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Endocrine, Metabolic & Immune Disorders - Drug Targets

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ISSN (Print): 1871-5303
ISSN (Online): 2212-3873

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Research Article

Correlation between High Incidence of Colorectal Neoplastic Polyps and High-risk Adenomas in Patients with Diabetes Mellitus: A Retrospective Study

Author(s): Chuan-yu Zheng, Wa Zhong, Ji-hao Xu, Yu-hong Yuan, Nai-zhao Chen, Wei-ling Liang, Qi-kui Chen and Yu Lai*

Volume 24, Issue 9, 2024

Published on: 25 September, 2023

Page: [1110 - 1119] Pages: 10

DOI: 10.2174/1871530323666230913105743

Price: $65

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Abstract

Background: Early detection and resection of colorectal polyps by routine colonoscopy screening can be effective in reducing the risk of colorectal cancer (CRC).

Objective: This study aimed to determine the association between diabetes mellitus (DM) and different types of colorectal polyps in the Chinese population.

Methods: A retrospective analysis was performed on inpatients admitted to the Gastroenterology Department of our hospital from January to December 2019. Clinical data, and colonoscopy and pathology findings of the subjects were collected. Bivariate analysis was used to assess factors associated with colorectal polyps. Significant variables from the bivariate evaluation were included in a stepwise multivariate logistic regression analysis to recognize independent predictors of neoplastic polyps and high-risk adenomas.

Results: The proportion of patients with DM was significantly higher in patients with neoplastic polyps and high-risk adenomas than in patients without polyps. Age ≥ 50 years, male gender, and a first-degree relative with a history of CRC were independent risk factors for neoplastic polyps and high-risk adenomas, even in non-smokers. An independent risk factor analysis that did not include a family history of CRC showed that age, gender, and alcohol consumption were independent risk factors for neoplastic polyps and high-risk adenomas. DM was an independent risk factor for high-risk adenomas (OR = 2.902, 95% CI = 1.221-6.899; p = 0.016) after adjusting for age, gender, alcohol consumption, and body mass index. Thus, a history of DM significantly increases the risk of high-risk adenomas.

Conclusion: This study demonstrated that patients with DM, age ≥ 50 years, male gender, alcohol consumption, and a first-degree relative with a history of CRC should undergo regular endoscopic screening and colonic polypectomy.

Keywords: Colorectal polyp, diabetes mellitus, neoplastic polyp, high-risk adenoma, CRC, endoscopic screening, colonic plypectomy, colonic polypectomy.

