Prospective evaluation of abnormal glucose metabolism and insulin resistance in patients with atypical endometrial hyperplasia and endometrial cancer

• Published in: Supportive care in cancer Vol. 25; no. 5; pp. 1495 - 1501
• Main Authors: Mitsuhashi, Akira, Uehara, Takashi, Hanawa, Shinsuke, Shozu, Makio
• Format: Journal Article
• Language: English
• Published: Berlin/Heidelberg Springer Berlin Heidelberg 01.05.2017; Springer; Springer Nature B.V
• Subjects: Adult; Aged; Analysis; Blood Glucose - metabolism; Body mass index; Cancer; Care and treatment; Diabetes; Diabetes Mellitus - etiology; Diagnosis; Endometrial cancer; Endometrial Hyperplasia - complications; Endometrial Neoplasms - complications; Female; Glucose; Glucose Intolerance; Glucose metabolism; Glucose tolerance test; Health aspects; Humans; Hyperplasia; Insulin resistance; Insulin Resistance - physiology; Medical schools; Medicine; Medicine & Public Health; Metabolism; Middle Aged; Nursing; Nursing Research; Obesity; Obesity - complications; Oncology; Original Article; Pain Medicine; Physiological aspects; Prospective Studies; Rehabilitation Medicine; Abnormal glucose metabolism; Insulin resistance; Endometrial cancer; Diabetes mellitus; Atypical endometrial hyperplasia
• ISSN: 0941-4355; 1433-7339
• DOI: 10.1007/s00520-016-3554-y

Purpose 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. Methods 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. Results 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. Conclusion 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.