结直肠癌代谢紊乱与胰岛素抵抗的研究

目的 探讨结直肠癌患者是否存在胰岛素抵抗及其临床意义.方法 前瞻性收集2007年6月至2010年6月间温州医学院附属第三医院135例结直肠癌患者作为结直肠癌组,选择同期进行查体的120名健康人为对照组,测量身高、体质量、血压,抽空腹血测量血糖、三酰甘油、HDL-C和胰岛素,计算胰岛素抵抗指数（lnHOMA-IR）.结果 结直肠癌组和对照组胰岛素抵抗指数分别为0.84±0.38和0.42±0.08,代谢综合征发生率分别为34.1%（46/135）和22.5%（27/120）,差异均有统计学意义（P＜0.05）.结直肠癌代谢综合征与非代谢综合征患者的胰岛素抵抗指数分别为0.98±0.41和0.74±0.22,差异无统计学意义（P＞0.05）.胰岛素抵抗指数与结直肠癌分化程度、浸润深度、淋巴结转移、远处转移及TNM分期均无关（P＞0.05）.结论 结直肠癌患者存在胰岛素抵抗,原因可能与代谢综合征及肿瘤本身有关.

Metabolic disturbance and insulin resistance in patients with colorectal cancer

Objective To investigate whether insulin resistance exists in patients with colorectal cancer and its clinical significance. Methods A total of 135 patients with colorectal cancer were included as the study group, and 120 healthy subjects were included as the control group. Height,weight, and blood pressure were recorded. Fasting plasma glucose, triglycerides, high-density lipoprotein cholesterol (HDL-C), and insulin were measured. Insulin resistance index (InHOMA-IR) was calculated. Results The lnHOMA-IR was 0.84±0.38 in the study group and 0.42±0.08 in the control group (P＜0.05). The incidence of metabolic syndrome was 34.1%(46/135) in the study group and 22.5%(27/120) in the control group (P＜0.05). Insulin resistance index did not differ between the groups according to metabolic syndrome (0.98±0.41 vs. 0.74±0.22, P＞0.05). There were no significant associations between insulin resistance index and tumor differentiation, depth of invasion, lymph node metastasis, distant metastasis, and TNM staging(P＞0.05). Conclusion Insulin resistance exists in colorectal cancer patients, and it is possibly associated with metabolic syndrome and the tumor.