Lu Jixuan, Sun Lijie, Li Xinyu, Cao Yan, Gao Jie, Yao Dengju, Zhan Xiaorong
Department of Endocrinology, The First Affiliated Hospital of Harbin Medical University Harbin 150001, Heilongjiang, China.
School of Computer Science and Technology, Harbin University of Science and Technology Harbin 150080, Heilongjiang, China.
Am J Transl Res. 2025 Jul 15;17(7):5355-5370. doi: 10.62347/TQUD3910. eCollection 2025.
In clinical practice, tumor occurrence and progression appear to be more frequent and rapid in patients with type 2 diabetes mellitus (T2DM) compared to non-diabetic individuals. Epidemiological studies have confirmed that the incidence of colorectal cancer (CRC) is relatively higher in patients with T2DM. However, the key candidate regulatory factors that mediate and drive the concurrent development and progression of T2DM and CRC remain unclear. Analysis using the Significant Bias Evaluation Method on clinical data revealed that patients with T2DM have a higher propensity for developing lung cancer, colorectal cancer, and breast cancer. Further analysis of the key factors associated with T2DM and related tumors identified GSK3β as a potential key regulatory factor in CRC development in T2DM patients, through differential expression analysis using the limma package on real-world data. Western blot and qRT-PCR validation revealed that, compared to the non-insulin-resistant HT29 CRC cell line group, the mRNA and protein expression levels of GSK3β were significantly elevated in the insulin-resistant group. Similarly, the mRNA and protein expression levels of factors associated with the GSK3β-β-catenin-CyclinD1/cMyc pathway were also upregulated. Furthermore, when GSK3β was silenced or overexpressed, the proliferative effect of tumor cells was markedly reduced or increased, respectively. In summary, GSK3β is upregulated in T2DM patients with CRC and contributes to tumor progression. GSK3β holds promise as a novel therapeutic target for the treatment of patients with T2DM complicated by CRC, potentially providing a solution to address clinical challenges.
在临床实践中,与非糖尿病个体相比,2型糖尿病(T2DM)患者的肿瘤发生和进展似乎更频繁、更迅速。流行病学研究证实,T2DM患者患结直肠癌(CRC)的发病率相对较高。然而,介导和驱动T2DM与CRC同时发生和进展的关键候选调控因子仍不清楚。对临床数据使用显著偏差评估方法进行分析发现,T2DM患者患肺癌、结直肠癌和乳腺癌的倾向更高。通过对真实世界数据使用limma软件包进行差异表达分析,进一步分析与T2DM及相关肿瘤相关的关键因素,确定GSK3β是T2DM患者CRC发生发展中的一个潜在关键调控因子。蛋白质免疫印迹和qRT-PCR验证显示,与非胰岛素抵抗的HT29 CRC细胞系组相比,胰岛素抵抗组中GSK3β的mRNA和蛋白质表达水平显著升高。同样,与GSK3β-β-连环蛋白-CyclinD1/cMyc通路相关的因子的mRNA和蛋白质表达水平也上调。此外,当GSK3β被沉默或过表达时,肿瘤细胞的增殖作用分别显著降低或增强。总之,GSK3β在患有CRC的T2DM患者中上调,并促进肿瘤进展。GSK3β有望成为治疗合并CRC的T2DM患者的新型治疗靶点,可能为解决临床挑战提供一种解决方案。