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Assessment of Insulin Resistance, HOMA-IR, and QUICKI Levels in Patients with Endometrial Cancer and Hyperplasia

Year 2024, Volume: 6 Issue: 4, 119 - 123, 06.11.2024

Canan Tapkan , Tayfun Güngör , Burçin Salman Özgü

https://doi.org/10.46969/EZH.1527966

Abstract

Aim: To analyze insulin resistance and related parameters in patients with endometrial cancer and hyperplasia.
Methods: The study included 102 patients in 3 groups. Group I and II included patients with a histologic diagnosis of endometrial cancer (n=41, 40.2%) and endometrial hyperplasia (n=31, 30.4%) based on the final pathology report. Group III was the control group and included patients who had undergone surgery for a benign indication other than endometrial hyperplasia (n=30, 29.4%). Age, body mass index (BMI), menarcheal age, menopausal status, gravidity, parity score, diabetes, oral contraceptive status, fasting glucose levels, insulin levels, endometrial thickness, HOMA-IR and QUICKI scores were assessed.
Results: The mean age of group I was statistically higher than that of group II (55.3±9.5 vs. 48.8±7.1, p=0.002). The average BMI of the two groups was similar (p=0.076). When fasting glucose values were evaluated, group I showed significantly higher values compared to group II. The mean insulin and HOMA-IR values in the control group were significantly higher than those in group I (p<0.001) and the QUICKI value was significantly higher in group I than in the control group (p=0.026).
Conclusion: Insulin resistance appears to be associated with endometrial cancer.

