Endocrine Abstracts

Hyperinsulinemia has been associated to an increased risk of colorectal cancer and adenomas, while higher serum 25-hydroxy vitamin D3 and folate seem to reduce the development of colonic lesions in general population. Acromegalic patients have an increased risk of colonic tumors and an association between higher fasting insulin levels and risk of colonic adenomas has been previously demonstrated. No data are available about the influence of vitamin D and folate-homocysteine levels on the development of colorectal lesion in acromegaly.

To investigate the role of insulin levels, 25-hydroxy vitamin D3 and folate-homocysteine status on the occurrence of colonic lesions in acromegalic patients, 146 acromegalic patients were submitted to a first colonoscopy screening after diagnosis. At the same time they were evaluated for fasting insulin levels, serum 25-hydroxy-vitamin D (25(OH)D3), homocysteine and folid acid. Data were collected retrospectively.

Colonic lesions were detected in 46 patients (31.5%) and consisted in hyperplastic polyps in 32 cases (21.9%), and adenomatous polyps in 14 patients (9.6%). Acromegalic patients with (n=14) or without (n=132) colonic adenomas did not significantly differ as to gender, age, BMI, family history of colorectal cancer, smoking habits, estimated duration of disease and baseline IGF1 even after excluding patient with drugs interfering with insulin levels. Fasting insulin, 25(OH)D3, folate and homocysteine levels, had not significant differences in patients with or without colonic adenomas (7.00±3.83 vs 9.93±7.3 P=0.66; 16.85±10.85 vs 18.18±9.92 P=0.64; 7.35±2.59 vs 7.49±2.94 P=0.94; 7.74±2.55 vs 8.38±2.58 P=0.36). All the parameters evaluated were not associated to colonic adenomas at univariate and multivariate analysis.

No relationship was identified between insulin, 25(OH)D3, folate and homocysteine serum levels and risk of developing colonic lesions in this subset of acromegalic patients.

Declaration of interest: The authors declare that there is no conflict of interest that could be perceived as prejudicing the impartiality of the research project.

Funding: This research did not receive any specific grant from any funding agency in the public, commercial or not-for-profit sector.