The association of fasting insulin concentrations and colonic neoplasms in acromegaly: A colonoscopy-based study in 210 patients

Annamaria Colao, Rosario Pivonello, Renata S. Auriemma, Mariano Galdiero, Diego Ferone, Francesco Minuto, Paolo Marzullo, Gaetano Lombardi

Research output: Contribution to journalArticle

Abstract

Context: Hyperinsulinemia is associated with colon carcinoma in the general population. Patients with acromegaly are considered to be at risk for developing colonic lesions and typically have hyperinsulinemia. Objective: Our objective was to evaluate the role of fasting insulin levels on the prevalence of colonic adenomatous polyps or adenocarcinoma in acromegaly. Design: This is an analytical, observational, prospective study. Patients: A total of 210 patients (111 women, 99 men, age 20-82 yr) undergoing complete colonoscopy at diagnosis of acromegaly were included in this study. Results: Colonic lesions were found in 81 patients (38.6%), and consisted of hyperplastic polyps in 33 (15.7%), adenomatous polyps in 42 (20.0%), and adenocarcinoma in six patients (2.8%). Polyps were single in 22 cases (27.1%). Fasting insulin levels were significantly lower in patients without lesions (16.0 ± 7.5 mU/liter) than in patients with hyperplastic polyps (22.4 ± 8.8 mU/liter; P <0.01), adenomatous polyps (38.0 ± 15.9 mU/liter; P <0.0001), and adenocarcinoma (59.0 ± 30.6 mU/liter; P <0.0001). Fasting insulin levels were also lower in patients with hyperplastic polyps than in those with adenomatous polyps (P <0.01). The odds ratio for harboring colonic adenomas was 14.8 (95% confidence interval 4.4-51.2; P <0.0001) and 8.6 times higher (95% confidence interval 2.8-29.0; P <0.0001) in patients with fasting insulin levels in the upper tertile [≥27.1 mIU/liter (n = 28)] compared with the lower [≤12.1 mIU/liter (n = 40)] and middle tertiles [>12.1 to

Original languageEnglish
Pages (from-to)3854-3860
Number of pages7
JournalJournal of Clinical Endocrinology and Metabolism
Volume92
Issue number10
DOIs
Publication statusPublished - Oct 2007

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ASJC Scopus subject areas

  • Biochemistry
  • Endocrinology, Diabetes and Metabolism

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