Keywords

insulin resistance endometrial cancer hyperplasia

References

  • Siegel RL, Miller KD, Jemal A. Cancer statistics, 2016. CA Cancer J Clin. 2016;66(1):7-30. https://doi.org/10.3322/caac.21332
  • Sénéchal C, Cottereau E, de Pauw A, et al. Environmental and genetic risk factors for endometrial carcinoma. Bull Cancer. 2015;102(3):256-69. https://doi.org/10.1016/j.bulcan.2015.01.006
  • Key TJ, Pike MC. The dose-effect relationship between 'unopposed' oestrogens and endometrial mitotic rate: its central role in explaining and predicting endometrial cancer risk. Br J Cancer. 1988;57(2):205-12. https://doi.org/10.1038/bjc.1988.44
  • Prescott J, Bao Y, Viswanathan AN, Giovannucci EL, Hankinson SE, De Vivo I. Dietary insulin index and insulin load in relation to endometrial cancer risk in the Nurses' Health Study. Cancer Epidemiol Biomarkers Prev. 2014;23(8):1512-20. https://doi.org/10.1158/1055-9965.EPI-14-0157
  • Trabert B, Wentzensen N, Felix AS, Yang HP, Sherman ME, Brinton LA. Metabolic syndrome and risk of endometrial cancer in the united states: a study in the SEER-medicare linked database. Cancer Epidemiol Biomarkers Prev. 2015;24(1):261-7. https://doi.org/10.1158/1055-9965.EPI-14-0923
  • Berstein LM, Kvatchevskaya JO, Poroshina TE, et al. Insulin resistance, its consequences for the clinical course of the disease, and possibilities of correction in endometrial cancer. J Cancer Res Clin Oncol. 2004;130(11):687-93. https://doi.org/10.1007/s00432-004-0587-2
  • Aizen D, Sarfstein R, Bruchim I, Weinstein D, Laron Z, Werner H. Proliferative and signaling activities of insulin analogues in endometrial cancer cells. Mol Cell Endocrinol. 2015;406:27-39. https://doi.org/10.1016/j.mce.2015.02.011
  • Kurman RJ, Ellenson LH, Ronnett BM. Blaustein’s pathology of female genital tract. 6 ed. Springer US; 2011.
  • Shan W, Ning C, Luo X, et al. Hyperinsulinemia is associated with endometrial hyperplasia and disordered proliferative endometrium: a prospective cross-sectional study. Gynecol Oncol. 2014;132(3):606-10. https://doi.org/10.1016/j.ygyno.2014.01.004
  • Dossus L, Lukanova A, Rinaldi S, et al. Hormonal, metabolic, and inflammatory profiles and endometrial cancer risk within the EPIC cohort--a factor analysis. Am J Epidemiol. 2013;177(8):787-99. https://doi.org/10.1093/aje/kws309
  • Burzawa JK, Schmeler KM, Soliman PT, et al. Prospective evaluation of insulin resistance among endometrial cancer patients. Am J Obstet Gynecol. 2011;204(4):355.e1-7. https://doi.org/10.1016/j.ajog.2010.11.033
  • Mariani A, Dowdy SC, Cliby WA, et al. Prospective assessment of lymphatic dissemination in endometrial cancer: a paradigm shift in surgical staging. Gynecol Oncol. 2008;109(1):11-8. https://doi.org/10.1016/j.ygyno.2008.01.023
  • Amant F, Moerman P, Neven P, Timmerman D, Van Limbergen E, Vergote I. Endometrial cancer. Lancet. 2005;366(9484):491-505. https://doi.org/10.1016/S0140-6736(05)67063-8
  • Kurman RJ, Norris HJ. Evaluation of criteria for distinguishing atypical endometrial hyperplasia from well-differentiated carcinoma. Cancer. 1982;49(12):2547-59. https://doi.org/10.1002/1097-0142(19820615)49:12<2547::aid-cncr2820491224>3.0.co;2-0
  • Kurman RJ, Kaminski PF, Norris HJ. The behavior of endometrial hyperplasia. A long-term study of "untreated" hyperplasia in 170 patients. Cancer. 1985;56(2):403-12. https://doi.org/cpngkn
  • Ovalle F, Azziz R. Insulin resistance, polycystic ovary syndrome, and type 2 diabetes mellitus. Fertil Steril. 2002;77(6):1095-105. https://doi.org/10.1016/s0015-0282(02)03111-4
  • Gunter MJ, Hoover DR, Yu H, et al. A prospective evaluation of insulin and insulin-like growth factor-I as risk factors for endometrial cancer. Cancer Epidemiol Biomarkers Prev. 2008;17(4):921-9. https://doi.org/10.1158/1055-9965.EPI-07-2686
  • Saltzman BS, Doherty JA, Hill DA, et al. Diabetes and endometrial cancer: an evaluation of the modifying effects of other known risk factors. Am J Epidemiol. 2008;167(5):607-14. https://doi.org/10.1093/aje/kwm333
  • Calle EE, Rodriguez C, Walker-Thurmond K, Thun MJ. Overweight, obesity, and mortality from cancer in a prospectively studied cohort of U.S. adults. N Engl J Med. 2003;348(17):1625-38. https://doi.org/10.1056/NEJMoa021423
  • Neff R, Havrilesky LJ, Chino J, O'Malley DM, Cohn DE. Bariatric surgery as a means to decrease mortality in women with type I endometrial cancer - An intriguing option in a population at risk for dying of complications of metabolic syndrome. Gynecol Oncol. 2015;138(3):597-602. https://doi.org/10.1016/j.ygyno.2015.07.002
  • Hernandez AV, Pasupuleti V, Benites-Zapata VA, Thota P, Deshpande A, Perez-Lopez FR. Insulin resistance and endometrial cancer risk: A systematic review and meta-analysis. Eur J Cancer. 2015;51(18):2747-58. https://doi.org/10.1016/j.ejca.2015.08.031
  • Rotterdam ESHRE/ASRM-Sponsored PCOS Consensus Workshop Group. Revised 2003 consensus on diagnostic criteria and long-term health risks related to polycystic ovary syndrome. Fertil Steril. 2004;81(1):19-25. https://doi.org/10.1016/j.fertnstert.2003.10.004
  • Arcidiacono B, Iiritano S, Nocera A, et al. Insulin resistance and cancer risk: an overview of the pathogenetic mechanisms. Exp Diabetes Res. 2012;2012:789174. https://doi.org/10.1155/2012/789174
  • Zhan Y, Wang J, Ma Y, et al. Serum insulin-like, growth factor binding protein-related protein 1 (IGFBP-rP1) and endometrial cancer risk in Chinese women. Int J Cancer. 2013;132(2):411-6. https://doi.org/10.1002/ijc.27622
  • McCampbell AS, Broaddus RR, Loose DS, Davies PJA. Overexpression of the insulin-like growth factor I receptor and activation of the AKT pathway in hyperplastic endometrium. Clin Cancer Res. 2006;12(21):6373-8. https://doi.org/10.1158/1078-0432.CCR-06-0912
  • Mu N, Zhu Y, Wang Y, Zhang H, Xue F. Insulin resistance: a significant risk factor of endometrial cancer. Gynecol Oncol. 2012;125(3):751-7. https://doi.org/10.1016/j.ygyno.2012.03.032
  • Pollak M. Insulin and insulin-like growth factor signalling in neoplasia. Nat Rev Cancer. 2008;8(12):915-28. https://doi.org/10.1038/nrc2536

