Association between insulin resistance with endometrial, ovarian and cervical cancers in non-diabetic women : A Cross sectional study

Insulin resistance (IR) refers to cells and tissues becoming insensitive to the peptide hormone, Insulin. It is well-established that hyperinsulinemia, a hallmark of IR, may play a role in tumorigenesis as well as IR is strongly associated with visceral adiposity dysfunction and systemic inflammation, both favouring the establishment of a pro-tumorigenic environment.  Polycystic ovary syndrome (PCOS) frequently shows IR accompanied by an increase of IGF-1 in plasma, being involved in the differentiation of various reproductive tissues, like endometrium and ovarian tissues. Metabolic Syndrome may contribute to viral-host interactions, which lead to persistent human papillomavirus (HPV) infection, leading to increased risk of cervical cancer. A higher risk for cervical, ovarian and endometrial cancer is related to high IGF-1 levels in post- and premenopausal women.   Many international studies have depicted the close association between IR and gynaecological malignancies. However, further evidence needs to be investigated as only a few studies have been published from the Indian subcontinent showing the association between insulin resistance and gynaecological cancers, and hence, this study has been planned to determine the association between insulin resistance and endometrial, ovarian and cervical cancer in non-diabetic women. The primary objective of the study is to evaluate the prevalence of Insulin resistance in non-diabetic women with endometrial, ovarian and cervical cancer. All non-diabetic women with endometrial, ovarian and cervical cancers willing to participate in the study will be recruited from Obstetrics and Gynaecology outpatient or inpatient departments at AIIMS Rishikesh for a period of one year and six months and blood samples will be collected from all patients in resting position and after 8–10 h of fasting and tested for fasting plasma glucose, fasting insulin, lipid profile and Hba1c. HOMA IR will be calculated with the help of fasting plasma glucose and fasting insulin and study population will be divided into two groups, insulin sensitive and insulin resistant and baseline characteristics (age, BMI, menopausal status), anthropometric measures, and metabolic parameters will be compared among insulin-resistant and insulin-sensitive groups.