title: Vitamin D Deficiency Adds an Element of Risk to Insulin Resistance in Colorectal Neoplasms.
abstract: BACKGROUND
  Both insulin resistance (IR) and vitamin D deficiency (VitDdef) have been suggested as risk factors for colorectal neoplasms (CRNs). However, the associations between the two with regard to CRNs are unclear.
  
  
  OBJECTIVE
  To determine whether IR is a risk factor for CRNs and whether VitDdef confers an additive risk of CRNs.
  
  
  METHODS
  Colonoscopy-naïve asymptomatic women undergoing a routine health screening program were analyzed. IR was defined as homeostatic model assessment of IR >3 and VitDdef set as <20 ng/mL. Multivariable logistic regression was performed between women with and without CRNs, matched for age and body mass index, to investigate associations with CRNs in IR, VitDdef, and VitDdef combined with IR.
  
  
  RESULTS
  We analyzed 216 women with CRNs and 216 without CRNs. A significant association was found between IR and CRNs (OR 1.838, 95 % CI 1.029-3.285, P = 0.040) but not with VitDdef. IR conferred a higher risk in advanced CRNs (OR 3.244, 95 % CI 1.588-6.631, P = 0.001) than CRNs. When VitDdef was combined with IR, risks of both CRNs and advanced CRNs increased (OR 2.131, 95 % CI 1.077-4.216, P = 0.030 and OR 4.438, 95 % CI 2.058-9.571, P < 0.001, respectively).
  
  
  CONCLUSIONS
  IR increases the risk of CRNs, and a combination of IR and VitDdef further increases this risk. As both VitDdef and IR are modifiable risk factors, such associations may have important clinical implications in the prevention of CRNs.
authors.affiliation: Division of Gastroenterology, Department of Internal Medicine, College of Medicine, The Catholic University of Korea, 222 Banpodaero, Seocho-Gu, Seoul, 137-701, Republic of Korea, baegmk@catholic.ac.kr.
authors.forename: Myong Ki
authors.initials: MK
authors.lastname: Baeg
authors.forename: Myung-Gyu
authors.initials: MG
authors.lastname: Choi
authors.forename: Sun-Hye
authors.initials: SH
authors.lastname: Ko
authors.forename: Bo-Geun
authors.initials: BG
authors.lastname: Park
authors.forename: Kyung-Do
authors.initials: KD
authors.lastname: Han
authors.forename: Jae Myung
authors.initials: JM
authors.lastname: Park
authors.forename: Bo-In
authors.initials: BI
authors.lastname: Lee
authors.forename: In-Seok
authors.initials: IS
authors.lastname: Lee
authors.forename: Sang-Woo
authors.initials: SW
authors.lastname: Kim
mesh_terms: D058070:Asymptomatic Diseases; D003113:Colonoscopy; D015179:Colorectal Neoplasms / Q000453:epidemiology*; D003430:Cross-Sectional Studies; D003924:Diabetes Mellitus, Type 2 / Q000453:epidemiology*; D005260:Female; D006801:Humans; D007333:Insulin Resistance; D016015:Logistic Models; D008875:Middle Aged; D012307:Risk Factors; D014808:Vitamin D Deficiency / Q000453:epidemiology*
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