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Metabolic factors affect the occurrence of colorectal neoplasm on surveillance colonoscopies
Author(s) -
So Hoonsub,
Han Seungbong,
Park Hye Won,
Kim Eun Hee,
Lee Ji Young,
Lee HoSu,
Chang HyeSook,
Kim HongKyu,
Choe Jaewon,
Park Sang Hyoung,
Yang DongHoon,
Myung SeungJae,
Yang SukKyun,
Byeon JeongSik
Publication year - 2016
Publication title -
journal of gastroenterology and hepatology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.214
H-Index - 130
eISSN - 1440-1746
pISSN - 0815-9319
DOI - 10.1111/jgh.13286
Subject(s) - medicine , colonoscopy , waist , metabolic syndrome , risk factor , hazard ratio , confidence interval , colorectal cancer , asymptomatic , gastroenterology , obesity , cancer
Background and Aim: Although metabolic factors such as obesity and hyperlipidemia were reported to be associated with high prevalence of colorectal neoplasm (CRN), their influence on the occurrence of CRN at surveillance colonoscopy has not been clarified. The purpose of this study was to analyze the association between metabolic factors and the risk of CRN at the time of surveillance colonoscopy. Methods: We reviewed the medical records of 1792 asymptomatic subjects (average 52.1 years, 1233 male) who underwent screening and follow‐up surveillance colonoscopies. Fasting glucose level, fasting insulin level, hemoglobin A1c (HbA1c), lipid profile, high sensitivity C‐reactive protein, and colonoscopic findings at the time of baseline screening were analyzed to find any associations with the occurrence of CRN at the time of surveillance colonoscopy. Results: The median interval between screening and surveillance colonoscopies was 3.34 years. The 3‐ and 5‐year cumulative CRN incidences were 22.3% and 54.8%, respectively. Several metabolic factors such as hypertension, waist circumference, fasting insulin, fasting glucose, HbA1c, and triglyceride were associated with the occurrence of CRN in univariate analysis. Age, current alcohol drinker status, and high‐risk colonoscopy findings at baseline remained independent risk factors for CRN occurrence in multivariate analysis. High waist circumference was also an independent risk factor (hazard ratio 1.03, 95% CI 1.02–1.04; P < 0.001). Conclusions: Metabolic factors, especially waist circumference, affect CRN occurrence at the time of surveillance colonoscopy. The surveillance colonoscopy interval may be optimized based on metabolic factors and screening colonoscopy findings.