Gao Songkun, Wang Jinhua, Wang Tong, Wang Jiandong
Gynecologic Oncology Department,Beijing Obstetrics and Gynecology Hospital, Capital Medical University, Beijing Maternal and Child Health Care Hospital, Beijing, People's Republic of China.
Department of Obstetrics and Gynecology, Beijing Youan Hospital, Capital Medical University, Beijing, People's Republic of China.
Int J Womens Health. 2024 Dec 27;16:2355-2363. doi: 10.2147/IJWH.S500936. eCollection 2024.
To evaluate the insulin resistance in patients with menopause who were newly diagnosed with endometrial cancer and its association with disease development.
The study included 356 patients with menopause who underwent hysteroscopy at Beijing Obstetrics and Gynecology Hospital between September 2013 and July 2018. Data on age, height, weight, menarche and menopausal age, pregnancies, births, and family history of tumors, hypertension, and diabetes were collected. Blood tests provided fasting blood glucose, triglycerides, total cholesterol, high-density lipoprotein, and low-density lipoprotein levels. Pathological testing determined whether patients had endometrial cancer or precancerous lesions. Differences in influencing factors between patients with endometrial cancer or precancerous lesions and those with normal or benign conditions were analyzed using univariate analysis. Quartile grouping of the Metabolic Score for Insulin Resistance (METS-IR) and Triglyceride-Glucose (TyG) index were applied to examine the impact of different insulin resistance on the development of endometrial cancer or precancerous lesions.
Univariate analysis revealed that the proportion of patients with hypertension and diabetes was significantly higher among those with endometrial cancer and precancerous lesions. METS-IR and TyG levels were significantly increased in patients with endometrial cancer and precancerous lesions. The quartile grouping results of METS-IR and TyG suggested that age, BMI, FBG, TG, hypertension, and diabetes prevalence rates increased with an increase in METS-IR or TyG, whereas lipid indicators were negatively correlated and unstable Logistic regression suggested that none of the above influencing factors and METS-IR or TyG were related to the pathological results of the patients.
Patients with endometrial or precancerous lesions showed evidence of insulin resistance compared to others, though this was not directly associated with disease presence. This study provides relevant information for preventing of endometrial cancer in the future. Larger studies are needed to evaluate the role of METS-IR and TyG in endometrial cancer prevention.
评估初诊子宫内膜癌的绝经患者的胰岛素抵抗情况及其与疾病发展的关联。
本研究纳入了2013年9月至2018年7月期间在北京妇产医院接受宫腔镜检查的356例绝经患者。收集了年龄、身高、体重、初潮和绝经年龄、妊娠次数、生育次数以及肿瘤、高血压和糖尿病家族史等数据。血液检测提供空腹血糖、甘油三酯、总胆固醇、高密度脂蛋白和低密度脂蛋白水平。病理检查确定患者是否患有子宫内膜癌或癌前病变。采用单因素分析比较子宫内膜癌或癌前病变患者与正常或良性病变患者之间影响因素的差异。应用胰岛素抵抗代谢评分（METS-IR）和甘油三酯-葡萄糖（TyG）指数的四分位数分组来研究不同胰岛素抵抗对子宫内膜癌或癌前病变发展的影响。
单因素分析显示，子宫内膜癌和癌前病变患者中高血压和糖尿病患者的比例显著更高。子宫内膜癌和癌前病变患者的METS-IR和TyG水平显著升高。METS-IR和TyG的四分位数分组结果表明，年龄、体重指数、空腹血糖、甘油三酯、高血压和糖尿病患病率随METS-IR或TyG的升高而增加，而血脂指标呈负相关且不稳定。Logistic回归分析表明，上述影响因素以及METS-IR或TyG均与患者的病理结果无关。
与其他患者相比，子宫内膜癌或癌前病变患者存在胰岛素抵抗的证据，尽管这与疾病的存在没有直接关联。本研究为未来预防子宫内膜癌提供了相关信息。需要更大规模的研究来评估METS-IR和TyG在子宫内膜癌预防中的作用。
