Research On The Correlation Between Insulin Resistance And Endometrial Carcinoma And Endometrial Atypical Hyperplasia

Objective To investigate the high-risk factors of endometrial cancer(EC)and endometrial atypical hyperplasia(EAH)and their correlation with insulin resistance(IR).Methods(1)From July 2019 to January 2021,129 patients diagnosed as EC or EAH in general hospital of Ningxia Medical University were chosen as study group.Meanwhile,70 patients with benign diseases were chosen as the control group.Comparative analysis of their clinical data: 1)General information: including age,body mass index(BMI),waist-hip ratio(WHR),history of menstrual disorder,birth history,breast-feeding history,hypertension history,diabetes history,family history(diabetes history,hypertension history,malignant tumor history,menstrual disorder history);2)Metabolism related indicators:total Triglyceride(TG),total cholesterol(TC),high density lipoprotein(HDL),low density lipoprotein(LDL),aspartate transaminase(AST),alanine transaminase(ALT),creatinine and uric acid;3)Insulin related indicators:fasting Plasma Glucose(FPG),fasting insulin(FINS),2 hours postprandial insulin(2h PINS),homeostasis model assessment of insulin resistance(HOMA-IR).Compare clinical information and analyze high-risk factors in patients with EC and EAH and the differences of insulin related indicators between the study group and the control group.(2)According to HOMA-IR,the study group was separated into insulin resistance group(IR group)and non-insulin resistance group(non-IR group).There were 87 cases in IR group and42 cases in non-IR group.In order to analyze the relationship between high-risk factors and IR to compare the clinical information of the two subgroups of patients.(3)According to postoperative pathology,the EC patients in the study group were separated into two subgroups:75 cases in type I EC group and 8 cases in type II EC group.Among them,there were 51 cases of IR in type I EC patients and 3 cases of IR in type II EC patients.Analyze the relationship between different pathological types and IR and insulin related indicators.(4)The study group and the control group were divided into two groups according to whether they had diabetes:1)Compare the insulin related indicators of the study group and the control group with a history of diabetes;2)Compare the insulin related indicators of the study group and the control group without a history of diabetes.Analyze the differences in insulin related indicators between the study group and the control group after eliminating the diabetes exposure factors.Results(1)In this study,129 cases were included in the study group and 70 cases were included in the control group.There was significant differencethe in BMI,WHR,history of menstrual disorder,history of hypertension,history of diabetes,family history(history of hypertension),TG,TC,LDL,uric acid,FINS,2h PINS,HOMA-IR between the study group and the control group(P<0.05).However,compared with the control group,there was no significant difference in age,birth history,breast-feeding history,family history(diabetes history,malignant tumor history,menstrual disorder history),HDL,AST,ALT,creatinine,FPG between between the two groups(P>0.05).Therefore,the high BMI,WHR,TG,TC,LDL,uric acid,FINS,2h PINS,HOMA-IR and menstrual disorder history,hypertension history,diabetes history,family history(hypertension history)may be the high risk factors of EC and EAH.(2)In the study group,the incidence rate of IR was 67.44%.Compared with the non-IR group,the IR group had higher BMI,WHR,history of hypertension,history of diabetes,TG,uric acid,FPG,FINS,2h PINS,and HOMA-IR(P<0.05);However,compared with the non-IR group,there was no significant difference in age,menstrual disorder,birth history,breast-feeding history,family history,TC,HDL,LDL,AST,ALT,creatinine between the two subgroups(P>0.05).Therefore,among the high risk factors of EC and EAH patients,the high BMI,WHR,TG,uric acid,FPG,FINS,2h PINS,HOMA-IR,history of hypertension and diabetes may be related to IR.(3)IR and insulin related indicators were not high in type I EC patients compared with those in type II EC patients(P>0.05).(4)Compared with the control group with diabetes,there was no significant difference in FPG,FINS,2h PINS,HOMA-IR between the study group with diabetes and the control group with diabetes(P>0.05).However,there was significant difference in FINS,2h PINS and HOMA-IR between the study group without diabetes and the control group without diabetes(P<0.05).Conclusion(1)Abnormal metabolism of blood lipids,uric acid and insulin,obesity,menstrual disorders,hypertension,and diabetes are high-risk factors for EC and EAH.(2)IR is closely related to the occurrence of EC or EAH.