Association of insulin and insulin-like growth factors with Barrett's oesophagus
| Autor: | William M. Grady, Li Li, Amitabh Chak, Lacie Brenner, Gary W. Falk, Dawn M. Dawson, Cheryl L. Thompson, Gregory S. Cooper, Beth Bednarchik, Joseph Willis, Katarina B. Greer |
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| Rok vydání: | 2011 |
| Předmět: |
Male
medicine.medical_specialty Colorectal cancer medicine.medical_treatment Colonoscopy Logistic regression Gastroenterology Article Barrett Esophagus Internal medicine medicine Humans Insulin Obesity Prospective Studies Insulin-Like Growth Factor I Prospective cohort study Aged medicine.diagnostic_test business.industry Case-control study Reflux Middle Aged medicine.disease Insulin-Like Growth Factor Binding Protein 1 Insulin-Like Growth Factor Binding Protein 3 Logistic Models Endocrinology Case-Control Studies Multivariate Analysis Gastroesophageal Reflux Female business |
| Zdroj: | Gut. 61:665-672 |
| ISSN: | 1468-3288 0017-5749 |
| DOI: | 10.1136/gutjnl-2011-300641 |
| Popis: | Background It is postulated that high serum levels of insulin and insulin growth factor 1 (IGF-1) mediate obesity-associated carcinogenesis. The relationship of insulin, IGF-1 and IGF binding proteins (IGFBP) with Barrett9s oesophagus (BO) has not been well examined. Methods Serum levels of insulin and IGFBPs in patients with BO were compared with two separate control groups: subjects with gastro-oesophageal reflux disease (GORD) and screening colonoscopy controls. Fasting insulin, IGF-1 and IGFBPs were assayed in the serum of BO cases (n=135), GORD (n=135) and screening colonoscopy (n=932) controls recruited prospectively at two academic hospitals. Logistic regression was used to estimate the risk of BO. Results Patients in the highest tertile of serum insulin levels had an increased risk of BO compared with colonoscopy controls (adjusted OR 2.02, 95% CI 1.15 to 3.54) but not compared with GORD controls (adjusted OR 1.55, 95% CI 0.76 to 3.15). Serum IGF-1 levels in the highest tertile were associated with an increased risk of BO (adjusted OR 4.05, 95% CI 2.01 to 8.17) compared with the screening colonoscopy control group but were not significantly different from the GORD control group (adjusted OR 0.57, 95% CI 0.27 to 1.17). IGFBP-1 levels in the highest tertile were inversely associated with a risk of BO in comparison with the screening colonoscopy controls (adjusted OR 0.11, 95% CI 0.05 to 0.24) but were not significantly different from the GORD control group (adjusted OR 1.04, 95% CI 0.49 to 2.16). IGFBP-3 levels in the highest tertile were inversely associated with the risk of BO compared with the GORD controls (OR 0.36, 95% CI 0.16 to 0.81) and also when compared with the colonoscopy controls (OR 0.40, 95% CI 0.20 to 0.79). Conclusions These results provide support for the hypothesis that the insulin/IGF signalling pathways have a role in the development of BO. |
| Databáze: | OpenAIRE |
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