Abstract

Simple SummaryInsulin resistance is one of the risk factors of endometrial cancer. Hyperinsulinemia can trigger many physiological effects that drive carcinogenesis, which is also modulated by epigenetic dysregulation including miRNAs expression. Our working hypothesis was that there must be a more pronounced relationship between insulin resistance and alterations in miRNA profiles of endometrial cancer patients. Consequently, this work was undertaken to better clarify this assumption. Our careful literature search indicated that miRNA could represent a potential molecular link between the metabolic alterations related to insulin resistance and endometrial cancer. Additionally, by reporting the known relationships between miRNA and both insulin resistance and endometrial cancer, we highlighted their potential role as predictive factors of future endometrial cancer in insulin resistant patients.Endometrial cancer (EC) remains one of the most common cancers of the female reproductive system. Epidemiological and clinical data implicate insulin resistance (IR) and its accompanying hyperinsulinemia as key factors in the development of EC. MicroRNAs (miRNAs) are short molecules of non-coding endogenous RNA that function as post-transcriptional regulators. Accumulating evidence has shown that the miRNA expression pattern is also likely to be associated with EC risk factors. The aim of this work was the verification of the relationships between IR, EC, and miRNA, and, as based on the literature data, elucidation of miRNA’s potential utility for EC prevention in IR patients. The pathways affected in IR relate to the insulin receptors, insulin-like growth factors and their receptors, insulin-like growth factor binding proteins, sex hormone-binding globulin, and estrogens. Herein, we present and discuss arguments for miRNAs as a plausible molecular link between IR and EC development. Specifically, our careful literature search indicated that dysregulation of at least 13 miRNAs has been ascribed to both conditions. We conclude that there is a reasonable possibility for miRNAs to become a predictive factor of future EC in IR patients.

Highlights

  • Endometrial cancer (EC) is the most common gynecological cancer in developed countries, with annual rates continuing to increase

  • Hyperinsulinemia and insulin resistance (IR) have been implicated as playing a major role in diabetes-promoted cancers

  • IGF1 is structurally related to insulin, unlike insulin, it circulates in the blood bound to specific carrier proteins, called insulin-like growth factors (IGFs) binding proteins (IGFBPs), with variable affinity

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Summary

Introduction

Endometrial cancer (EC) is the most common gynecological cancer in developed countries, with annual rates continuing to increase. EC is generally considered to be hormone-sensitive, its development is widely considered to be regulated by environmental and lifestyle factors One of this cancer’s risk factors is insulin resistance (IR), a prominent component in many metabolic disorders, including prediabetes, type 2 diabetes mellitus (T2DM), metabolic syndrome, and polycystic ovary syndrome (PCOS) [15,16,17,18]. IR is the primary cause of T2DM and occurs years before its clinical manifestation [30] This prediabetic state plays an important role in the development and progression of some types of cancers, including breast, prostate, colorectal, and endometrial neoplasia [31]. Epidemiological shows that the Elevated levels insulin in risk prediabetic and diabetic patients seem to affectevidence their cancer risk rather presence accompanying diseases substantially influences estimations [17]. Worrying in the present era of widespread overweight and obesity

Insulin
Insulin Receptor
Insulin-Like Growth Factors and Their Receptors
Insulin-Like Growth Factor Binding Proteins
Estrogens
Sex Hormone-Binding Globulin
Adipokines
Perspective and Future Directions
Findings
Conclusions

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