title: Prospective evaluation of abnormal glucose metabolism and insulin resistance in patients with atypical endometrial hyperplasia and endometrial cancer.
abstract: Obesity and diabetes (DM) are known to increase the risk of endometrial cancer (EC). However, little is known about the prevalence of abnormal glucose metabolism and insulin resistance (IR) in EC patients. We aimed to evaluate the prevalence of abnormal glucose metabolism and IR in EC patients.
  
  
  
  We prospectively enrolled atypical endometrial hyperplasia (AEH) and EC patients who had received planned treatment at Chiba University Hospital, Japan. All patients, except those with a confirmed diagnosis of DM, underwent the 75-g oral glucose tolerance test (OGTT) before treatment. We evaluated the prevalence of obesity, defined as body mass index (BMI) ≥25, IR, abnormal glucose metabolism, and the associations between these three factors and the clinical characteristics of AEH and EC patients.
  
  
  
  We enrolled 279 patients from April 2009 to March 2015. Of these, 56 had a confirmed diagnosis of DM. Abnormal OGTT results, including impaired fasting glucose (n = 7), impaired glucose tolerance (n = 69), and newly identified DM (n = 33), were noted in 109 patients. Obesity, IR, and abnormal glucose metabolism were observed in 49.8, 51.6, and 59.1% of patients, respectively. Abnormal glucose metabolism was significantly associated with age (P < 0.001), body mass index (P = 0.004), and IR status (P < 0.001) in multivariate analysis.
  
  
  
  Abnormal glucose metabolism, IR, and obesity were highly prevalent in patients with AEH and EC. These results indicate that physicians should consider a patient's metabolic status in the postoperative management of AEH and EC patients.
authors.affiliation: Department of Reproductive Medicine, Graduate School of Medicine, Chiba University, 1-8-1 Inohana, Chuo-ku, Chiba, 260-8670, Japan. antira@faculty.chiba-u.jp.
authors.forename: Akira
authors.initials: A
authors.lastname: Mitsuhashi
authors.affiliation: Department of Reproductive Medicine, Graduate School of Medicine, Chiba University, 1-8-1 Inohana, Chuo-ku, Chiba, 260-8670, Japan.
authors.forename: Takashi
authors.initials: T
authors.lastname: Uehara
authors.affiliation: Department of Reproductive Medicine, Graduate School of Medicine, Chiba University, 1-8-1 Inohana, Chuo-ku, Chiba, 260-8670, Japan.
authors.forename: Shinsuke
authors.initials: S
authors.lastname: Hanawa
authors.affiliation: Department of Reproductive Medicine, Graduate School of Medicine, Chiba University, 1-8-1 Inohana, Chuo-ku, Chiba, 260-8670, Japan.
authors.forename: Makio
authors.initials: M
authors.lastname: Shozu
mesh_terms: D000328:Adult; D000368:Aged; D001786:Blood Glucose / Q000378:metabolism*; D003920:Diabetes Mellitus / Q000209:etiology*; D004714:Endometrial Hyperplasia / Q000150:complications*; D016889:Endometrial Neoplasms / Q000150:complications*; D005260:Female; D018149:Glucose Intolerance; D006801:Humans; D007333:Insulin Resistance / Q000502:physiology*; D008875:Middle Aged; D009765:Obesity / Q000150:complications*; D011446:Prospective Studies
chemical_list: D001786:Blood Glucose
keywords: Abnormal glucose metabolism; Atypical endometrial hyperplasia; Diabetes mellitus; Endometrial cancer; Insulin resistance