Abstract Aim: It has been suggested that chronic hyperinsulinemia from insulin resistance is
involved in the etiology of endometrial cancer (EC). We performed a systematic review and
meta-analysis to assess whether insulin resistance is associated with the risk of EC.
Methods: We searched PubMed-Medline, Embase, Scopus, and Web of Science for articles
published from database inception through 30th September 2014. We included all observational
studies evaluating components defining insulin resistance in women with and without
EC. Quality of the included studies was assessed by NewcastleeOttawa scale. Randomeffects
models and inverse variance method were used to meta-analyze the association between
insulin resistance components and EC.
Results: Twenty-five studies satisfied our inclusion criteria. Fasting insulin levels (13 studies,
n Z 4088) were higher in women with EC (mean difference [MD] 33.94 pmol/L, 95% confi-
dence interval [CI] 15.04e52.85, p Z 0.0004). No differences were seen in postmenopausal
versus pre- and postmenopausal subgroup analysis. Similarly, non-fasting/fasting C-peptide
levels (five studies, n Z 1938) were also higher in women with EC (MD 0.14 nmol/L, 95% CI 0.08e0.21, p < 0.00001). Homeostatic model assessment - insulin resistance (HOMA-IR)
values (six studies, n Z 1859) in EC patients were significantly higher than in women without
EC (MD 1.13, 95% CI 0.20e2.06, p Z 0.02). There was moderate-to-high heterogeneity
among the included studies.
Conclusion: Currently available epidemiologic evidence is suggestive of significantly higher
risk of EC in women with high fasting insulin, non-fasting/fasting C-peptide and HOMAIR
values.
| Identifer | oai:union.ndltd.org:PERUUPC/oai:repositorioacademico.upc.edu.pe:10757/582697 |
| Date | 25 November 2015 |
| Creators | Hernández, Adrian V., Pasupuleti, Vinay, Benites Zapata, Vicente A., Thota, Priyaleela, Deshpande, Abhishek, Perez Lopez, Faustino R. |
| Publisher | Elsevier B.V. |
| Source Sets | Universidad Peruana de Ciencias Aplicadas (UPC) |
| Language | English |
| Detected Language | English |
| Type | info:eu-repo/semantics/article |
| Rights | info:eu-repo/semantics/openAccess |
| Relation | http://www.ejcancer.com/article/S0959-8049(15)00851-5/abstract |
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