The Association of Serum Lipids With Colorectal Adenomas

Yang, Moon Hee; Rampal, Sanjay; Sung, Jidong; Choi, Yoon Ho; Son, Hee Jung; Lee, Jun Haeng; Kim, Young Ho; Chang, Dong Kyung; Rhee, Poong‐Lyul; Kim, Jae J.; Rhee, Jong Chul; Chun, Ho Kyung; Güallar, Eliseo; Cho, Juhee

doi:10.1038/ajg.2013.64

Cited by 82 publications

(95 citation statements)

References 29 publications

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“…However, the standard protocol recommends that screening is initiated after the age of 50 years. Previous studies have suggested that there is a certain degree of correlation between metabolic syndrome and colorectal adenoma, a precancerous lesion of CRC (12)(13)(14), our study aimed to develop a risk determinant for younger patients who may benefit from screening on the basis of their metabolic profiles and associated clinical history. The general adenoma detection rate of 20% for both sexes, 23% in males and 17% in females, is in line with standard quality indicators in colonoscopic practice (15).…”

Section: Discussionmentioning

confidence: 99%

Predicting the occurrence of cancer-associated colorectal polyp using a metabolic risk score

Orannapalai

Attawettayanon

Kanngern

et al. 2013

Molecular and Clinical Oncology

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Abstract. This study was conducted with the aim of developing a metabolic risk score to help identify patients who are likely to have a cancer-associated polyp (CAP) on colonoscopy, based on a metabolic syndrome-related clinical profile. The clinical history and anthropometric and metabolic profiles of patients who came for a screening colonoscopy at our institute between June, 2010 and December, 2012 were prospectively collected. The data were analyzed for their association with the occurrence of CAP. Subsequently, six parameters were selected in order to construct a metabolic risk score that correlated with the presence of CAP. A total of 286 subjects (132 males and 154 females), with an age range of 19-85 years, were included in this study. The colonoscopy detected polyps in 56 cases (19.6%). Anthropometric parameters that were significantly associated with CAP included a body mass index (BMI) of >23.4 kg/m 2 and a waist circumference of >32 inches in females. Laboratory profiles that were significantly associated with CAP were fasting blood sugar (FBS) >110 mg%, hemoglobin A1C (HbA1C) >7%, aspartate transaminase (SGOT) >40 IU̸l, alanine transaminase (SGPT) >50 IU̸l and uric acid >7 mg%. When a metabolic risk score was constructed, it was observed that moderate (2-3) and high risk (4-6) was significantly associated with CAP [odds ratio (OR)=4.9, 95% confidence interval (CI): 2.0-12.0 and OR=13.7, 95% CI: 4.4-43.0, respectively]. The association between the risk score and CAP was stronger in the subgroup of patients aged <65 years, in whom the moderate and high metabolic risk groups exhibited ORs of 5.6 (95% CI: 1.8-17.9) and 39.0 (95% CI: 8.2-186.6), respectively. In conclusion, this study demonstrated that it is possible to use a metabolic profile to construct a reliable scoring method to identify patients at higher risk of having CAP who should be fast-tracked for a colonoscopy.

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Section: Discussionmentioning

confidence: 99%

Predicting the occurrence of cancer-associated colorectal polyp using a metabolic risk score

Orannapalai

Attawettayanon

Kanngern

et al. 2013

Molecular and Clinical Oncology

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“…Nine studies were conducted in the USA (16,18,20,32,35,(37)(38)(39)(40) , one in Sweden (42) , five in Korea (6,9,10,22,27) , two in China (23,30) , eight in Japan (8,24,26,28,29,31,36,43) , one in Austria (41) and three in European countries (4,17,34) (Tables 1 and 2). Pooled analysis showed a significant association between serum TAG and CRN (n 29 studies; summary RR = 1·08; 95 % CI 1·05, 1·12, P < 0·00001; Fig.…”

Section: Study Characteristicsmentioning

confidence: 99%

“…Two studies were conducted in the USA (20,39) , one in Germany (19) , three in Korea (9,10,22) and three in Japan (28,29,36) ( Table 2). The results from nine studies showed that serum TC had a significant association with risk of CRA (RR = 1·04; 95 % CI 1·01, 1·09, P = 0·02) and there was no significant heterogeneity among these studies (Q = 5·26, P value for heterogeneity = 0·73, I 2 = 0 %; Table 3).…”

Section: Study Characteristicsmentioning

confidence: 99%

“…The sixteen studies on TAG (four cohort studies, four cross-sectional and eight case-control studies) and risk of CRA were published between 1990 and 2013 and involved a total of 17 830 CRA cases (Table 2) (6,(8)(9)(10)18,20,22,23,(26)(27)(28)(29)(30)(31)36,39) . Three studies were conducted in the USA (18,20,39) , five in Korea (6,9,10,22,27) , two in China (23,30) and six in Japan (8,26,28,29,31,36) (Table 2). The pooled RR for CRA was 1·06 (95 % CI 1·03, 1·10, P = 0·0009) which indicated that serum TAG was significantly associated with CRA development.…”

Section: Study Characteristicsmentioning

confidence: 99%

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The association between serum lipids and colorectal neoplasm: a systemic review and meta-analysis

Tian

Wang

et al. 2015

Public Health Nutr.

