP-3 levels were compared between the two groups.Results The positive rates of IGF-1 and IGFBP-3 were higher in gastric cancer complicated with diabetes group than in single gastric cancer group(all P<0.05).Serum IGF-1/IGFBP-3 levels were higher in gastric cancer complicated with diabetes group than in single gastric cancer group(all P<0.05).There was no significant difference in IGFBP-3 between the two groups(P>0.05).Fasting blood-glucose,2-hour postprandial blood glucose(2 hPBG),and Hb A1 c were significantly higher in the gastric cancer complicated with diabetes mellitus group than in the single gastric cancer group,(all P<0.05).IGF-1 was positively associated with IGFBP-3(P<0.05).Multivariate analysis showed IGF-1,IGFBP-3,IGF-1/IGFBP-3,fasting blood-glucose and Hb A1 c were risk factors for gastric cancer complicated with diabetes mellitus(all P<0.05).2 hPBG did not have an obvious effect on gastric cancer(P>0.05).Conclusion IGF-1 and IGFBP-3 are involved in the onset of diabetes mellitus complicated with gastric cancer,and play a certain role in predicting the disease progression.