Liu Zhonghui, Hu Xiaoming, Cui Shengjin, Gu Jianfen, Joe King Man Fan, Fion Siu Yin Chan, Peng Junsheng
Department of Gastrointestinal Surgery, The University of Hong Kong-Shenzhen Hospital, Shenzhen 518000, China.
Department of Endocrinology, The University of Hong Kong-Shenzhen Hospital, Shenzhen 518000, China.
Zhonghua Wei Chang Wai Ke Za Zhi. 2016 Jun;19(6):675-9.
To evaluate the association of colorectal adenoma with metabolic syndrome (MS) and relevant parameters.
Clinical data of 289 subjects who underwent screening colonoscopy in the University of Hong Kong-Shenzhen Hospital from January 2014 to June 2015 were retrospectively analyzed, including 130 normal subjects (normal group) and 159 cases with colorectal adenoma confirmed by pathology(adenoma group). Levels of MS-associated parameters were compared between the two groups, and the association of metabolic diseases with colorectal adenoma was examined.
The gender, smoking and drinking habit, regular physical activity, family history of colorectal cancer, and consumption history of long-term non-steroidal anti-inflammatory drugs were not significantly different between two groups (all P>0.05). As compared to normal group, adenoma group had higher body mass index (BMI) [(23.5±3.2) kg/m(2) vs. (22.7±2.8) kg/m(2), t=1.97, P=0.050], larger abdominal circumference [(83.4±10.3) cm vs. (79.6±13.8) cm, t=2.46, P=0.015], higher serum high-density lipoprotein level [(1.3±0.3) mmol/L vs. (1.2±0.3) mmol/L, t=2.03, P=0.044], and higher serum cholesterol [(5.4±1.0) mmol/L vs. (5.0±1.1) mmol/L, t=2.39, P=0.018]. No significant difference was demonstrated in comparing hip circumference and waist-hip ratio, as well as serum fasting glucose and triglyceride(all P>0.05). Higher incidence of colorectal adenoma was found in subjects with MS [69.8%(37/53) vs. 1.7%(122/236), P=0.017], overweight or obesity [65.1% (56/86) vs. 50.7%(103/203), P=0.025], hypertension [67.3%(37/55) vs. 52.1%(122/234), P=0.046] and hypercholesterolemia [66.7%(64/96) vs. 49.2%(95/193), P=0.005].
Metabolic syndrome increased the risk of developing colorectal adenoma. The mechanism may be related to higher serum cholesterol and high density lipoprotein, which may lead to the elevated catabolism of serum cholesterol. Screening colonoscopy should be performed for patients diagnosed as metabolic syndrome, especially for those with central obesity and hypercholesterolemia, thus early diagnosis and treatment of colorectal adenoma may be available.
评估结肠直肠腺瘤与代谢综合征(MS)及相关参数之间的关联。
回顾性分析2014年1月至2015年6月在香港大学深圳医院接受结肠镜筛查的289例受试者的临床资料,其中130例正常受试者(正常组),159例经病理确诊为结肠直肠腺瘤的患者(腺瘤组)。比较两组间MS相关参数水平,并检测代谢性疾病与结肠直肠腺瘤的关联。
两组间性别、吸烟和饮酒习惯、规律体育活动、结直肠癌家族史以及长期非甾体抗炎药使用史差异均无统计学意义(均P>0.05)。与正常组相比,腺瘤组体重指数(BMI)更高[(23.5±3.2)kg/m² vs.(22.7±2.8)kg/m²,t=1.97,P=0.050],腹围更大[(83.4±10.3)cm vs.(79.6±13.8)cm,t=2.46,P=0.015],血清高密度脂蛋白水平更高[(1.3±0.3)mmol/L vs.(1.2±0.3)mmol/L,t=2.03,P=0.044],血清胆固醇更高[(5.4±1.0)mmol/L vs.(5.0±1.1)mmol/L,t=2.39,P=0.018]。髋围、腰臀比以及血清空腹血糖和甘油三酯比较差异均无统计学意义(均P>0.05)。MS患者[69.8%(37/53)vs. 1.7%(122/236),P=0.017]、超重或肥胖患者[65.1%(56/86)vs. 50.7%(103/203),P=0.025]、高血压患者[67.3%(37/55)vs. 52.1%(122/234),P=0.046]和高胆固醇血症患者[66.7%(64/96)vs. 49.2%(95/193),P=0.005]的结肠直肠腺瘤发病率更高。
代谢综合征增加了患结肠直肠腺瘤的风险。其机制可能与血清胆固醇和高密度脂蛋白升高有关,这可能导致血清胆固醇分解代谢增强。对于诊断为代谢综合征的患者,尤其是伴有中心性肥胖和高胆固醇血症的患者,应进行结肠镜筛查,以便早期诊断和治疗结肠直肠腺瘤。