Circulating C-peptide level is a predictive factor for colorectal neoplasia: evidence from the meta-analysis of prospective studies
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Abstract
Purpose
C-peptide, a hormone secreted by the pancreas, is a marker for insulin production and hyperinsulinemia. Epidemiological studies have suggested an association between circulating C-peptide level and colorectal neoplasia risk; however, the results were not always consistent. Herein, we conducted a systematic review and meta-analysis study to evaluate the association between circulating C-peptide level and the colorectal neoplasia risk.
Methods
The PubMed database was searched for the eligibility studies updated to May 2013, which prospectively evaluated the association between circulating C-peptide level and colorectal neoplasia risk. The summary estimates and 95 % confidential intervals (95 % CIs) for those with the highest quantile C-peptide level in contrast to the lowest quantile were estimated with the random-effects model. Heterogeneity between the studies was assessed with the Q test and the I 2 statistic. Potential publication bias was evaluated with the Egger’s test.
Results
We identified 9 nested case–control studies that have recruited a total of 3,109 cases and 4,285 controls met the criteria. From the meta-analysis, we found that subjects with high circulating C-peptide were associated with a 37 % increased colorectal neoplasia risk [pooled odds ratios (OR) 1.37, 95 % CI 1.09–1.72] under the random-effects model. In the stratification studies, we found the association was more prominent in the men (pooled OR 2.34, 95 % CI 1.36–4.04) compared to women (pooled OR 1.41, 95 % CI 0.89–2.25). Significant association between circulating C-peptide level and colon cancer risk was found (pooled OR 1.72, 95 % CI 1.26–2.36), but not for rectal cancer (pooled OR 1.14, 95 % CI 0.75–1.73). No significant publication bias was found for any meta-analysis study.
Conclusion
In conclusion, the results of the meta-analysis studies suggested that higher circulating C-peptide could be a predictive factor for higher colorectal neoplasia susceptibility.
Keywords
C-peptide Colorectal cancer Meta-analysisAbbreviations
- OR
Odds ratio
- 95 % CI
95 % confidential interval
- IGFBP
Insulin-like growth factor binding proteins
- IGF
Insulin-like growth factor
Notes
Acknowledgments
This work was supported by the Clinical Support Grant of the Chinese PLA General Hospital (2012FC-TSYS-4028).
Conflict of interest
The authors confirm that there are no conflicts of interest.
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