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[1]
Bray, F.; Ferlay, J.; Soerjomataram, I.; Siegel, R.L.; Torre, L.A.; Jemal, A. Global cancer statistics 2018: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries. CA Cancer J. Clin., 2018, 68(6), 394-424.
[http://dx.doi.org/10.3322/caac.21492] [PMID: 30207593]
[2]
Chen, W.; Zheng, R.; Baade, P.D.; Zhang, S.; Zeng, H.; Bray, F.; Jemal, A.; Yu, X.Q.; He, J. Cancer statistics in China, 2015. CA Cancer J. Clin., 2016, 66(2), 115-132.
[http://dx.doi.org/10.3322/caac.21338] [PMID: 26808342]
[3]
Giovannucci, E.; Harlan, D.M.; Archer, M.C.; Bergenstal, R.M.; Gapstur, S.M.; Habel, L.A.; Pollak, M.; Regensteiner, J.G.; Yee, D. Diabetes and Cancer. Diabetes Care, 2010, 33(7), 1674-1685.
[http://dx.doi.org/10.2337/dc10-0666] [PMID: 20587728]
[4]
Richardson, L.C.; Pollack, L.A. Therapy insight: Influence of type 2 diabetes on the development, treatment and outcomes of cancer. Nat. Clin. Pract. Oncol., 2005, 2(1), 48-53.
[http://dx.doi.org/10.1038/ncponc0062] [PMID: 16264856]
[5]
Song, S.; Wang, B.; Zhang, X.; Hao, L.; Hu, X.; Li, Z.; Sun, S. Long-term diabetes mellitus is associated with an increased risk of pancreatic cancer: A meta-analysis. PLoS One, 2015, 10(7), e0134321.
[http://dx.doi.org/10.1371/journal.pone.0134321] [PMID: 26222906]
[6]
Xu, B.; Zhou, X.; Li, X.; Liu, C.; Yang, C. Diabetes mellitus carries a risk of esophageal cancer. Medicine, 2017, 96(35), e7944.
[http://dx.doi.org/10.1097/MD.0000000000007944] [PMID: 28858123]
[7]
Hu, F.B.; Manson, J.E.; Liu, S.; Hunter, D.; Colditz, G.A.; Michels, K.B.; Speizer, F.E.; Giovannucci, E. Prospective study of adult onset diabetes mellitus (type 2) and risk of colorectal cancer in women. J. Natl. Cancer Inst., 1999, 91(6), 542-547.
[http://dx.doi.org/10.1093/jnci/91.6.542] [PMID: 10088625]
[8]
Limburg, P.J.; Vierkant, R.A.; Fredericksen, Z.S.; Leibson, C.L.; Rizza, R.A.; Gupta, A.K.; Ahlquist, D.A.; Melton, L.J., III; Sellers, T.A.; Cerhan, J.R. Clinically confirmed type 2 diabetes mellitus and colorectal cancer risk: A population-based, retrospective cohort study. Am. J. Gastroenterol., 2006, 101(8), 1872-1879.
[http://dx.doi.org/10.1111/j.1572-0241.2006.00725.x] [PMID: 16790032]
[9]
Zauber, A.G.; Winawer, S.J.; O’Brien, M.J.; Lansdorp-Vogelaar, I.; van Ballegooijen, M.; Hankey, B.F.; Shi, W.; Bond, J.H.; Schapiro, M.; Panish, J.F.; Stewart, E.T.; Waye, J.D. Colonoscopic polypectomy and long-term prevention of colorectal-cancer deaths. N. Engl. J. Med., 2012, 366(8), 687-696.
[http://dx.doi.org/10.1056/NEJMoa1100370] [PMID: 22356322]
[10]
Colucci, P.M.; Yale, S.H.; Rall, C.J. Colorectal polyps. Clin. Med. Res., 2003, 1(3), 261-262.
[http://dx.doi.org/10.3121/cmr.1.3.261] [PMID: 15931318]
[11]
Thompson, P.A.; Gerner, E.W. Current concepts in colorectal cancer prevention. Expert Rev. Gastroenterol. Hepatol., 2009, 3(4), 369-382.
[http://dx.doi.org/10.1586/egh.09.28] [PMID: 19673624]
[12]
Gupta, S.; Lieberman, D.; Anderson, J.C.; Burke, C.A.; Dominitz, J.A.; Kaltenbach, T.; Robertson, D.J.; Shaukat, A.; Syngal, S.; Rex, D.K. Recommendations for follow-up after colonoscopy and polypectomy: A consensus update by the us multi-society task force on colorectal cancer. Am. J. Gastroenterol., 2020, 115(3), 415-434.
[http://dx.doi.org/10.14309/ajg.0000000000000544] [PMID: 32039982]
[13]
Fang, H.; Shan, S.; Zhou, Y.; Zhong, L. Diabetes mellitus and the risk of gastrointestinal cancer in women compared with men: A meta-analysis of cohort studies. BMC Cancer, 2018, 18(1), 422.
