Association between Cardiovascular Risk and Diabetes with Colorectal Neoplasia: A Site-Specific Analysis

Abstract

Several studies have shown site-specific differences in colorectal cancer (CRC) with respect to the risk factors. CRC was shown to be associated with cardiovascular risk (CVR) factors, but site-specific variations have not been investigated so far. This study aimed to assess the associations between the prevalence and subsite-specific differences of colorectal neoplasia and established CVR scores or known coronary artery disease (CAD) in a large asymptomatic European screening cohort (N = 2098). Participants underwent simultaneous screening colonoscopy and CVR evaluation, using the Framingham Risk Score and Heart Score. Lesions found in the colonoscopy were classified by location (proximal/distal colon or rectum). More neoplasias were found in the proximal versus the distal colon (p < 0.001). The Framingham Risk Score and Heart Score showed incremental risk for colorectal adenoma, across the tertiles in the proximal and the distal colon (p < 0.001). The prevalence of adenomas in the rectum was much lower, but also here, incremental risk could be shown for the Framingham Risk but not the Heart Risk Score tertiles. Prevalence of adenomas in the proximal colon was higher in subjects with type 2 diabetes (T2DM) (p = 0.006), but no association was found between adenomas and T2DM in the distal colon (p = 0.618) and the rectum (p = 0.071). Males had a higher CVR and more findings, in the screening colonoscopy, as compared to females, however, no site-specific differences were noted. Patients with known CAD and high CVR have an increased risk of colorectal neoplasia in both the proximal and distal colon. Patients with T2DM have a higher risk for neoplasia in the proximal colon.

Nonalcoholic Fatty Liver Disease in Lean Subjects: Associations With Metabolic Dysregulation and Cardiovascular Risk—A Single-Center Cross-Sectional Study

“…As previously described, participants were examined on 2 consecutive days ( 10 ), including ultrasound ± transient elastography and laboratory characterization including Homeostatic Model Assessment for Insulin Resistance (HOMA-IR) and an oral glucose tolerance test (OGTT). In addition, participants completed a questionnaire about lifestyle and dietary habits.…”

<p>Association of Cardiovascular Risk Assessment with Early Colorectal Neoplasia Detection in Asymptomatic Population: A Systematic Review and Meta-Analysis</p>

“…Forty-four records were excluded due to the inclusion and exclusion criteria. Finally, a total of 12 studies [28][29][30][31][32][33][38][39][40][41][42][43] including one study which was identified through cross-references were included. The detailed information of the selection process was presented in Figure 1.…”

“…All studies explored the role of CVD risk assessment method on the detection of AD, and some of them also focused on colorectal high risk adenoma 30,32 and AN. 28,29,38,42,43 Creative Commons license and disclaimer available from: http://creativecommons.org/licenses/by/4.0/legalcode. 36 Abbreviations: CVD, cardiovascular disease; CRN, colorectal neoplasia.…”

“…We also observed that less than half of included studies reported the associations of CVD risk with both risk of AN and AD. 28,29,38,42,43 Colonoscopy is considered to as a valid primary screening tool for CRC, and is able to detect both AD and AN. The lower prevalence of AN and the limited number of participants in several included studies might limit the power to explore the relation of AN with CVD risk, which could partly explain why most of studies did not include AN as outcome.…”

Tumour Microbiome-Based Subtypes of Colorectal Cancer Correlate with Clinical Variables

“…Butyrate is critical for intestinal microbial balance and colon health and the atrophy of butyrate metabolism was associated with the pathogenesis of various colonic diseases [83]. The association of Tyzzerella 4 from the Lachnospiraceae family with CRC can be due to its increased occurrence in patients with higher cardiovascular risk (CVR) factor scores [84], that are associated also with CRC [85]. Presence of Massilia in CRC patients was also never described previously, but it was detected in patients with pancreatic cancer [86].…”