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Hsu SH, Syu DK, Chen YC, Liu CK, Sun CA, Chen M. The Association between Hypertriglyceridemia and Colorectal Cancer: A Long-Term Community Cohort Study in Taiwan. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19137804. [PMID: 35805464 PMCID: PMC9265720 DOI: 10.3390/ijerph19137804] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/01/2022] [Revised: 06/22/2022] [Accepted: 06/24/2022] [Indexed: 02/04/2023]
Abstract
(1) Background: Colorectal cancer (CRC) is the third most common malignancy and the second leading cause of cancer deaths worldwide. It often diagnosed at advanced stages, and with increasing incidence at younger generation. CRC poses a heavy financial burden and a huge public health challenge nowadays. Lipoproteins and serum lipids may have an influence on carcinogenesis by making oxidative stress, inflammation, and insulin resistance. Dyslipidemia plays a potential role in the risk of CRC. The purpose of this study is to use nationally representative samples to determine epidemiologic characteristics of CRC in the Taiwanese population, and to evaluate the associations between baseline levels of lipid profile and their effect on risk of colorectal cancer (CRC) comprehensively and quantitatively. The control of dyslipidemia in primary and secondary prevention may reduce the disease burden of CRC. (2) Methods: This is a nationwide long-term community-based prospective cohort study. Data were retrieved from the nationwide population-based Taiwanese Survey on Hypertension, Hyperglycemia and Hyperlipidemia (TwSHHH). Variables were estimated by the Cox proportional hazards model which was then further adjusted for age. We also calculated the relative ratios (RRs) of CRC for joint categories of serum cholesterol, triglyceride (TG), low-density lipoproteins cholesterol (LDL-C), and high-density lipoprotein cholesterol (HDL-C) level, and to examine their combined effect and statistical interactions. (3) Results: Male, age, waist circumference, diabetes mellitus (DM), high TG, high cholesterol level, smoking history, and metabolic syndrome were proved to increase the risk of CRC. In addition, DM patients with a TG level ≥150 mg/dL and cholesterol ≥180 mg/dL had a 4.118-fold higher risk of CRC as compared with a TG level <150 mg/dL and cholesterol level <180 mg/dL, which was a significant difference (95% CI, 1.061−15.975; p = 0.0407). (4) Conclusions: Patients with DM should control TG and cholesterol level through diet, exercise, or taking medications more aggressively, not only for preventing cardiovascular disease, but also for first prevention of CRC. The study can be valuable for the clinicians and policy makers to implement more precisely goals about dyslipidemia management.
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Affiliation(s)
- Shu-Hua Hsu
- Department of Family Medicine, Fu Jen Catholic University Hospital, Fu Jen Catholic University, No. 69, Guizi Rd., Taishan Dist., New Taipei City 24352, Taiwan;
- Graduate Institute of Business Administration, College of Management, Fu Jen Catholic University, No. 510, Zhongzheng Rd., Xinzhuang Dist., New Taipei City 242062, Taiwan;
| | - De-Kai Syu
- Department of Orthopedics, Fu Jen Catholic University Hospital, Fu Jen Catholic University, No. 69, Guizi Rd., Taishan Dist., New Taipei City 24352, Taiwan;
| | - Yong-Chen Chen
- Master Program of Big Data in Biomedicine, College of Medicine, Fu Jen Catholic University, No. 510, Zhongzheng Rd., Xinzhuang Dist., New Taipei City 242062, Taiwan;
- Data Science Center, College of Medicine, Fu Jen Catholic University, No. 510, Zhongzheng Rd., Xinzhuang Dist., New Taipei City 242062, Taiwan
| | - Chih-Kuang Liu
- Graduate Institute of Business Administration, College of Management, Fu Jen Catholic University, No. 510, Zhongzheng Rd., Xinzhuang Dist., New Taipei City 242062, Taiwan;
- Department of Urology, Fu Jen Catholic University Hospital, Fu Jen Catholic University, No. 69, Guizi Rd., Taishan Dist., New Taipei City 24352, Taiwan
| | - Chien-An Sun
- Data Science Center, College of Medicine, Fu Jen Catholic University, No. 510, Zhongzheng Rd., Xinzhuang Dist., New Taipei City 242062, Taiwan
- Department of Public Health, College of Medicine, Fu Jen Catholic University, Xinzhuang Dist., New Taipei City 24205, Taiwan
- Correspondence: (C.-A.S.); (M.C.)
| | - Mingchih Chen
- Graduate Institute of Business Administration, College of Management, Fu Jen Catholic University, No. 510, Zhongzheng Rd., Xinzhuang Dist., New Taipei City 242062, Taiwan;
- Artificial Intelligence Development Center, Fu Jen Catholic University, No. 510, Zhongzheng Rd., Xinzhuang Dist., New Taipei City 242062, Taiwan
- Correspondence: (C.-A.S.); (M.C.)