Endometrium Kanseri ve Hiperplazisi Olan Hastalarda İnsülin Direnci, HOMA-IR ve QUICKI Düzeylerinin Değerlendirilmesi

Year 2024, Volume: 6 Issue: 4, 119 - 123, 06.11.2024

Canan Tapkan , Tayfun Güngör , Burçin Salman Özgü

https://doi.org/10.46969/EZH.1527966

Abstract

Amaç: Endometriyal kanser ve hiperplazi hastalarında insülin direncini ve ilgili parametreleri analiz etmek.
Yöntemler: Çalışmaya 3 grupta 102 hasta dahil edildi. Grup I ve II, nihai patoloji raporuna göre histolojik tanısı endometriyal kanser (n=41, %40.2) ve endometriyal hiperplazi (n=31, %30.4) olan hastaları içermekteydi. Grup III kontrol grubuydu ve endometriyal hiperplazi dışında iyi huylu bir endikasyon nedeniyle ameliyat geçiren hastaları içeriyordu (n=30, %29,4). Yaş, vücut kitle indeksi (VKİ), menarş yaşı, menopoz durumu, gravidite, parite skoru, diyabet, oral kontraseptif durumu, açlık glukoz düzeyleri, insülin düzeyleri, endometriyal kalınlık, HOMA-IR ve QUICKI skorları değerlendirildi.
Bulgular: Grup I’in yaş ortalaması grup II’den istatistiksel olarak daha yüksekti (55.3±9.5 vs. 48.8±7.1, p=0.002). İki grubun VKİ ortalaması benzerdi (p=0.076). Açlık glukoz değerleri değerlendirildiğinde, grup I, grup II’ye kıyasla anlamlı derecede daha yüksek değerler göstermiştir. Kontrol grubundaki ortalama insülin ve HOMA-IR değerleri grup I’dekilerden anlamlı derecede yüksekti (p<0.001) ve QUICKI değeri grup I’de kontrol grubundan anlamlı derecede yüksekti (p=0.026).
Sonuç: İnsülin direnci endometriyal kanser ile ilişkili görünmektedir.

