title: Is there any relation between hyperinsulinemia, insulin resistance and colorectal lesions in patients with acromegaly?
abstract: BACKGROUND
  Pathogenesis of colonic lesions in patients with acromegaly remains still unclear. There are suggestions that apart from somatotropin axis hormones (GH and IGF-1), other agents also take part in this process. Molecular and animal studies indicate a vital role of hyperinsulinemia in development of colorectal neoplasms.
  
  
  OBJECTIVE
  To evaluate a relation between insulin level, insulin resistance and its anthropometric markers and colorectal lesions in patients with acromegaly.
  
  
  METHODS
  The study consisted of 40 patients with active, newly diagnosed acromegaly; 24 women and 16 men aged from 24 to 77 years (mean age 50.1, SD+/-12.1). The analysis included the results of somatotropin axis function (GH and IGF-1 level), carbohydrate metabolism assessment (fasting serum glucose and insulin levels, oral glucose tolerance test, HOMA-IR for insulin resistance), the results of anthropometric measurement (BMI, WHR) and colonoscopy.
  
  
  RESULTS
  Colon pathologies (60 polyps and 2 flat lesions) were discovered in 19 (47.5%) patients with acromegaly, 8 of them had multiple polyps. Hyperplastic polyps were revealed in 11 (27.5%), while adenomas in 8 (20%) acromegalics. Patients with colorectal lesions were found to have higher WHR then subjects with normal colon (p=0.033). Positive correlation between the number of hyperplastic polyps in the patients with multiple changes in the colon and IGF-1 (p=0.025), insulin level (p=0.005) and HOMA-IR (p=0.001) was found. Multiple adenomas correlated positively with insulin level (p=0.007), HOMA-IR (p=0.006) and BMI (p=0.015).
  
  
  CONCLUSIONS
  The study results show a relation between hyperinsulinemia, insulin resistance and colon pathologies in acromegaly. Fasting insulin level and HOMA-IR correlate positively with the number of hyperplastic polyps and adenomas in acromegalic patients with multiply colorectal lesions.
authors.affiliation: Division of Endocrinology, Department of Pathophysiology and Endocrinology, Medical University of Silesia, Zabrze, Poland. wandafoltyn@poczta.onet.pl
authors.forename: Wanda
authors.initials: W
authors.lastname: Foltyn
authors.forename: Beata
authors.initials: B
authors.lastname: Kos-Kudla
authors.forename: Janusz
authors.initials: J
authors.lastname: Strzelczyk
authors.forename: Violetta
authors.initials: V
authors.lastname: Matyja
authors.forename: Jacek
authors.initials: J
authors.lastname: Karpe
authors.forename: Adam
authors.initials: A
authors.lastname: Rudnik
authors.forename: Bogdan
authors.initials: B
authors.lastname: Marek
authors.forename: Dariusz
authors.initials: D
authors.lastname: Kajdaniuk
authors.forename: Aleksander
authors.initials: A
authors.lastname: Sieron
authors.forename: Wojciech
authors.initials: W
authors.lastname: Latos
mesh_terms: D000172:Acromegaly / Q000150:complications* / Q000503:physiopathology; D000236:Adenoma / Q000209:etiology* / Q000503:physiopathology; D000328:Adult; D000368:Aged; D001786:Blood Glucose / Q000378:metabolism; D003111:Colonic Polyps / Q000209:etiology* / Q000503:physiopathology; D015179:Colorectal Neoplasms / Q000209:etiology* / Q000503:physiopathology; D005260:Female; D013006:Growth Hormone / Q000097:blood; D006706:Homeostasis / Q000502:physiology; D006801:Humans; D006946:Hyperinsulinism / Q000150:complications*; D007328:Insulin / Q000097:blood; D007333:Insulin Resistance / Q000502:physiology*; D007334:Insulin-Like Growth Factor I / Q000378:metabolism; D008297:Male; D008875:Middle Aged; D012727:Sex Characteristics; D049629:Waist-Hip Ratio
chemical_list: D001786:Blood Glucose; D007328:Insulin; D007334:Insulin-Like Growth Factor I; D013006:Growth Hormone