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Loke SS, Chuah SK. Factors Associated with Colorectal Polyps in Middle-Aged and Elderly Populations. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19127543. [PMID: 35742789 PMCID: PMC9223574 DOI: 10.3390/ijerph19127543] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 04/25/2022] [Revised: 06/08/2022] [Accepted: 06/18/2022] [Indexed: 11/16/2022]
Abstract
Colorectal polyps are the precursor lesions of most colorectal cancers. This study aimed to evaluate associations between bone mineral density (BMD), metabolic syndrome (MetS), and gastrointestinal diseases with colorectal polyps in middle-aged and elderly populations. A retrospective cross-sectional study was performed using data from the health examination database of a tertiary medical center in southern Taiwan in 2015. Subjects aged 50 years and older who had been assessed for metabolic factors and had undergone colonoscopy, upper gastrointestinal endoscopy, and dual energy X-ray absorptiometry scan (DEXA) were included. Factors associated with colorectal polyps were evaluated using univariate and multivariate logistic regression. In total, 1515 subjects were included, with mean age 60.1 years. Among them, 710 (46.9%) had colorectal polyps. Multivariate logistic regression analysis showed that high fasting glucose (OR = 1.08, p = 0.001), high triglycerides (OR = 1.02, p = 0.008), high total cholesterol (OR = 1.004, p = 0.009), reflux esophagitis (OR = 1.44, p = 0.002), duodenal polyps (OR = 1.75, p = 0.026), gastric ulcer (OR = 1.38, p = 0.024), duodenal ulcers (OR = 1.45, p = 0.028), osteopenia (OR = 1.48, p = 0.001), and MetS (OR = 1.46, p < 0.001) were independently associated with colorectal polyps. In conclusion, hyperglycemia, hypercholesterolemia, hypertriglyceridemia, MetS, duodenal polyps, gastric and duodenal ulcers, reflux esophagitis, and low BMD are independent risk factors associated with colorectal polyps in the middle-aged and elderly Taiwanese population.
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Affiliation(s)
- Song-Seng Loke
- Division of Geriatric Medicine, Department of Family Medicine, Kaohsiung Chang Gung Memorial Hospital, Chang Gung University College of Medicine, 123, Dapi Road, Niaosong District, Kaohsiung 833, Taiwan
- Correspondence: ; Tel.: +886-7-7317123
| | - Seng-Kee Chuah
- Division of Hepatogastroenterology, Department of Internal Medicine, Kaohsiung Chang Gung Memorial Hospital, Chang Gung University College of Medicine, 123, Dapi Road, Niaosong District, Kaohsiung 833, Taiwan;
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Kim YJ, Lee KJ, Park SY, Han JH, Kwon KY, Kim JH. Association between Dyslipidemia and the Prevalence of Colon Polyps Based on a Health Evaluation of Subjects at a Hospital. Korean J Fam Med 2014; 35:143-51. [PMID: 24921033 PMCID: PMC4040432 DOI: 10.4082/kjfm.2014.35.3.143] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2010] [Accepted: 10/30/2013] [Indexed: 01/13/2023] Open
Abstract
Background Colonic neoplasm is associated with western diet intake and physical inactivity. These life styles are also risk factors for dyslipidemia and metabolic syndrome. The aim of this study was to evaluate the association between dyslipidemia and the prevalence of colon polyps including colon adenoma as a precancerous lesion of colonic neoplasms. Methods We selected subjects undergoing a colonoscopy for health screening at the Health Promotion Center of Eulji General Hospital from January 2006 to June 2010. Subjects with histories of cancers, dyslipidemia treatment, and other intestinal diseases like Crohn's disease and ulcerative colitis were excluded. The total numbers of subjects included in the study was 605. Chi-square test and t-test and were used for the analysis. Additionally we used multivariate logistic regression to adjust for sex, age, smoking, drinking, and other risk factors. Results The prevalence of colon polyps was 48.70% and 28.05% in males and females, respectively. When adjusting for variables that included age, body mass index, hypertension, diabetes mellitus, smoking, drinking, and exercise, dyslipidemia was not significantly associated with the prevalence of colon polyps. However upon analyzing adenomatous colon polyps in men, dyslipidemias due to triglycerides and high density lipoproteins were significant factors (odds ratio [OR], 2.13; confidence interval [CI], 1.14 to 3.98; OR, 2.24; CI, 1.15 to 4.34, respectively). Conclusion Dyslipidemia was not a significant factor in the prevalence of colon polyps. However it had a significant association with the prevalence of adenomatous colon polyps in men.
