Chowdhury Deepshikha Nag, Botros Youssef, DeBari Vincent A, Baddoura Walid, Chandran Chandra B
Department of Internal Medicine, St. Joseph's Regional Medical Center, New York Medical College, Paterson, NJ, USA.
Division of Gastroenterology, St. Joseph's Regional Medical Center, New York Medical College, Paterson, NJ, USA.
Ann Clin Lab Sci. 2016 Dec;46(6):608-615.
Previous studies have shown a higher prevalence of malignancy in patients with diabetes mellitus (DM) and chronic kidney disease (CKD). The purpose of this study was to investigate the prevalence of adenomatous colon polyps (ACP) as they occur in subjects with DM and coexisting CKD. This is a retrospective cohort study of patients with DM (n=565) who had undergone colonoscopy between 2000-2010. The cohort was further bifurcated into those with CKD (n=296) and those with normal renal function (n=269). Presence or absence of ACP was measured in both groups. Concentrations of serum parathyroid hormone (PTH), Calcium (Ca), and phosphorous (P) were recorded for the CKD group. The levels of these variables in patients with ACP (n=171) were compared with the levels from those without ACP (n=175). Nonparametric statistical methods were applied with statistical significance suggested by p<0.05 (two-sided). The presence of CKD in this cohort demonstrated a significant association with ACP (OR: 2.96; 95% CI: 2.02 to 4.34; p<0.0001). We did not detect a statistically significant difference in P or Ca between the groups. There was, however, a statistically significant difference in PTH; for the group with ACP, PTH: 387.7±351.3 ng/L vs. 172.2±196.7 ng/L; p<0.0001. This data suggests that CKD is associated with ACP in subjects with DM and those with ACP exhibit higher PTH levels when compared to those without ACP.
既往研究表明，糖尿病（DM）和慢性肾脏病（CKD）患者中恶性肿瘤的患病率较高。本研究的目的是调查腺瘤性结肠息肉（ACP）在合并CKD的DM患者中的患病率。这是一项对2000年至2010年间接受结肠镜检查的DM患者（n = 565）的回顾性队列研究。该队列进一步分为CKD患者（n = 296）和肾功能正常患者（n = 269）。两组均检测是否存在ACP。记录CKD组患者的血清甲状旁腺激素（PTH）、钙（Ca）和磷（P）浓度。将有ACP的患者（n = 171）的这些变量水平与无ACP的患者（n = 175）的水平进行比较。采用非参数统计方法，p<0.05（双侧）表示具有统计学意义。该队列中CKD的存在与ACP有显著相关性（OR：2.96；95%CI：2.02至4.34；p<0.0001）。我们未检测到两组之间P或Ca的统计学显著差异。然而，PTH存在统计学显著差异；有ACP的组，PTH：387.7±351.3 ng/L，而无ACP的组为172.2±196.7 ng/L；p<0.0001。该数据表明，在DM患者中，CKD与ACP相关，且与无ACP的患者相比，有ACP的患者PTH水平更高。
