2016 年第 3 期 第 14 卷

C-肽及胰岛素抵抗水平与结直肠癌发病风险的相关性研究

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关键词：胰岛素C-肽胰岛素抵抗指数结直肠癌，结直肠腺瘤性息肉

• 摘要：
• 【摘要】目的：探讨胰岛素及C肽、血糖、胰岛素抵抗水平与结直肠癌发病的相关性。方法：随机选择我科结直肠癌患者、结直肠腺瘤患者以及经过肠镜检查正常患者共113名，比较其空腹血清胰岛素（FINS）、C肽、血糖水平以及胰岛素抵抗的差异。结果：胰岛素水平对照组 6.51（2.3，23.8）uU/ml，腺瘤性息肉组 7.26（2.6，34.0）uU/ml，结直肠癌组 8.2（5.16，22.1）uU/ml。C-肽水平对照组2.0±0.7ng/ml，腺瘤性息肉组 2.6±1.1ng/ml，结直肠癌组 2.8±1.1ng/ml。空腹血糖对照组 5(3.9,7.3)mmol/l，腺瘤性息肉组 5.5(4.1,12.2) mmol/l, 结直肠癌组 5.7(3.6,14.5) mmol/l。胰岛素抵抗水平（IRI）对照组 1.4（0.5，5.6），腺瘤性息肉组 1.9（0.5，11.2），结直肠癌组 2.4（1.1，8.9）。三组患者血清空腹胰岛素、C-肽、空腹血糖、胰岛素抵抗水平的比较，差异均有意义（P<0.05）。结直肠癌组患者胰岛素、胰岛素抵抗水平、C-肽、空腹血糖均高于正常人，差异有统计学意义(P<0．01)。腺瘤性息肉组患者只有C-肽、空腹血糖与健康对照组差异有统计学意义(P>0．05)。多因素logistic回归分析发现年龄、C-肽、空腹血糖与结直肠癌的发病有关，C-肽、胰岛素抵抗水平与结直肠息肉发病有关。结论：C-肽、空腹血糖及胰岛素抵抗与结直肠息肉、结直肠癌发病相关。
• Objective：To investigate the role of insulin，C-peptide ，blood glucose,insulin resistance(IR) in colorectal carcinoma （CRC）. Methods：The fasting serum insulin, C-peptide, blood glucose(FPG) was determined in 113 participants，including colorectal cancer,colorectal adenoma and matched control participants with colonoscopy examination and histologically confirmation. insulin resistance index (IRI)was calculated in the end according to the formula in homeostasis model assessment (HOMA model).Result: differences of serum fasting insulin, c-peptide, the level of fasting blood glucose, IRI for the above three groups of patients were significant. Compared with matched control patients, FINS,C-peptide, level of fasting blood glucose and IRI in colorectal cancer patients was significantly higher．Only C-peptide and level of fasting blood glucose were significantly higher in participants with colorectal adenomas compared with controls.Logistic regression analysis showed age, C-peptide, and fasting blood glucose was independently associated with the risk of colorectal cancer. C-peptide and IR was independently associated with the risk of colorectal adenoma.Conclusion：There was a positive corelation between C-peptide, fasting blood glucose, and IRI with morbidity of colorectal cancer or colorectal adenoma．