[http://dx.doi.org/10.1186/s12885-018-4351-4] [PMID: 29661174]
[14]
Song, M.; Emilsson, L.; Bozorg, S.R.; Nguyen, L.H.; Joshi, A.D.; Staller, K.; Nayor, J.; Chan, A.T.; Ludvigsson, J.F. Risk of colorectal cancer incidence and mortality after polypectomy: A Swedish record-linkage study. Lancet Gastroenterol. Hepatol., 2020, 5(6), 537-547.
[http://dx.doi.org/10.1016/S2468-1253(20)30009-1] [PMID: 32192628]
[15]
Hsu, P.K.; Huang, J.Y.; Su, W.W.; Wei, J.C.C. Type 2 diabetes and the risk of colorectal polyps. Medicine, 2021, 100(19), e25933.
[http://dx.doi.org/10.1097/MD.0000000000025933] [PMID: 34106663]
[16]
Ali Khan, U.; Fallah, M.; Tian, Y.; Sundquist, K.; Sundquist, J.; Brenner, H.; Kharazmi, E. Personal history of diabetes as important as family history of colorectal cancer for risk of colorectal cancer: A nationwide cohort study. Am. J. Gastroenterol., 2020, 115(7), 1103-1109.
[http://dx.doi.org/10.14309/ajg.0000000000000669] [PMID: 32618661]
[17]
Ali Khan, U.; Fallah, M.; Sundquist, K.; Sundquist, J.; Brenner, H.; Kharazmi, E. Risk of colorectal cancer in patients with diabetes mellitus: A Swedish nationwide cohort study. PLoS Med., 2020, 17(11), e1003431.
[http://dx.doi.org/10.1371/journal.pmed.1003431] [PMID: 33186354]
[18]
James, P.T.; Leach, R.; Kalamara, E.; Shayeghi, M. The worldwide obesity epidemic. Obes. Res., 2001, 9(S11), 228S-233S.
[http://dx.doi.org/10.1038/oby.2001.123] [PMID: 11707546]
[19]
Budzynska, K.; Passerman, D.; White-Perkins, D.; Rees, D.A.; Xu, J.; Lamerato, L.; Schooley, S. Diabetes mellitus and hyperglycemia control on the risk of colorectal adenomatous polyps: A retrospective cohort study. BMC Fam. Pract., 2018, 19(1), 145.
[http://dx.doi.org/10.1186/s12875-018-0835-1] [PMID: 30157768]
[20]
Eddi, R.; Karki, A.; Shah, A.; DeBari, V.A.; DePasquale, J.R. Association of type 2 diabetes and colon adenomas. J. Gastrointest. Cancer, 2012, 43(1), 87-92.
[http://dx.doi.org/10.1007/s12029-011-9316-7] [PMID: 21894459]
[21]
Huang, H.E.; Yang, Y.C.; Wu, J.S.; Wang, R.H.; Lu, F.H.; Chang, C.J. The relationship between different glycemic statuses and colon polyps in a Taiwanese population. J. Gastroenterol., 2014, 49(7), 1145-1151.
[http://dx.doi.org/10.1007/s00535-013-0863-5] [PMID: 24429895]
[22]
Kim, J.H.; Lim, Y.J.; Kim, Y.H.; Sung, I.K.; Shim, S.G.; Oh, S.O.; Park, S.S.; Yang, S.; Son, H.J.; Rhee, P.L.; Kim, J.J.; Rhee, J.C.; Choi, Y.H. Is metabolic syndrome a risk factor for colorectal adenoma? Cancer Epidemiol. Biomarkers Prev., 2007, 16(8), 1543-1546.
[http://dx.doi.org/10.1158/1055-9965.EPI-07-0199] [PMID: 17684126]
[23]
Lee, G.E.; Park, H.S.; Yun, K.E.; Jun, S.H.; Kim, H.K.; Cho, S.; Kim, J.H. Association between BMI and metabolic syndrome and adenomatous colonic polyps in Korean men. Obesity, 2008, 16(6), 1434-1439.
[http://dx.doi.org/10.1038/oby.2008.216] [PMID: 18388894]
[24]
Dash, C.; Palmer, J.R.; Boggs, D.A.; Rosenberg, L.; Adams-Campbell, L.L. Type 2 diabetes and the risk of colorectal adenomas: Black Women’s Health Study. Am. J. Epidemiol., 2014, 179(1), 112-119.
[http://dx.doi.org/10.1093/aje/kwt227] [PMID: 24091887]
[25]
Hu, N.C.; Chen, J.D.; Lin, Y.M.; Chang, J.Y.; Chen, Y.H. Stepwise relationship between components of metabolic syndrome and risk of colorectal adenoma in a Taiwanese population receiving screening colonoscopy. J. Formos. Med. Assoc., 2011, 110(2), 100-108.
[http://dx.doi.org/10.1016/S0929-6646(11)60016-8] [PMID: 21377064]
[26]
