Baeg Myong Ki, Choi Myung-Gyu, Ko Sun-Hye, Park Bo-Geun, Han Kyung-Do, Park Jae Myung, Lee Bo-In, Lee In-Seok, Kim Sang-Woo
Division of Gastroenterology, Department of Internal Medicine, College of Medicine, The Catholic University of Korea, 222 Banpodaero, Seocho-Gu, Seoul, 137-701, Republic of Korea,
Dig Dis Sci. 2015 Aug;60(8):2488-94. doi: 10.1007/s10620-015-3644-6. Epub 2015 Apr 4.
Both insulin resistance (IR) and vitamin D deficiency (VitDdef) have been suggested as risk factors for colorectal neoplasms (CRNs). However, the associations between the two with regard to CRNs are unclear.
To determine whether IR is a risk factor for CRNs and whether VitDdef confers an additive risk of CRNs.
Colonoscopy-naïve asymptomatic women undergoing a routine health screening program were analyzed. IR was defined as homeostatic model assessment of IR >3 and VitDdef set as <20 ng/mL. Multivariable logistic regression was performed between women with and without CRNs, matched for age and body mass index, to investigate associations with CRNs in IR, VitDdef, and VitDdef combined with IR.
We analyzed 216 women with CRNs and 216 without CRNs. A significant association was found between IR and CRNs (OR 1.838, 95 % CI 1.029-3.285, P = 0.040) but not with VitDdef. IR conferred a higher risk in advanced CRNs (OR 3.244, 95 % CI 1.588-6.631, P = 0.001) than CRNs. When VitDdef was combined with IR, risks of both CRNs and advanced CRNs increased (OR 2.131, 95 % CI 1.077-4.216, P = 0.030 and OR 4.438, 95 % CI 2.058-9.571, P < 0.001, respectively).
IR increases the risk of CRNs, and a combination of IR and VitDdef further increases this risk. As both VitDdef and IR are modifiable risk factors, such associations may have important clinical implications in the prevention of CRNs.
胰岛素抵抗（IR）和维生素D缺乏（VitDdef）均被认为是结直肠肿瘤（CRNs）的危险因素。然而，二者与CRNs之间的关联尚不清楚。
确定IR是否为CRNs的危险因素，以及VitDdef是否会增加CRNs的额外风险。
对接受常规健康筛查项目且未行结肠镜检查的无症状女性进行分析。IR定义为稳态模型评估的胰岛素抵抗>3，VitDdef设定为<20 ng/mL。在年龄和体重指数匹配的有或无CRNs的女性之间进行多变量逻辑回归分析，以研究IR、VitDdef以及VitDdef与IR联合对CRNs的关联。
我们分析了216例患有CRNs的女性和216例未患CRNs的女性。发现IR与CRNs之间存在显著关联（OR 1.838，95% CI 1.029 - 3.285，P = 0.040），但与VitDdef无关。IR在进展期CRNs中（OR 3.244，95% CI 1.588 - 6.631，P = 0.001）比在CRNs中带来更高的风险。当VitDdef与IR联合时，CRNs和进展期CRNs的风险均增加（分别为OR 2.131，95% CI 1.077 - 4.216，P = 0.030和OR 4.438，95% CI 2.058 - 9.571，P < 0.001）。
IR增加CRNs的风险，IR与VitDdef联合进一步增加此风险。由于VitDdef和IR均为可改变的危险因素，此类关联可能在CRNs的预防中具有重要的临床意义。
