血清甘油三酯和低密度脂蛋白胆固醇升高可促进结直肠息肉的形成。
Elevated serum triglyceride and low-density lipoprotein cholesterol promotes the formation of colorectal polyps.
机构信息
Department of Gastroenterology, Zhongshan Hospital Affiliated to Xiamen University, Xiamen, Fujian Province, 361000, People's Republic of China.
Department of Gastroenterology, Meizhou Affiliated Hospital of Sun Yat-sen University, Meizhou, Guangdong Province, 514000, People's Republic of China.
出版信息
BMC Gastroenterol. 2019 Nov 21;19(1):195. doi: 10.1186/s12876-019-1115-9.
BACKGROUND
Hyperlipidaemia may be a potential risk factor for the occurrence of intestinal polyps. This study aimed to evaluate correlation between lipidaemia and the formation of colorectal polyps.
METHODS
One hundred and fourteen patients with colorectal polyps and forty-eight healthy controls were included in this study. Colonoscopies were performed for all patients and controls within 1 week before blood samples were taken. The concentrations of serum lipids and lipoproteins were measured simultaneously using an automatic biochemical analyser. The colorectal lesions were classified based on pathological characteristics, and four types were identified in the study: hyperplastic polyp (HP), tubular adenoma (TA), tubulovillous adenoma (TVA) and adenoma with high-grade dysplasia (A-HGD). Advanced adenoma was classified according to the number, size and histological type of polyps.
RESULTS
The value of low-density lipoprotein cholesterol (LDL-C) was significantly higher in the group with advanced adenoma than in the controls (p < 0.05). Moreover, the LDL-C values in the HP and TA groups were higher when compared to that of controls (p < 0.05). Obesity, age, and increased TG and LDL-C were independent risk factors for the formation of colorectal polyps. The cut-off values of triglyceride (TG) and LDL-C to distinguish polyp patients from healthy controls were 0.96 mmol/L (AUC = 0.604, p = 0.036) and 3.05 mmol/L (AUC = 0.654, p = 0.002). The combined use of increased LDL-C and TG levels to distinguish polyp patients was effective, with a sensitivity of 50.0% and a specificity of 89.6% (AUC = 0.733, p < 0.01).
CONCLUSIONS
Colorectal polyps are more often found in obese and older patients. Increased LDL-C and TG were correlated with the occurrence of polyps. Combination of the two serum indicators was useful to assess risk of colorectal lesions, maybe more effective in screening hyperplastic polyp, tubular adenoma and advanced adenoma.
背景
高脂血症可能是肠息肉发生的潜在危险因素。本研究旨在评估血脂与结直肠息肉形成之间的相关性。
方法
本研究纳入了 114 例结直肠息肉患者和 48 例健康对照者。所有患者和对照者均在采血前 1 周内行结肠镜检查。同时使用自动生化分析仪测量血清脂质和脂蛋白的浓度。根据病理特征对结直肠病变进行分类，研究中发现了四种类型：增生性息肉（HP）、管状腺瘤（TA）、管状绒毛状腺瘤（TVA）和高级别异型增生性腺瘤（A-HGD）。根据息肉的数量、大小和组织学类型对高级别腺瘤进行分类。
结果
高级别腺瘤组的低密度脂蛋白胆固醇（LDL-C）值明显高于对照组（p<0.05）。此外，HP 和 TA 组的 LDL-C 值也高于对照组（p<0.05）。肥胖、年龄、甘油三酯（TG）和 LDL-C 升高是结直肠息肉形成的独立危险因素。区分息肉患者和健康对照者的 TG 和 LDL-C 截断值分别为 0.96mmol/L（AUC=0.604，p=0.036）和 3.05mmol/L（AUC=0.654，p=0.002）。联合使用升高的 LDL-C 和 TG 水平来区分息肉患者是有效的，其敏感性为 50.0%，特异性为 89.6%（AUC=0.733，p<0.01）。
结论
结直肠息肉在肥胖和老年患者中更为常见。升高的 LDL-C 和 TG 与息肉的发生相关。联合使用两种血清指标有助于评估结直肠病变的风险，在筛查增生性息肉、管状腺瘤和高级别腺瘤时可能更有效。
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