Keywords

insülin direnci endometrial kanser hiperplazi

References

  • Siegel RL, Miller KD, Jemal A. Cancer statistics, 2016. CA Cancer J Clin. 2016;66(1):7-30. https://doi.org/10.3322/caac.21332
  • Sénéchal C, Cottereau E, de Pauw A, et al. Environmental and genetic risk factors for endometrial carcinoma. Bull Cancer. 2015;102(3):256-69. https://doi.org/10.1016/j.bulcan.2015.01.006
  • Key TJ, Pike MC. The dose-effect relationship between 'unopposed' oestrogens and endometrial mitotic rate: its central role in explaining and predicting endometrial cancer risk. Br J Cancer. 1988;57(2):205-12. https://doi.org/10.1038/bjc.1988.44
  • Prescott J, Bao Y, Viswanathan AN, Giovannucci EL, Hankinson SE, De Vivo I. Dietary insulin index and insulin load in relation to endometrial cancer risk in the Nurses' Health Study. Cancer Epidemiol Biomarkers Prev. 2014;23(8):1512-20. https://doi.org/10.1158/1055-9965.EPI-14-0157
  • Trabert B, Wentzensen N, Felix AS, Yang HP, Sherman ME, Brinton LA. Metabolic syndrome and risk of endometrial cancer in the united states: a study in the SEER-medicare linked database. Cancer Epidemiol Biomarkers Prev. 2015;24(1):261-7. https://doi.org/10.1158/1055-9965.EPI-14-0923
  • Berstein LM, Kvatchevskaya JO, Poroshina TE, et al. Insulin resistance, its consequences for the clinical course of the disease, and possibilities of correction in endometrial cancer. J Cancer Res Clin Oncol. 2004;130(11):687-93. https://doi.org/10.1007/s00432-004-0587-2
  • Aizen D, Sarfstein R, Bruchim I, Weinstein D, Laron Z, Werner H. Proliferative and signaling activities of insulin analogues in endometrial cancer cells. Mol Cell Endocrinol. 2015;406:27-39. https://doi.org/10.1016/j.mce.2015.02.011
  • Kurman RJ, Ellenson LH, Ronnett BM. Blaustein’s pathology of female genital tract. 6 ed. Springer US; 2011.
  • Shan W, Ning C, Luo X, et al. Hyperinsulinemia is associated with endometrial hyperplasia and disordered proliferative endometrium: a prospective cross-sectional study. Gynecol Oncol. 2014;132(3):606-10. https://doi.org/10.1016/j.ygyno.2014.01.004
  • Dossus L, Lukanova A, Rinaldi S, et al. Hormonal, metabolic, and inflammatory profiles and endometrial cancer risk within the EPIC cohort--a factor analysis. Am J Epidemiol. 2013;177(8):787-99. https://doi.org/10.1093/aje/kws309
  • Burzawa JK, Schmeler KM, Soliman PT, et al. Prospective evaluation of insulin resistance among endometrial cancer patients. Am J Obstet Gynecol. 2011;204(4):355.e1-7. https://doi.org/10.1016/j.ajog.2010.11.033
  • Mariani A, Dowdy SC, Cliby WA, et al. Prospective assessment of lymphatic dissemination in endometrial cancer: a paradigm shift in surgical staging. Gynecol Oncol. 2008;109(1):11-8. https://doi.org/10.1016/j.ygyno.2008.01.023
  • Amant F, Moerman P, Neven P, Timmerman D, Van Limbergen E, Vergote I. Endometrial cancer. Lancet. 2005;366(9484):491-505. https://doi.org/10.1016/S0140-6736(05)67063-8
  • Kurman RJ, Norris HJ. Evaluation of criteria for distinguishing atypical endometrial hyperplasia from well-differentiated carcinoma. Cancer. 1982;49(12):2547-59. https://doi.org/10.1002/1097-0142(19820615)49:12<2547::aid-cncr2820491224>3.0.co;2-0
  • Kurman RJ, Kaminski PF, Norris HJ. The behavior of endometrial hyperplasia. A long-term study of "untreated" hyperplasia in 170 patients. Cancer. 1985;56(2):403-12. https://doi.org/cpngkn
  • Ovalle F, Azziz R. Insulin resistance, polycystic ovary syndrome, and type 2 diabetes mellitus. Fertil Steril. 2002;77(6):1095-105. https://doi.org/10.1016/s0015-0282(02)03111-4
  • Gunter MJ, Hoover DR, Yu H, et al. A prospective evaluation of insulin and insulin-like growth factor-I as risk factors for endometrial cancer. Cancer Epidemiol Biomarkers Prev. 2008;17(4):921-9. https://doi.org/10.1158/1055-9965.EPI-07-2686
  • Saltzman BS, Doherty JA, Hill DA, et al. Diabetes and endometrial cancer: an evaluation of the modifying effects of other known risk factors. Am J Epidemiol. 2008;167(5):607-14. https://doi.org/10.1093/aje/kwm333
  • Calle EE, Rodriguez C, Walker-Thurmond K, Thun MJ. Overweight, obesity, and mortality from cancer in a prospectively studied cohort of U.S. adults. N Engl J Med. 2003;348(17):1625-38. https://doi.org/10.1056/NEJMoa021423
  • Neff R, Havrilesky LJ, Chino J, O'Malley DM, Cohn DE. Bariatric surgery as a means to decrease mortality in women with type I endometrial cancer - An intriguing option in a population at risk for dying of complications of metabolic syndrome. Gynecol Oncol. 2015;138(3):597-602. https://doi.org/10.1016/j.ygyno.2015.07.002
  • Hernandez AV, Pasupuleti V, Benites-Zapata VA, Thota P, Deshpande A, Perez-Lopez FR. Insulin resistance and endometrial cancer risk: A systematic review and meta-analysis. Eur J Cancer. 2015;51(18):2747-58. https://doi.org/10.1016/j.ejca.2015.08.031
  • Rotterdam ESHRE/ASRM-Sponsored PCOS Consensus Workshop Group. Revised 2003 consensus on diagnostic criteria and long-term health risks related to polycystic ovary syndrome. Fertil Steril. 2004;81(1):19-25. https://doi.org/10.1016/j.fertnstert.2003.10.004
  • Arcidiacono B, Iiritano S, Nocera A, et al. Insulin resistance and cancer risk: an overview of the pathogenetic mechanisms. Exp Diabetes Res. 2012;2012:789174. https://doi.org/10.1155/2012/789174
  • Zhan Y, Wang J, Ma Y, et al. Serum insulin-like, growth factor binding protein-related protein 1 (IGFBP-rP1) and endometrial cancer risk in Chinese women. Int J Cancer. 2013;132(2):411-6. https://doi.org/10.1002/ijc.27622
  • McCampbell AS, Broaddus RR, Loose DS, Davies PJA. Overexpression of the insulin-like growth factor I receptor and activation of the AKT pathway in hyperplastic endometrium. Clin Cancer Res. 2006;12(21):6373-8. https://doi.org/10.1158/1078-0432.CCR-06-0912
  • Mu N, Zhu Y, Wang Y, Zhang H, Xue F. Insulin resistance: a significant risk factor of endometrial cancer. Gynecol Oncol. 2012;125(3):751-7. https://doi.org/10.1016/j.ygyno.2012.03.032
  • Pollak M. Insulin and insulin-like growth factor signalling in neoplasia. Nat Rev Cancer. 2008;8(12):915-28. https://doi.org/10.1038/nrc2536
There are 27 citations in total.