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Affiliation(s)
- Yeong-Ju Kim
- Department of Family Medicine, Eulji General Hospital, Eulji University School of Medicine, Seoul, Korea
| | - Kyung-Jin Lee
- Department of Family Medicine, Eulji General Hospital, Eulji University School of Medicine, Seoul, Korea
| | - Si-Young Park
- Department of Family Medicine, Eulji General Hospital, Eulji University School of Medicine, Seoul, Korea
| | - Jee-Hae Han
- Department of Family Medicine, Eulji General Hospital, Eulji University School of Medicine, Seoul, Korea
| | - Kil-Young Kwon
- Department of Family Medicine, Eulji General Hospital, Eulji University School of Medicine, Seoul, Korea
| | - Jung-Hwan Kim
- Department of Family Medicine, Eulji General Hospital, Eulji University School of Medicine, Seoul, Korea
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Abstract
Colorectal cancer and myocardial infarction are associated at population level and in autoptic studies. Furthermore, they share many blood variables: cholesterol, triglycerides and HDL cholesterol, fructosamine, glycated haemoglobin and glycated apolipoprotein B. These blood variables are intermediates between dietary, mainly saturated fats and high glycemic index and load diets, and colorectal cancer and myocardial infarction. Blood intermediate variables can be used in dietary trials as outcomes, and even to throw light on the pathogenesis of both diseases.
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Sun ZJ, Huang YH, Wu JS, Yang YC, Chang YF, Lu FH, Chang CJ. The association of serum lipids with the histological pattern of rectosigmoid adenoma in Taiwanese adults. BMC Gastroenterol 2011; 11:54. [PMID: 21575164 PMCID: PMC3112117 DOI: 10.1186/1471-230x-11-54] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/20/2010] [Accepted: 05/15/2011] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND The mortality rate of colorectal cancer ranks third behind lung and hepatic cancer in Taiwan. Colorectal cancer mostly arises from adenomatous polyps of left colon. The aim of our study was to examine the association of serum lipids with the histological pattern of rectosigmoid adenoma. METHODS There were 2,506 eligible examinees aged 20 and above who underwent sigmoidoscopy as a screening examination in National Cheng Kung University Hospital between January 2003 and October 2006. They were classified into three groups: tubular adenoma (333 subjects), villous-rich (tubulovillous/villous) adenoma (53 subjects) and normal (2,120 subjects). We defined high total cholesterol (TC) as a level ≧200 mg/dl, low high-density lipoprotein cholesterol (HDL-C) as a level <40 mg/dL, and high triglyceride (TG) as a level ≧200 mg/dl according to the third report of the National Cholesterol Education Program expert panel on detection, evaluation, and treatment of high blood cholesterol in adults. Adenoma histology was classified as tubular, tubulovillous and villous according to the proportion of villous part. RESULTS Among the study population, 333 subjects (13.3%) had tubular adenomas and 53 subjects (2.1%) had villous-rich adenomas. The odds ratio (OR) for villous-rich adenoma in subjects with TG≧200 mg/dL compared to those with TG < 200 mg/dL was 3.20 (95% confidence interval [CI]:1.71-6.01), after adjusting for age, gender, general obesity, central obesity, diabetes, hypertension, smoking, and alcohol consumption. If further taking high TC and low HDL-C into consideration, the OR was 4.42 (95% CI:2.03-9.63). CONCLUSIONS Our study showed that subjects with high serum TG tended to have a higher risk of tubulovillous/villous adenoma in rectosigmoid colon. Therefore, reducing the serum TG level might be one method to prevent the incidence of colorectal cancer.
