Influence of alcohol consumption on the association between serum lipids and colorectal adenomas

Blood Lipid Concentrations and Colorectal Adenomas: A Systematic Review and Meta-Analysis of Colonoscopy Studies in Asia, 2000-2014

It is unclear whether dyslipidemia is associated with risk of colorectal neoplasia. The incidence of both conditions is increasing in Asia, motivating a number of new studies from this region. We performed a systematic literature search of Asian colonoscopy-based studies that collected blood lipid concentrations at the time of endoscopy. Persons found to have colorectal adenoma were considered cases, and those found to be adenoma-free were considered controls. Seventeen studies published between 2000 and 2014 met inclusion criteria, collectively enrolling 17,387 cases and 30,427 controls. Mean differences and adjusted odds ratios were summarized with random-effects meta-analyses. Compared with controls, cases had higher total cholesterol (mean difference (MD) = 2.4 mg/dL, 95% confidence interval (CI): 0.2, 4.6), higher low-density lipoprotein cholesterol (MD = 1.3 mg/dL, 95% CI: 0.1, 2.6), higher triglyceride (MD = 16.4 mg/dL, 95% CI: 11.2, 21.5), and lower high-density lipoprotein (HDL) cholesterol (MD = -2.1 mg/dL, 95% CI: -2.7, -1.6) concentrations. Based on adjusted odds ratios, associations for 40-mg/dL-higher triglyceride levels (odds ratio = 1.13, 95% CI: 1.05, 1.21) and 10-mg/dL-higher HDL cholesterol levels (odds ratio = 0.96, 95% CI: 0.92, 1.00) achieved statistical significance. Persons with adenoma were more likely to have unfavorable cholesterol profiles at the time of colonoscopy than those without adenoma. The most convincing evidence for an association between dyslipidemia and colorectal neoplasia was observed for hypertriglyceridemia.

Determination of the minimal essential serum folate concentration for reduced risk of colorectal adenoma

BACKGROUND & AIMS

There are no data regarding basal folate levels in patients without colorectal adenoma. This study aimed to determine the minimum serum folate concentration that associates with reduced risk of colorectal adenoma.

METHODS

1510 consecutive patients underwent total colonoscopy for suspected colorectal lesions after barium enema examination. Prior to colonoscopy, history of alcohol consumption was noted and blood serum analyzed for folate and vitamin B12 levels. Polypoid lesions were evaluated histologically. We excluded patients with anemia, history of colonoscopy, overconsumption of alcohol, or malignancies. In all, 458/1510 patients (male/female; 258/200, 40-75 years) were determined eligible. Variables were compared between patients with adenoma and those without adenoma.

RESULTS

Serum folate concentration was the variable with the most significant statistical variation between males with adenoma (8.0 ng/ml) and males without adenoma (9.2) (p = 0.001). Serum folate concentrations in females with adenoma did not differ significantly from those in females without adenoma (10.7 versus 10.9). When subjects were stratified into groups according to serum folate, we found no significant difference in the prevalence of adenoma in patients with folate levels greater than 8.0 ng/ml.

CONCLUSION

Patients with serum folate concentrations above 8.0 ng/ml had the lowest risk of developing colorectal adenoma.

Association Between Rectosigmoid Adenomas and Cardiovascular Risk Factors: A Hospital-based, Cross-sectional Study

Introduction: Little was known about the association between colorectal adenomas and cardiovascular risk factors in Taiwan. The aim of this study was to assess the association between rectosigmoid adenomas and related factors. Materials and Methods: This was a hospital-based, cross-sectional study. We analysed subjects receiving self-referred health examinations at 1 medical centre in Taiwan between 2001 and 2004. In total, 4413 subjects were enrolled in this study. There were 2444 men (55.4%) and 1969 women (44.6%). The mean age was 49.3 ±12.3 years (range, 20 to 87). All subjects underwent a 60-cm flexible sigmoidoscopic examination and laboratory survey. Adjusted odds ratio (OR) and 95% confidence interval (CI) were expressed using a multivariate logistic regression analysis. Results: In the final model, increasing age (OR, 1.05; 95% CI, 1.03-1.06), hypertriglyceridemia (OR, 1.49; 95% CI, 1.07-2.07), and alcohol consumption (OR, 2.11; 95% CI, 1.47-3.04) were the risk factors for rectosigmoid adenomas in men. Increasing age was the only risk factor for rectosigmoid adenomas in women (OR, 1.03; 95% CI, 1.01-1.06). Conclusion: Age, hypertriglyceridemia and alcohol consumption are associated with rectosigmoid adenomas in men, and only age is significantly associated with rectosigmoid adenomas in women. Key words: Alcohol, Cardiovascular, Hypertriglyceridemia

Meta analysis of risk factors for colorectal cancer

AIM: To study the risk factors for colorectal cancer in China.

METHODS: A meta-analysis of the risk factors of colorectal cancer was conducted for 14 case-control studies, and reviewed 14 reports within 13 years which included 5034 cases and 5205 controls. Dersimonian and Laird random effective models were used to process the results.

RESULTS: Meta analysis of the 14 studies demonstrated that proper physical activites and dietary fibers were protective factors (pooled OR < 0.8), while fecal mucohemorrhage, chronic diarrhea and polyposis were highly associated with colorectal cancer (all pooled OR > 4). The stratified results showed that different OR values of some factors were due to geographic factors or different resourses.

CONCLUSION: Risks of colorectal cancer are significantly associated with the histories of intestinal diseases or relative symptoms, high lipid diet, emotional trauma and family history of cancers. The suitable physical activities and dietary fibers are protective factors.