| Recently with the improvement of life level and westernization of diet structure the number of patients undergoing diabetes mellitus (DM) and colorectal cancer (CRC) become more and more . A lot of data demonstrated that the relationship between DM and CRC were close. DM could increase the risk of CRC , moreover it was risk factor of CRC as well as CRC family history .Our aim is to acquaint the relationship among CRC family history , DM family history and DM history make sure if DM is risk factor of CRC and the rate of CRC metastasis with DM is higher than not DM.Methods: 660 CRC cases hospitalized in China- Japan Union hospital of Ji Lin University between January 2000 and March 2003 were surely diagnosed CRC on the basis of operation and biopsies. Controls enrolled 4573 patients admitted to the department of Cardiology, Respiratory, Urology and Ophthalmology of the same hospital who were unaffected by tumor. CRC family history, DM family history , DM history and the metastasis of CRC were registered. Statistics methods: analysis of single factor adopted x 2 test and odds ratios (ORs) and their 95% confidence interval was caculated to estimate relativerisk.Results: The odds ratio (OR ) undergoing CRC with CRC family history is 8. 45 and the OR with DM family history is 4.58 and the OR with DM history is 4. 01; the OR with CRC family history , DM family history or DM history in male patients are 8.64,4.13 and 3.99 respectively .Similar in female patients the figure are 8. 18, 5. 38 and 4. 03 respectively ;the OR with DM in without CRC family history patients is 3. 55 and the OR with DM in with CRC family history patients is 4. 22;the OR with DM in without DM family history patients is 3. 34 and the OR with DM in with DM family history patients is 3.82; the OR is 2.40 in the patients whose DM history from 0 to 5 years , the OR is 3.29 in the patients whose DM history from 5 to 10 years , the OR is 7. 20 in the patients whose DM history above 10 years ;the OR is 2. 26 in the CRC patients with DM whose organ or lymph node were found metastasis .Discussion: We find the OR with CRC family history is 8.45 and with DM history is 4.01 through investigating 660 cases of CRC patients about CRC family history and DM history. The results are similar with Switzerland scholar's and show CRC family history, DM family history and DM historyare all the risk factors in the North of China. The pathogenesis is unknown that DM family history can also increase the risk of CRC .To exclude the interference CRC and DM family history for the results, we use stratification analyzation to find that DM history increase the risk of CRC either having CRC and DM family history or not having CRC and DM family history. The result is similar with England scholar's and shows DM surely increase the risk of CRC. Moreover , we find either male or female , the DM history , CRC family history and DM family history are all increase the risk of CRC .While foreign study found only in female could DM increase the risk of CRC. To analyze the difference we think it may be relative with race or small quantity of sample. We still find with the increasing of DM history time the risk of CRC increase. The mentioned results further verify DM is relative with the increased risk of CRC. It was confirmed by medical circles that CRC family history is risk factor of CRC, while DM may be independent risk factor or synergism companied other risk factors. The possible mechanism that DM increased risk of CRC is as follows: on one hand DM directly or indirectly cause hyperinsulinemia and the high level of insulin show mitogenic is propertiesand biology function though IGF-I. IGF-1 binding IGF-IR can inhibits apoptosis, promotes cell split and increases cellular turnover may enhance the accumulation of molecular alteration. Moreover, insulin could reduce hepatic secretion of IGFBP-1 that binds IGF-1 and inhibits its action to raise the level of IGF-1 . On other hand, DM patients might lead to disorders of gastrointestinal motility and showed abnormal structu... |
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