Association of insulin and insulin-like growth factors with Barrett's oesophagus

Katarina B. Greer, Cheryl L. Thompson, Lacie Brenner, Beth Bednarchik, Dawn Dawson, Joseph Willis, William M. Grady, Gary W. Falk, Gregory S. Cooper, Li Li, Amitabh Chak

Research output: Contribution to journalArticlepeer-review

59 Scopus citations

Abstract

Background: It is postulated that high serum levels of insulin and insulin growth factor 1 (IGF-1) mediate obesity-associated carcinogenesis. The relationship of insulin, IGF-1 and IGF binding proteins (IGFBP) with Barrett's oesophagus (BO) has not been well examined. Methods: Serum levels of insulin and IGFBPs in patients with BO were compared with two separate control groups: subjects with gastro-oesophageal reflux disease (GORD) and screening colonoscopy controls. Fasting insulin, IGF-1 and IGFBPs were assayed in the serum of BO cases (n=135), GORD (n=135) and screening colonoscopy (n=932) controls recruited prospectively at two academic hospitals. Logistic regression was used to estimate the risk of BO. Results: Patients in the highest tertile of serum insulin levels had an increased risk of BO compared with colonoscopy controls (adjusted OR 2.02, 95% CI 1.15 to 3.54) but not compared with GORD controls (adjusted OR 1.55, 95% CI 0.76 to 3.15). Serum IGF-1 levels in the highest tertile were associated with an increased risk of BO (adjusted OR 4.05, 95% CI 2.01 to 8.17) compared with the screening colonoscopy control group but were not significantly different from the GORD control group (adjusted OR 0.57, 95% CI 0.27 to 1.17). IGFBP-1 levels in the highest tertile were inversely associated with a risk of BO in comparison with the screening colonoscopy controls (adjusted OR 0.11, 95% CI 0.05 to 0.24) but were not significantly different from the GORD control group (adjusted OR 1.04, 95% CI 0.49 to 2.16). IGFBP-3 levels in the highest tertile were inversely associated with the risk of BO compared with the GORD controls (OR 0.36, 95% CI 0.16 to 0.81) and also when compared with the colonoscopy controls (OR 0.40, 95% CI 0.20 to 0.79). Conclusions: These results provide support for the hypothesis that the insulin/IGF signalling pathways have a role in the development of BO.

Original languageEnglish (US)
Pages (from-to)665-672
Number of pages8
JournalGut
Volume61
Issue number5
DOIs
StatePublished - May 2012

All Science Journal Classification (ASJC) codes

  • Gastroenterology

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