High serum Androgen and Insulin concentrations increase the tendency of Endometrial Carcinoma

Abstract

Purpose: The objective of the study was to evaluate the important role played by androgen and insulin in the development of endometrial carcinoma (EC), and their combined effect on EC risk. Methods: We enrolled 510 type I EC patients and 510 age-, time-, and nationality-matched subjects into this study. Metabolic and hormonal parameters of enrolled subjects were examined. Univariate and multivariate logistic regression analyses for EC and control subjects were performed. Type I EC risk was evaluated with respect to testosterone, androstenedione, and insulin levels based on odds ratios (ORs) using stratified data. Results: EC risk was positively associated with C-peptide, estrone, androgen (including testosterone and androstenedione) and insulin levels, BMI, WHR, family history of cancer, nulliparity, irregular menstruation, diabetes, and hypertension. In multivariate logistic regression models, high C-peptide and testosterone levels, diabetes, and hypertension were independent risk factors after adjustment for BMI, WHR, family history of cancer, high serum insulin, and estrone levels. Increased serum total testosterone and insulin levels were positively correlated with EC risk in total, premenopausal, and postmenopausal women. Androstenedione was correlated with EC in total and postmenopausal, but not in premenopausal subjects. Compared with higher testosterone and insulin, odds ratios (ORs) for higher testosterone with lower insulin and lower testosterone with higher insulin were decreased in total, premenopausal, and postmenopausal women. Similarly, compared to both higher FAI and insulin, ORs for higher FAI with lower insulin and lower FAI with higher insulin were decreased in all three groups. Coordinately, ORs for higher androstenedione with lower insulin and lower androstenedione with higher insulin were decreased in total and postmenopausal, but not premenopausal subjects. Conclusions: These findings suggested that androgen and insulin were risk factors of type I EC, and relatively high levels of both testosterone and insulin synergistically affected EC risk.

Fertility-preserving treatment outcome in endometrial cancer or atypical hyperplasia patients with polycystic ovary syndrome

“…PCOS and BMI ≥25 kg/m 2 were two independent risk factors that affect fertility-preserving treatment. This is consistent with studies showing that PCOS patients tend to show obesity, IR and higher testosterone levels, which are all thought to negatively affect fertility-preserving treatment outcome [ 7 21 ].…”

The Clinicopathological Significance and Prognostic Value of Androgen Receptor in Endometrial Carcinoma: A Meta-Analysis

“…Notably, numerous studies have also examined the potential role of androgens as risk factors for EC. In addition, most of them claimed to have found that elevated serum testosterone level increased EC risk (18)(19)(20)(21). It is tempting to speculate that AR is one of negative prognostic factors in EC.…”

Endocrine disorders and fertility and pregnancy: An update

“…Since it occurs mainly in adipose tissue, estrogen production will be increased in obese PCOS patients. Furthermore, unbalanced estrogen stimulation can lead to endometrial hyperplasia and endometrial cancer ( 230 ).…”