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Affiliation(s)
- Zih-Jie Sun
- Department of Family Medicine, National Cheng Kung University College of Medicine and Hospital, Dou-Liou Branch, No.345, Zhuangjing Rd., Douliou City, Yunlin County 640, Taiwan
| | - Ying-Hsiang Huang
- Department of Family Medicine, National Cheng Kung University Hospital, No.138, Shengli Rd., East Dist., Tainan City 701, Taiwan
| | - Jin-Shang Wu
- Department of Family Medicine, National Cheng Kung University Hospital, No.138, Shengli Rd., East Dist., Tainan City 701, Taiwan
| | - Yi-Ching Yang
- Department of Family Medicine, National Cheng Kung University Hospital, No.138, Shengli Rd., East Dist., Tainan City 701, Taiwan
| | - Ying-Fang Chang
- Department of Family Medicine, National Cheng Kung University Hospital, No.138, Shengli Rd., East Dist., Tainan City 701, Taiwan
| | - Feng-Hwa Lu
- Department of Family Medicine, National Cheng Kung University Hospital, No.138, Shengli Rd., East Dist., Tainan City 701, Taiwan
| | - Chih-Jen Chang
- Department of Family Medicine, National Cheng Kung University Hospital, No.138, Shengli Rd., East Dist., Tainan City 701, Taiwan
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Reduction in low-density lipoprotein cholesterol levels during statin therapy is associated with a reduced incidence of advanced colon polyps. Am J Med Sci 2009; 338:378-81. [PMID: 19794305 DOI: 10.1097/maj.0b013e3181b4c496] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
BACKGROUND Elevated serum cholesterol levels may stimulate proliferation in adenomatous polyps (AP). Our aim was to determine how a reduction of low-density lipoprotein (LDL) cholesterol levels in patients taking statins influences the incidence of APs. METHODS We performed a retrospective study of patients taking statins who were found to have > or =1 APs on an index colonoscopy, and who also had a follow-up colonoscopy within 3 to 5 years. Patients were divided into 2 groups: (1) those with > or =30% reduction in LDL levels and (2) those with < 30% reduction in LDL levels during the interval between colonoscopies. Univariate and multivariate analysis were evaluated for their association with advanced APs. RESULTS We identified 231 patients. Univariate analysis showed that patients with > or =30% LDL reduction had fewer mean total numbers of APs (2.6 versus 3.3, P = 0.02), fewer advanced APs (14% versus 26%, P = 0.04), and smaller APs (5 mm versus 6.1 mm, P = 0.01) than those with <30% reduction in LDL. Multiple logistic regression analysis confirmed that > or =30% LDL reduction was associated with smaller APs (P < 0.01). Subjects with > or =30% LDL reduction also had a 53% reduced incidence of advanced APs (OR, 0.47; CI, 0.22-0.96; P < 0.05). These findings remained significant even when adjusted for nonsteroidal antiinflammatory drug use, age, family history of APs, and body mass index. CONCLUSIONS A reduction in LDL levels of > or=30% during a 3- to 5-year period of statin therapy was associated with a 53% reduction in the incidence of advanced APs, even after adjustment for other known polyp risk factors.
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Combined treatment with niacin and chromium caused a protective effect on the small-intestine tissue of hyperlipidemic rats. Med Chem Res 2007. [DOI: 10.1007/s00044-007-9030-y] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/15/2023]
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Misciagna G, De Michele G, Guerra V, Cisternino AM, Di Leo A, Freudenheim JL. Serum fructosamine and colorectal adenomas. Eur J Epidemiol 2004; 19:425-32. [PMID: 15233314 DOI: 10.1023/b:ejep.0000027359.95727.24] [Citation(s) in RCA: 33] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
The relationship of glucose in the blood with colorectal adenoma or cancer is not clear. Fructosamine, equivalent to total serum glycated proteins, is a marker of blood glucose levels in the previous 3 weeks. We evaluated in a case-control study the association between fructosamine and colorectal adenoma, a precursor of colorectal cancer. Cases were subjects with the first occurrence of one or more histologically confirmed colorectal adenomatous polyps removed after a complete colonoscopy (153 cases), and controls were subjects with normal colonoscopy performed in the same endoscopy units during the same period (84 controls). Serum fructosamine was measured by a colorimetric method. Unconditional multiple logistic regression was used for statistical analysis. We found that in non-diabetic subjects the risk of colorectal adenoma increased with the level of fructosamine, and the odds ratio of colorectal adenoma in subjects with fructosamine levels higher than the median (270 microg/100 ml), in comparison with subjects with fructosamine lower than the median, was 2.3 (95% CI: 1.1-4.8). The risk of colorectal adenoma increased also with increasing levels of serum triglycerides and cholesterol, and decreased with increasing levels of fasting serum insulin. The results of this study show that the risk of colorectal adenoma increases with the level of fructosamine, an indicator of the level of glucose in the blood more sensitive to foods with a high glycemic index.
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Affiliation(s)
- Giovanni Misciagna
- Laboratory of Epidemiology, IRCCS S. De Bellis, Research Hospital for Digestive Diseases, Castellana, Bari 70013, Italy.
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