Choi Chi Hyeon, Moon Sang Yi, Lee Jong Yoon
Division of Gastroenterology, Department of Internal Medicine, Dong-A University College of Medicine, Busan 49201, Republic of Korea.
J Pers Med. 2024 Sep 13;14(9):971. doi: 10.3390/jpm14090971.
(1) Background: Young-onset colorectal adenomas (YOAs) are precursors to early-onset colorectal cancer, a growing concern among individuals under 50 years old. This study investigated the association between surrogate markers of insulin resistance (IR) and YOAs occurrence. (2) Methods: A retrospective cross-sectional analysis was conducted on 4467 individuals aged 20 to 49 years who underwent their first screening colonoscopy at Dong-A University Hospital from 2018 to 2022. IR was assessed using the triglyceride-glucose (TyG) index, triglyceride-to-high-density lipoprotein cholesterol ratio (TG/HDL-C), and metabolic score for insulin resistance (METS-IR). (3) Results: Individuals with YOAs exhibited significantly higher median TyG index (8.51 ± 0.71 vs. 8.32 ± 0.61, < 0.001), TG/HDL-C ratio (2.78 ± 3.05 vs. 2.12 ± 1.85, < 0.001), and METS-IR (35.72 ± 8.37 vs. 33.44 ± 9.11, < 0.001) values than controls. The adjusted odds ratios for YOAs were 1.064 (95% CI: 1.22-2.23, = 0.021) for the TyG index, 1.067 (95% CI: 1.031-1.105, < 0.001) for the TG/HDL-C ratio, and 1.011 (95% CI: 1.002-1.021, = 0.023) for METS-IR values, indicating a strong association between higher IR marker values and the presence of YOAs. (4) Conclusions: Elevated IR marker values are strongly associated with the occurrence of YOAs in individuals under 50 years old.
（1）背景：青年期结直肠腺瘤（YOAs）是早发性结直肠癌的前驱病变，在50岁以下人群中日益受到关注。本研究调查了胰岛素抵抗（IR）替代标志物与YOAs发生之间的关联。（2）方法：对2018年至2022年在东国大学医院接受首次结肠镜筛查的4467名20至49岁个体进行回顾性横断面分析。使用甘油三酯-葡萄糖（TyG）指数、甘油三酯与高密度脂蛋白胆固醇比值（TG/HDL-C）以及胰岛素抵抗代谢评分（METS-IR）评估IR。（3）结果：患有YOAs的个体的TyG指数中位数（8.51±0.71 vs. 8.32±0.61，<0.001）、TG/HDL-C比值（2.78±3.05 vs. 2.12±1.85，<0.001）和METS-IR（35.72±8.37 vs. 33.44±9.11，<0.001）值均显著高于对照组。TyG指数的YOAs调整比值比为1.064（95%CI：1.22 - 2.23，=0.021），TG/HDL-C比值为1.067（95%CI：1.031 - 1.105，<0.001），METS-IR值为1.011（95%CI：1.002 - 1.021，=0.023），表明较高的IR标志物值与YOAs的存在之间存在密切关联。（4）结论：IR标志物值升高与50岁以下个体中YOAs的发生密切相关。
