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2型糖尿病与结直肠癌均为常见的慢性疾病,并且2型糖尿病患者易并发结直肠癌。国外流行病学发现,2型糖尿病(Lype 2 diabetes mellitus,T2DM)患者高胰岛素血症与结直肠癌患病风险增加具有潜在相关性,而且长期接受胰岛素治疗的患者可使这种风险加倍,并随着胰岛素治疗年限的增加其患病风险也增加。高胰岛素血症假说认为,血清异常增高的胰岛素及游离胰岛素生长因子-1(insulin-like growth factor-l,ICF-1)水平可通过胰岛素-胰岛素样生长因子-1轴促进结直肠上皮细胞增殖转化、抑制细胞凋亡导致结直肠癌的发生,因此胰岛素-ICF-1轴在2型糖尿病患者结直肠癌的发生、发展过程中具有重要作用由于结直肠癌早期大多无症状或症状不明显,故2型糖尿病患者均应选择合适的筛选形式,有效防止结直肠癌的发生和向晚期发展,以提高患者生存率和生存质量。本文主要就2型糖尿病患者胰岛素治疗与结直肠癌的流行病学以及相关机制胰岛素-胰岛素样生长因子-1轴进行综述,并展望胰岛素-胰岛素样生长因子-1轴在实现结直肠癌靶向治疗的应用前景,为结直肠癌的早期预防和靶向治疗提供有益的参考。
Type 2 diabetes and colorectal cancer are common chronic diseases, and patients with type 2 diabetes are susceptible to colorectal cancer. Epidemiology abroad found that hyperinsulinemia in patients with type 2 diabetes mellitus (T2DM) is potentially associated with an increased risk of colorectal cancer, and this risk is doubled by long-term insulin treatment in patients with T2DM As the duration of insulin therapy increases its risk increases. Hyperinsulinemia hypothesis suggests that abnormally elevated serum levels of insulin and free insulin-like growth factor-1 (ICF-1) promote colorectal epithelial cell proliferation via the insulin-insulin-like growth factor-1 axis Therefore, insulin-ICF-1 axis plays an important role in the occurrence and development of colorectal cancer in patients with type 2 diabetes. Because colorectal cancer is mostly asymptomatic or has no obvious symptoms, Therefore, type 2 diabetes patients should choose the appropriate screening form, effectively prevent the occurrence of colorectal cancer and to the late development in order to improve patient survival and quality of life. This review summarizes the epidemiology of insulin therapy and colorectal cancer in patients with type 2 diabetes mellitus and related mechanisms of insulin-insulin-like growth factor-1 axis, and looks forward to insulin-like growth factor-1 axis in achieving colorectal cancer targeting Therapeutic application prospects for the prevention of colorectal cancer and targeted therapy provide a useful reference.