Department of Gastroenterology, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel.
Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.
Obesity (Silver Spring). 2017 Nov;25 Suppl 2:S72-S80. doi: 10.1002/oby.22001.
Prevention of colorectal cancer (CRC) by colonoscopy is recommended according to age and personal/familial history. Metabolic alterations are associated with colorectal adenomas, but data are scarce regarding serrated polyps and advanced polyps. The aim of this study was to evaluate the association between metabolic alterations and colorectal polyp type and advanced polyps.
A case-control study was conducted among consecutive subjects, 40 to 70 years old, who underwent screening/diagnostic colonoscopy from 2010 to 2015. Subjects who were treated for diabetes, who had a family/personal history of CRC, and who were at high risk for CRC were excluded. Participants underwent anthropometric, laboratory, and ultrasonographic evaluations and a medical and lifestyle interview. Polyps were histologically classified as adenomatous or serrated polyps and divided into advanced and non-advanced categories.
The study included 828 participants (58.4 ± 6.6 years, 50.4% men). Abdominal obesity (odds ratio [OR] = 1.67, 95% CI: 1.20-2.30), hypertension (OR = 1.47, 95% CI: 1.03-2.09), and a high glycosylated hemoglobin percentage (HbA1c%) (OR = 1.57, 95% CI: 1.06-2.34) were independently associated with colorectal adenomas, whereas a high triglyceride to high-density lipoprotein cholesterol (TG/HDL) ratio was independently associated with serrated polyps (OR = 2.31, 95% CI: 1.32-4.03). A combination of three metabolic alterations was strongly associated with colorectal polyps.
Abdominal obesity, hypertension, and a high HbA1c% are independently associated with adenomas, whereas a high TG/HDL ratio is associated with serrated polyps. These parameters are easily accessible in clinical practice and may help define high-risk groups for CRC.
根据年龄和个人/家族史，推荐结肠镜检查预防结直肠癌（CRC）。代谢改变与结直肠腺瘤有关，但关于锯齿状息肉和高级别息肉的数据很少。本研究旨在评估代谢改变与结直肠息肉类型和高级别息肉之间的关系。
这是一项病例对照研究，纳入了 2010 年至 2015 年间接受筛查/诊断性结肠镜检查的连续受试者，年龄在 40 至 70 岁之间。排除了接受糖尿病治疗、有 CRC 家族/个人病史以及 CRC 高危人群的患者。参与者接受了人体测量、实验室和超声评估以及医学和生活方式访谈。息肉组织学分类为腺瘤性或锯齿状息肉，并分为高级别和非高级别。
研究纳入了 828 名参与者（58.4±6.6 岁，50.4%为男性）。腹部肥胖（比值比[OR] = 1.67，95%置信区间[CI]：1.20-2.30）、高血压（OR = 1.47，95% CI：1.03-2.09）和高糖化血红蛋白百分比（HbA1c%）（OR = 1.57，95% CI：1.06-2.34）与结直肠腺瘤独立相关，而甘油三酯与高密度脂蛋白胆固醇（TG/HDL）比值升高（OR = 2.31，95% CI：1.32-4.03）与锯齿状息肉独立相关。三种代谢改变的组合与结直肠息肉强烈相关。
腹部肥胖、高血压和高 HbA1c%与腺瘤独立相关，而 TG/HDL 比值升高与锯齿状息肉相关。这些参数在临床实践中易于获得，可能有助于确定 CRC 的高危人群。
