The aim of the article was to evaluate the important role played by
insulin in the development of
endometrial cancer (EC) among Chinese premenopausal women. In this study, 128
endometrial cancer patients and 294 controls who were all premenopausal were included. Baseline characteristics data were collected and serum
insulin,
C-peptide,
sex hormone-binding globulin, C-reaction
protein,
interleukin-6, and
tumor necrosis factor-α levels were measured. Paired t test, χ(2) test, Spearman correlation coefficients, and univariate and multivariate logistic regression models were used in data analysis. Furthermore,
insulin levels were categorized into quartiles, and likelihood ratio was calculated for the four categories. Blood
insulin levels of the patients were significantly higher than those of the controls (P < 0.001). Factor analysis identified
insulin (OR = 2.46; 95 % confidence interval (CI) = 1.55-3.91; P < 0.001) as the independent risk factor of EC. When
insulin levels were categorized into quartiles, we found that
insulin was positively associated with
endometrial cancer risk [HR comparing extreme quartiles (HR q4-q1) = 4.44; 95 % CI = 2.59-7.62; P trend = 0.025]. After adjustment for body mass index (BMI) or waist-hip ratio (WHR), this association was attenuated, but still significant. In conclusion,
insulin plays an important role in the
carcinogenesis of EC among premenopausal women. Treatment targeting down-regulation of blood
insulin levels seems effective in the prevention of this
malignancy.