Hwang, S.T.; Cho, Y.K.; Park, J.H.; Kim, H.J.; Park, D.I.; Sohn, C.I.; Jeon, W.K.; Kim, B.I.; Won, K.H.; Jin, W. Relationship of non-alcoholic fatty liver disease to colorectal adenomatous polyps. J. Gastroenterol. Hepatol., 2010, 25(3), 562-567.
[http://dx.doi.org/10.1111/j.1440-1746.2009.06117.x] [PMID: 20074156]
[27]
Niv, Y.; Hazazi, R.; Levi, Z.; Fraser, G. Screening colonoscopy for colorectal cancer in asymptomatic people: A meta-analysis. Dig. Dis. Sci., 2008, 53(12), 3049-3054.
[http://dx.doi.org/10.1007/s10620-008-0286-y] [PMID: 18463980]
[28]
Jacobs, E.T.; Gupta, S.; Baron, J.A.; Cross, A.J.; Lieberman, D.A.; Murphy, G.; Martínez, M.E. Family history of colorectal cancer in first-degree relatives and metachronous colorectal adenoma. Am. J. Gastroenterol., 2018, 113(6), 899-905.
[http://dx.doi.org/10.1038/s41395-018-0007-x] [PMID: 29463834]
[29]
Far, P.M.; Alshahrani, A.; Yaghoobi, M. Quantitative risk of positive family history in developing colorectal cancer: A meta-analysis. World J. Gastroenterol., 2019, 25(30), 4278-4291.
[http://dx.doi.org/10.3748/wjg.v25.i30.4278] [PMID: 31435179]
[30]
Expert groups of China colorectal cancer screening and early diagnosis and early treatment guidelines, National Cancer Center. The 2020 guidelines for screening and early diagnosis and treatment of colorectal cancer. Chin J. Oncol., 2021, 43(1), 16-38.
[31]
Liu, C.S.; Hsu, H.S.; Li, C.I.; Jan, C.I.; Li, T.C.; Lin, W.Y.; Lin, T.; Chen, Y.C.; Lee, C.C.; Lin, C.C. Central obesity and atherogenic dyslipidemia in metabolic syndrome are associated with increased risk for colorectal adenoma in a Chinese population. BMC Gastroenterol., 2010, 10(1), 51.
[http://dx.doi.org/10.1186/1471-230X-10-51] [PMID: 20507579]
[32]
Tsilidis, K.K.; Brancati, F.L.; Pollak, M.N.; Rifai, N.; Clipp, S.L.; Hoffman-Bolton, J.; Helzlsouer, K.J.; Platz, E.A. Metabolic syndrome components and colorectal adenoma in the CLUE II cohort. Cancer Causes Control, 2010, 21(1), 1-10.
[http://dx.doi.org/10.1007/s10552-009-9428-6] [PMID: 19774471]
[33]
Vincent, E.E.; Yaghootkar, H. Using genetics to decipher the link between type 2 diabetes and cancer: Shared aetiology or downstream consequence? Diabetologia, 2020, 63(9), 1706-1717.
[http://dx.doi.org/10.1007/s00125-020-05228-y] [PMID: 32705315]
[34]
Hivert, M.F.; Vassy, J.L.; Meigs, J.B. Susceptibility to type 2 diabetes mellitus—from genes to prevention. Nat. Rev. Endocrinol., 2014, 10(4), 198-205.
[http://dx.doi.org/10.1038/nrendo.2014.11] [PMID: 24535206]
[35]
Meigs, J.B.; Shrader, P.; Sullivan, L.M.; McAteer, J.B.; Fox, C.S.; Dupuis, J.; Manning, A.K.; Florez, J.C.; Wilson, P.W.F.; D’Agostino, R.B., Sr; Cupples, L.A. Genotype score in addition to common risk factors for prediction of type 2 diabetes. N. Engl. J. Med., 2008, 359(21), 2208-2219.
[http://dx.doi.org/10.1056/NEJMoa0804742] [PMID: 19020323]
[36]
Ottaiano, A.; Circelli, L.; Santorsola, M.; Savarese, G.; Fontanella, D.; Gigantino, V.; Di Mauro, A.; Capuozzo, M.; Zappavigna, S.; Lombardi, A.; Perri, F.; Cascella, M.; Granata, V.; Capuozzo, M.; Nasti, G.; Caraglia, M. Metastatic colorectal cancer and type 2 diabetes: Prognostic and genetic interactions. Mol. Oncol., 2022, 16(2), 319-332.
[http://dx.doi.org/10.1002/1878-0261.13122] [PMID: 34668636]
[37]
Fernandez, C.J.; George, A.S.; Subrahmanyan, N.A.; Pappachan, J.M. Epidemiological link between obesity, type 2 diabetes mellitus and cancer. World J. Methodol., 2021, 11(3), 23-45.
[http://dx.doi.org/10.5662/wjm.v11.i3.23] [PMID: 34026577]

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