Yonsei Med J.  2017 Mar;58(2):347-354. 10.3349/ymj.2017.58.2.347.

Parameters of Glucose and Lipid Metabolism Affect the Occurrence of Colorectal Adenomas Detected by Surveillance Colonoscopies

• Kim NH
• Suh JY
• Park JH
• Park DI
• Cho YK
• Sohn CI
• Choi K
• Jung YS

• KMID: 2427123
• DOI: http://doi.org/10.3349/ymj.2017.58.2.347

Abstract

PURPOSE
Limited data are available regarding the associations between parameters of glucose and lipid metabolism and the occurrence of metachronous adenomas. We investigated whether these parameters affect the occurrence of adenomas detected on surveillance colonoscopy.
MATERIALS AND METHODS
This longitudinal study was performed on 5289 subjects who underwent follow-up colonoscopy between 2012 and 2013 among 62171 asymptomatic subjects who underwent an initial colonoscopy for a health check-up between 2010 and 2011. The risk of adenoma occurrence was assessed using Cox proportional hazards modeling.
RESULTS
The mean interval between the initial and follow-up colonoscopy was 2.2±0.6 years. The occurrence of adenomas detected by the follow-up colonoscopy increased linearly with the increasing quartiles of fasting glucose, hemoglobin A1c (HbA1c), insulin, homeostasis model assessment of insulin resistance (HOMA-IR), and triglycerides measured at the initial colonoscopy. These associations persisted after adjusting for confounding factors. The adjusted hazard ratios for adenoma occurrence comparing the fourth with the first quartiles of fasting glucose, HbA1c, insulin, HOMA-IR, and triglycerides were 1.50 [95% confidence interval (CI), 1.26-1.77; p(trend)<0.001], 1.22 (95% CI, 1.04-1.43; p(trend)=0.024), 1.22 (95% CI, 1.02-1.46; p(trend)=0.046), 1.36 (95% CI, 1.14-1.63; p(trend)=0.004), and 1.19 (95% CI, 0.99-1.42; p(trend)=0.041), respectively. In addition, increasing quartiles of low-density lipoprotein-cholesterol and apolipoprotein B were associated with an increasing occurrence of adenomas.
CONCLUSION
The levels of parameters of glucose and lipid metabolism were significantly associated with the occurrence of adenomas detected on surveillance colonoscopy. Improving the parameters of glucose and lipid metabolism through lifestyle changes or medications may be helpful in preventing metachronous adenomas.

Keyword

Colorectal adenoma; surveillance; glucose metabolism; dyslipidemia

MeSH Terms

Adenoma/blood/*diagnosis
Apolipoproteins B/metabolism
Cholesterol, LDL/metabolism
*Colonoscopy
Colorectal Neoplasms/blood/*diagnosis
Fasting/metabolism
Female
Glucose/*metabolism
Glycated Hemoglobin A/analysis
Humans
Insulin/metabolism
*Lipid Metabolism
Longitudinal Studies
Male
Proportional Hazards Models
Risk
Risk Factors
Triglycerides/metabolism
Apolipoproteins B
Cholesterol, LDL
Glycated Hemoglobin A
Insulin
Triglycerides
Glucose