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Markers of glucose metabolism associated with colorectal adenomas

July's issue of Gastroenterology studies the association between markers of glucose metabolism and metabolic syndrome and the presence of colorectal adenomas.

News image

Diabetes is a risk factor for colorectal cancer.

Dr Juhee Cho and colleagues from South Korea studied the association between markers of glucose metabolism and metabolic syndrome and the presence of colorectal adenomas in a large number of asymptomatic men and women attending a health screening program in South Korea.

The research team also investigated whether these associations depend on adenoma location.

In a cross-sectional study, the team measured fasting levels of glucose, insulin, hemoglobin A1c, and C-peptide and calculated homeostatic model assessment (HOMA) values for 19,361 asymptomatic South Korean subjects who underwent colonoscopy examinations from 2006 to 2009.

Participants completed a standardized self-administered health questionnaire and a validated semiquantitative food frequency questionnaire.
The prevalence ratio for any adenoma was 1.08 for fasting glucose 
Gastroenterology

Blood samples were collected on the day of the colonoscopy, and fasting blood samples were also collected.

Robust Poisson regression was used to model the associations of glucose markers with the prevalence of any adenoma.

Using detailed multivariable-adjusted dose-response models, the prevalence ratios for any adenoma, comparing the 90th with the 10th percentile, were 1.08 for fasting glucose, 1.07 for insulin, 1.09 for HOMA, 1.09 for hemoglobin A1c, and 1.14 for C-peptide.

The research team noted that the corresponding ratios for nonadvanced adenomas were 1.11, 1.10, 1.15, 1.14, and 1.20, respectively.

The team found that the corresponding ratios for advanced adenomas were 1.32, 1.23, 1.30, 1.13, and 1.67, respectively.

The team noted that metabolic syndrome was associated with the prevalence of any adenoma, nonadvanced adenoma, and advanced adenoma.

Associations were similar for adenomas located in the distal versus proximal colon.

Dr Cho's team concludes, "Increasing levels of glucose, HOMA values, levels of hemoglobin A1c and C-peptide, and metabolic syndrome are significantly associated with the prevalence of adenomas."

"Adenomas should be added to the list of consequences of altered glucose metabolism."

Gastroenterol 2014: 147(1): 78–87.e3
26 June 2014

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