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Objective: There have been inconsistent results published regarding the relationship between dyslipidaemia and an increased risk of colorectal neoplasia (CRN), including colorectal adenoma (CRA) and colorectal cancer (CRC). We conducted a meta-analysis to explore the relationship between dyslipidaemia and CRN. Design: We identified studies by performing a literature search using PubMed, EMBASE and the Science Citation Index through October 2013. Setting: We analysed thirty-three independent studies reporting the association between CRN and at least one of the selected lipid components, including total cholesterol (TC), TAG, HDL-cholesterol (HDL-C) and LDL-cholesterol (LDL-C). Subjects: CRN cases (n 21 809) were identified. Results: Overall, people with high levels of serum TAG (risk ratio (RR) = 1·08; 95 % CI 1·05, 1·12, P < 0·00001) and LDL-C (RR = 1·07; 95 % CI 1·00, 1·14, P = 0·04) presented an increased prevalence of CRN. Subgroup analyses revealed that high levels of serum TC (RR = 1·04; 95 % CI 1·01, 1·09, P = 0·02), TAG (RR = 1·06; 95 % CI 1·03, 1·10, P = 0·0009) and LDL-C (RR = 1·11; 95 % CI 1·04, 1·19, P = 0·003) increased the risk of CRA but not of CRC. No association between serum HDL-C and risk for CRN (including CRA and CRC) was observed. Conclusions: Both TAG and LDL-C were significantly associated with an increasing prevalence of CRN. High levels of serum TC, TAG and LDL-C were positively associated with CRA but not with CRC. No significant association was observed between levels of serum HDL-C and CRN. Keywords Serum lipids Colorectal adenomaColorectal cancer TAG Meta-analysis Colorectal cancer (CRC) is reported to be the fourth most commonly diagnosed cancer and is the second most common cause of cancer deaths in North America (1) . CRC is believed to arise from colorectal adenoma (CRA) through a sequence from adenoma to adenocarcinoma as a consequence of a limited set of molecular events that largely originate with a relatively benign adenoma that progresses to cancer (2) . Accumulated data indicate that metachronous lesions occur at a rate of 20 to 30 % per year in post-polypectomy patients. The propensity to develop CRA identifies a sizeable subgroup of the population at an enhanced risk for subsequent adenoma formation and colorectal carcinoma. This indicates that identifying risk factors associated with CRN is essential for the reduction of colorectal carcinoma.The positive association between obesity and CRA prevalence demonstrates an underlying dose-response relationship according to BMI (3) . Timely screening of obese patients for CRA is thus recommended. Dyslipidaemia is an important component of metabolic syndrome and is demonstrated to contribute to colorectal tumorigenesis through insulin resistance, oxidative stress and inflammatory † The first three authors contributed equally to this work.

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“…The study population included 20,500 consecutive participants undergoing colonoscopy as part of routine health check-up examinations at the Center for Health Promotion of the Samsung Medical Center in Seoul, Korea, from January 2006 to June 2009 (9). If a participant had more than one colonoscopy during the study period, we included only the first colonoscopy.…”

Section: Study Populationmentioning

confidence: 99%

The Prevalence of Colorectal Adenomas in Asymptomatic Korean Men and Women

Yang

Rampal

Sung

et al. 2014

Cancer Epidemiology, Biomarkers &Amp; Prevention

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Background: Colorectal cancer incidence is rapidly rising in many Asian countries, with rates approaching those of Western countries. This study aimed to evaluate the prevalence and trends of colorectal adenomas by age, sex, and risk strata in asymptomatic Koreans.Methods: Cross-sectional study of 19,372 consecutive participants aged 20 to 79 years undergoing screening colonoscopy at the Center for Health Promotion of the Samsung Medical Center in Korea from January 2006 to June 2009.Results: Among participants at average risk, those without a history of colorectal polyps or a family history of colorectal cancer, the prevalence of colorectal adenomas and advanced adenomas were 34.5% and 3.1%, respectively, in men and 20.0% and 1.6%, respectively, in women. The prevalence of adenomas increased with age in both men and women, with a more marked increase for advanced adenoma. Participants with a family history of colorectal cancer or with a history of colorectal polyps had significantly higher prevalence of adenomas compared with participants of average risk (36.9% vs. 26.9%; age-and sex-adjusted prevalence ratio ¼ 1.16; 95% confidence interval, 1.09-1.22). The prevalence of adenomas increased annually in both men and women.Conclusions: In this large study of asymptomatic Korean men and women participating in a colonoscopy screening program, the prevalence of colorectal adenomas was comparable and possibly higher than previously reported in Western countries.Impact: Cost-effectiveness studies investigating the optimal age for starting colonoscopy screening and etiological studies to identify the reasons for the increasing trend in colorectal adenomas in Koreans are needed. Cancer Epidemiol Biomarkers Prev; 23(3); 499-507. Ó2014 AACR.

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The Association of Serum Lipids With Colorectal Adenomas

Cited by 82 publications

References 29 publications

Predicting the occurrence of cancer-associated colorectal polyp using a metabolic risk score

Predicting the occurrence of cancer-associated colorectal polyp using a metabolic risk score

The association between serum lipids and colorectal neoplasm: a systemic review and meta-analysis

The Prevalence of Colorectal Adenomas in Asymptomatic Korean Men and Women

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