Details

Primary Language English
Subjects Obstetrics and Gynaecology
Journal Section Research Article
Authors

Canan Tapkan 0000-0002-0849-0281

Tayfun Güngör 0000-0002-7869-9662

Burçin Salman Özgü 0000-0002-1392-8612

Publication Date November 6, 2024
Submission Date August 4, 2024
Acceptance Date October 6, 2024
Published in Issue Year 2024 Volume: 6 Issue: 4

Cite

APA Tapkan, C., Güngör, T., & Salman Özgü, B. (2024). Assessment of Insulin Resistance, HOMA-IR, and QUICKI Levels in Patients with Endometrial Cancer and Hyperplasia. Türk Kadın Sağlığı Ve Neonatoloji Dergisi, 6(4), 119-123. https://doi.org/10.46969/EZH.1527966
AMA Tapkan C, Güngör T, Salman Özgü B. Assessment of Insulin Resistance, HOMA-IR, and QUICKI Levels in Patients with Endometrial Cancer and Hyperplasia. Türk Kadın Sağlığı ve Neonatoloji Dergisi. November 2024;6(4):119-123. doi:10.46969/EZH.1527966
Chicago Tapkan, Canan, Tayfun Güngör, and Burçin Salman Özgü. “Assessment of Insulin Resistance, HOMA-IR, and QUICKI Levels in Patients With Endometrial Cancer and Hyperplasia”. Türk Kadın Sağlığı Ve Neonatoloji Dergisi 6, no. 4 (November 2024): 119-23. https://doi.org/10.46969/EZH.1527966.
EndNote Tapkan C, Güngör T, Salman Özgü B (November 1, 2024) Assessment of Insulin Resistance, HOMA-IR, and QUICKI Levels in Patients with Endometrial Cancer and Hyperplasia. Türk Kadın Sağlığı ve Neonatoloji Dergisi 6 4 119–123.
IEEE C. Tapkan, T. Güngör, and B. Salman Özgü, “Assessment of Insulin Resistance, HOMA-IR, and QUICKI Levels in Patients with Endometrial Cancer and Hyperplasia”, Türk Kadın Sağlığı ve Neonatoloji Dergisi, vol. 6, no. 4, pp. 119–123, 2024, doi: 10.46969/EZH.1527966.
ISNAD Tapkan, Canan et al. “Assessment of Insulin Resistance, HOMA-IR, and QUICKI Levels in Patients With Endometrial Cancer and Hyperplasia”. Türk Kadın Sağlığı ve Neonatoloji Dergisi 6/4 (November 2024), 119-123. https://doi.org/10.46969/EZH.1527966.
JAMA Tapkan C, Güngör T, Salman Özgü B. Assessment of Insulin Resistance, HOMA-IR, and QUICKI Levels in Patients with Endometrial Cancer and Hyperplasia. Türk Kadın Sağlığı ve Neonatoloji Dergisi. 2024;6:119–123.
MLA Tapkan, Canan et al. “Assessment of Insulin Resistance, HOMA-IR, and QUICKI Levels in Patients With Endometrial Cancer and Hyperplasia”. Türk Kadın Sağlığı Ve Neonatoloji Dergisi, vol. 6, no. 4, 2024, pp. 119-23, doi:10.46969/EZH.1527966.
Vancouver Tapkan C, Güngör T, Salman Özgü B. Assessment of Insulin Resistance, HOMA-IR, and QUICKI Levels in Patients with Endometrial Cancer and Hyperplasia. Türk Kadın Sağlığı ve Neonatoloji Dergisi. 2024;6(4):119-23.
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