Elevated C-peptide and insulin predict increased risk of colorectal adenomas in normal mucosa.

Vidal, Adriana C

Lund, Pauline Kay

Hoyo, Cathrine

Galanko, Joseph

Burcal, Lauren

Holston, Rachel

Massa, Berri

Omofoye, Oluwaseun

Sandler, Robert S

Keku, Temitope O

England

2013-01-16T18:27:47Z

2012-09-05

BACKGROUND: Lower concentrations of the insulin-like growth factor binding protein-1 (IGFBP-1) and elevated concentrations of insulin or C-peptide have been associated with an increase in colorectal cancer risk (CRC). However few studies have evaluated IGFBP-1 and C-peptide in relation to adenomatous polyps, the only known precursor for CRC. METHODS: Between November 2001 and December 2002, we examined associations between circulating concentrations of insulin, C-peptide, IGFBP-1 and apoptosis among 190 individuals with one or more adenomatous polyps and 488 with no adenomatous polyps using logistic regression models. RESULTS: Individuals with the highest concentrations of C-peptide were more likely to have adenomas (OR = 2.2, 95% CI 1.4-4.0) than those with the lowest concentrations; associations that appeared to be stronger in men (OR = 4.4, 95% CI 1.7-10.9) than women. Individuals with high insulin concentrations also had a higher risk of adenomas (OR = 3.5, 95% CI 1.7-7.4), whereas higher levels of IGFBP-1 were associated with a reduced risk of adenomas in men only (OR = 0.3, 95% CI 0.1-0.7). Overweight and obese individuals with higher C-peptide levels (>1(st) Q) were at increased risk for lower apoptosis index (OR = 2.5, 95% CI 0.9-7.1), an association that remained strong in overweight and obese men (OR = 6.3, 95% CI 1.0-36.7). Higher levels of IGFBP-1 in overweight and obese individuals were associated with a reduced risk of low apoptosis (OR = 0.3, 95% CI 0.1-1.0). CONCLUSIONS: Associations between these peptides and the apoptosis index in overweight and obese individuals, suggest that the mechanism by which C-peptide could induce adenomas may include its anti-apoptotic properties. This study suggests that hyperinsulinemia and IGF hormones predict adenoma risk, and that outcomes associated with colorectal carcinogenesis maybe modified by gender.

http://www.ncbi.nlm.nih.gov/pubmed/22950808

1471-2407-12-389

1471-2407

https://hdl.handle.net/10161/6104

eng

Springer Science and Business Media LLC

BMC Cancer

10.1186/1471-2407-12-389

BMC Cancer

Adenoma

Adult

Aged

Apoptosis

Body Mass Index

C-Peptide

Case-Control Studies

Colorectal Neoplasms

Female

Humans

Insulin

Insulin-Like Growth Factor Binding Protein 1

Intestinal Mucosa

Male

Middle Aged

Odds Ratio

Risk

Elevated C-peptide and insulin predict increased risk of colorectal adenomas in normal mucosa.

Journal article

1

12

http://www.ncbi.nlm.nih.gov/pubmed/22950808

1

8

Duke

Faculty

Published online

12