title: Serum factors associated with precancerous colonic lesions in acromegaly.
abstract: BACKGROUND
  Insulin, 25-hydroxy vitamin D3 [25(OH)D3] and folate have been differently associated with a risk of colonic neoplasms in the general population. Acromegalic patients have an increased risk of colorectal tumors and an association between fasting insulin concentrations and colonic lesions has been reported. However, it is unknown whether insulin, 25(OH)D3, folate, and homocysteine interact to determine the risk of colonic tumors in acromegaly.
  
  
  OBJECTIVE
  To investigate whether serum insulin, 25(OH)D3, folate, and homocysteine concentrations were associated with precancerous colonic lesions in acromegalic patients.
  
  
  METHODS
  A cohort of 146 consecutive acromegalic patients was evaluated for colonoscopy findings and fasting insulin, 25(OH)D3, folate, and homocysteine levels. A preliminary study was conducted in 9 naïve acromegalic patients to evaluate the effect of somatostatin analogues (SSA) on serum levels of those factors.
  
  
  RESULTS
  Insulin reduced during SSA whereas the other factors did not change. In the cohort study, colonic lesions (14 adenomas; 32 hyperplastic polyps) were detected in 46 patients. Fasting insulin, 25(OH)D3, folate, and homocysteine levels did not differ in patients with or without colonic adenomas. High folate levels were associated with a lower risk of developing precancerous colonic lesions at the multivariate analysis, when corrected by age, gender, disease activity and SSA therapy.
  
  
  CONCLUSIONS
  Serum insulin, 25(OH)D3 and homocysteine serum concentrations do not seem to influence the development of precancerous colonic lesions in acromegalic patients, while higher folate levels may be associated with a lower risk of colonic lesions.
authors: Department of Endocrinology and Metabolism, University of Pisa, Ospedale di Cisanello, Via Paradisa 2, 56124 Pisa, Italy.
authors: M
authors: M
authors: Lombardi
authors: I
authors: I
authors: Scattina
authors: C
authors: C
authors: Sardella
authors: C
authors: C
authors: Urbani
authors: E
authors: E
authors: Marciano
authors: S
authors: S
authors: Signori
authors: L
authors: L
authors: Ruocco
authors: G
authors: G
authors: Pellegrini
authors: E
authors: E
authors: Martino
authors: F
authors: F
authors: Bogazzi
mesh_terms: D000172:Acromegaly / Q000097:blood / Q000473:pathology*; D000236:Adenoma / Q000209:etiology; D000328:Adult; D000368:Aged; D002112:Calcifediol / Q000097:blood*; D015331:Cohort Studies; D003110:Colonic Neoplasms / Q000209:etiology; D003111:Colonic Polyps / Q000209:etiology; D003113:Colonoscopy; D005215:Fasting; D005260:Female; D005492:Folic Acid / Q000097:blood*; D006710:Homocysteine / Q000097:blood*; D006801:Humans; D007328:Insulin / Q000097:blood*; D008297:Male; D008875:Middle Aged; D011230:Precancerous Conditions / Q000097:blood* / Q000473:pathology; D013004:Somatostatin / Q000031:analogs & derivatives / Q000627:therapeutic use
chemical_list: D007328:Insulin; D006710:Homocysteine; D013004:Somatostatin; D005492:Folic Acid; D002112:Calcifediol