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

43 Citations (Scopus)

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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Acromegaly
Colonoscopy
Colonic Neoplasms
Fasting
Insulin
Polyps
Adenomatous Polyps
Hyperinsulinism
Adenocarcinoma
Colonic Polyps
Observational Studies
Colon
Prospective Studies
Carcinoma
Population

ASJC Scopus subject areas

  • Biochemistry
  • Endocrinology, Diabetes and Metabolism

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The association of fasting insulin concentrations and colonic neoplasms in acromegaly : A colonoscopy-based study in 210 patients. / Colao, Annamaria; Pivonello, Rosario; Auriemma, Renata S.; Galdiero, Mariano; Ferone, Diego; Minuto, Francesco; Marzullo, Paolo; Lombardi, Gaetano.

In: Journal of Clinical Endocrinology and Metabolism, Vol. 92, No. 10, 10.2007, p. 3854-3860.

Research output: Contribution to journalArticle

Colao, Annamaria ; Pivonello, Rosario ; Auriemma, Renata S. ; Galdiero, Mariano ; Ferone, Diego ; Minuto, Francesco ; Marzullo, Paolo ; Lombardi, Gaetano. / The association of fasting insulin concentrations and colonic neoplasms in acromegaly : A colonoscopy-based study in 210 patients. In: Journal of Clinical Endocrinology and Metabolism. 2007 ; Vol. 92, No. 10. pp. 3854-3860.
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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",
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