Bayerdörffer E, Mannes G A, Richter W O, Ochsenkühn T, Seeholzer G, Köpcke W, Wiebecke B, Paumgartner G
Medical Department II, Klinikum Grosshadern, University of Munich, Germany.
Ann Intern Med. 1993 Apr 1;118(7):481-7. doi: 10.7326/0003-4819-118-7-199304010-00001.
To study the relation between serum lipoprotein levels and the frequency of colorectal adenomas, the benign precursors of colorectal cancer.
Cross-sectional.
University hospital in Germany.
The study included 822 of 1124 consecutive patients who underwent colonoscopy at our institution (302 patients were excluded because of malignant disease, chronic inflammatory bowel disease, familial polyposis, partial colectomy, or other chronic diseases). Of the 822 study patients, 194 had colorectal adenoma.
Serum cholesterol fractions (high-density lipoprotein [HDL], low-density lipoprotein [LDL], and very low-density lipoprotein [VLDL]) and presence or absence of adenomas; univariate and logistic regression analyses were carried out to evaluate the association between serum HDL, LDL, and VLDL cholesterol levels and the frequency of colorectal adenoma.
Univariate analysis of the total patient group showed that the HDL cholesterol level was inversely related to the frequency of colorectal adenoma (odds ratio, 0.36; 95% Cl, 0.21 to 0.62) and that LDL and VLDL cholesterol levels were positively associated with adenoma frequency (odds ratio, 2.31 [Cl, 1.36 to 3.92] and 1.72 [Cl, 1.03 to 2.86], respectively). Univariate analysis of the subgroup of 89 patients with high-risk adenomas showed an inverse association between such adenomas and HDL cholesterol (odds ratio, 0.37; Cl, 0.18 to 0.76). A logistic regression analysis that included age and body mass index showed an association between lipoprotein levels and the presence of adenomas. The relative strength (in descending order) of these associations was as follows: HDL, LDL, VLDL, and total serum cholesterol. A logistic regression analysis of patients with high-risk adenoma showed a significant association between such adenomas and the HDL cholesterol level.
Patients with colorectal adenomas have lower HDL cholesterol levels and higher LDL and VLDL cholesterol levels; these lipoproteins may have prognostic significance for the development of colorectal adenomas.
研究血清脂蛋白水平与结直肠癌良性前体——结直肠腺瘤发生频率之间的关系。
横断面研究。
德国大学医院。
本研究纳入了在我院接受结肠镜检查的1124例连续患者中的822例（302例患者因恶性疾病、慢性炎症性肠病、家族性息肉病、部分结肠切除术或其他慢性疾病而被排除）。在这822例研究患者中，194例患有结直肠腺瘤。
血清胆固醇组分（高密度脂蛋白[HDL]、低密度脂蛋白[LDL]和极低密度脂蛋白[VLDL]）以及腺瘤的有无；进行单因素和逻辑回归分析以评估血清HDL、LDL和VLDL胆固醇水平与结直肠腺瘤发生频率之间的关联。
对整个患者组的单因素分析表明，HDL胆固醇水平与结直肠腺瘤发生频率呈负相关（比值比，0.36；95%可信区间，0.21至0.62），而LDL和VLDL胆固醇水平与腺瘤发生频率呈正相关（比值比分别为2.31[可信区间，1.36至3.92]和1.72[可信区间，1.03至2.86]）。对89例高危腺瘤患者亚组的单因素分析显示，此类腺瘤与HDL胆固醇之间存在负相关（比值比，0.37；可信区间，0.18至0.76）。一项纳入年龄和体重指数的逻辑回归分析显示脂蛋白水平与腺瘤的存在之间存在关联。这些关联的相对强度（从高到低）如下：HDL胆固醇、LDL胆固醇、VLDL胆固醇和总血清胆固醇。对高危腺瘤患者的逻辑回归分析显示，此类腺瘤与HDL胆固醇水平之间存在显著关联。
结直肠腺瘤患者的HDL胆固醇水平较低，LDL和VLDL胆固醇水平较高；这些脂蛋白可能对结直肠腺瘤的发生具有预后意义。
