Open AccessFasting serum insulin levels and insulin resistance are associated with colorectal adenoma in K oreans
Author(s) -
Kim Eun Hee,
Kim HongKyu,
Bae Sung Jin,
Chang HyeSook,
Park Hye Won,
Do Mi Young,
Kim KyungJo,
Jung Chang Hee,
Lee Woo Je,
Park JoongYeol,
Choe Jaewon
Publication year - 2014
Publication title -
journal of diabetes investigation
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.089
H-Index - 50
eISSN - 2040-1124
pISSN - 2040-1116
DOI - 10.1111/jdi.12178
Subject(s) - medicine , insulin resistance , colorectal cancer , colorectal adenoma , colonoscopy , gastroenterology , insulin , adenoma , polypectomy , quartile , diabetes mellitus , tubular adenoma , family history , endocrinology , cancer , confidence interval
Aims/Introduction Insulin has been associated with the risk of colorectal cancer ( CRC ). However, few studies have evaluated the association between insulin and colorectal adenoma. We investigated the relationship between fasting serum insulin levels or homeostasis model assessment of insulin resistance ( HOMA ‐ IR ) and colorectal adenoma. Materials and Methods We retrospectively enrolled 15,427 participants who underwent both fasting serum insulin measurement and colonoscopy for a routine health examination at A san M edical C enter from J anuary 2007 to D ecember 2008. Participants with a history of any cancer, previous colectomy or polypectomy, those taking antidiabetic medications, and inflammatory bowel disease, non‐specific colitis, non‐adenomatous polyps only or CRC on colonoscopic findings were excluded. Finally, 3,606 participants with histologically confirmed colorectal adenoma and 6,019 controls with no abnormal findings on colonoscopy were included. Participants were categorized into quartiles ( Q ) based on fasting serum insulin levels and HOMA ‐ IR . Results Fasting serum insulin and HOMA ‐ IR were significantly higher in participants with colorectal adenomas compared with controls. Multivariate regression analysis adjusting for age, sex, smoking habits, drinking habits and family history of CRC showed that participants with higher quartiles of fasting serum insulin levels (odd ratio [ OR ] 1.17 for 2nd Q , 1.19 for 3rd Q , and 1.42 for 4th Q , P < 0.05) or HOMA ‐ IR ( OR 1.18 for 2nd Q and 1.45 for 4th Q , P < 0.05) showed significantly increased OR s of colorectal adenoma compared with the lowest quartiles. Conclusions These findings showed that increased serum insulin levels and insulin resistance were significantly associated with the presence of colorectal adenoma.