Study of Insulin Resistance in Patients with Cancer
Abstract. The pro-oncogenic effects of obesity, insulin resistance and hyperinsulinemia have been proven in some types of cancer, as well as in type 2 diabetes mellitus.
The objective of the research was to investigate the state of insulin resistance in patients suffering from oncological diseases and to compare insulin correlations in patients with type 2 diabetes mellitus and those with cancer.
Materials and Methods. The study included the following groups of patients: Group I included healthy individuals (the control group); Group II comprised patients with type 2 diabetes mellitus; Group ІІІ included patients with cancer: subgroup IIIa comprised patients with breast cancer, subgroup IIIb included patients with endometrial cancer, subgroup IIIс comprised patients with colorectal cancer. Fasting blood glucose was determined by glucose oxidase method; hemoglobin A1c was determined by ion exchange chromatography; the levels of insulin and insulin-like growth factor-1 were determined by immune-enzyme method. Insulin resistance was assessed by the homeostatic model assessment for insulin resistance index. The results obtained were analyzed using statistical analysis.
Results. Obesity was confirmed in all the groups of patients with cancer. Significantly higher body mass index, as compared to the control group, was found in patients with endometrial cancer (p = 0.008). In comparison with the control group, the levels of insulin and insulin-like growth factor-1 increased significantly in all groups of patients with cancer (p < 0.001). Fasting blood sugar levels and hemoglobin A1c did not differ from the indicators in the control group (p > 0.05). Direct correlations between insulin and body mass index (p < 0.05), insulin-like growth factor-1 (p < 0.05) and the homeostatic model assessment for insulin resistance index in patients of Group II and Group III were detected (p < 0.05).
Conclusions. In obese patients with breast, uterine and colorectal cancer, there was found a decrease in insulin sensitivity, which might increase the proliferative effects of insulin and insulin-like growth factor-1. Correlation analysis showed a probable association of cancer and diabetes mellitus due to obesity and insulin resistance.
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