Cancer Causes & Control

, Volume 23, Issue 2, pp 321–328

Glycated hemoglobin A1c is superior to fasting plasma glucose as an independent risk factor for colorectal neoplasia

Authors

  • Yao-Chun Hsu
    • Department of Internal MedicineE-Da Hospital, I-Shou University
  • Han-Mo Chiu
    • Department of Internal MedicineNational Taiwan University Hospital, National Taiwan University College of Medicine
  • Jyh-Ming Liou
    • Department of Internal MedicineNational Taiwan University Hospital, National Taiwan University College of Medicine
  • Chun-Chao Chang
    • Division of Gastroenterology and Hepatology, Department of Internal MedicineTaipei Medical University Hospital
  • Jaw-Town Lin
    • Department of Internal MedicineE-Da Hospital, I-Shou University
    • Department of Internal MedicineNational Taiwan University Hospital, National Taiwan University College of Medicine
    • School of Public Health, College of Public Health and Nutrition, Taipei Medical University
    • Imperial Clinic
    • Department of Internal MedicineNational Taiwan University Hospital, National Taiwan University College of Medicine
Original paper

DOI: 10.1007/s10552-011-9880-y

Cite this article as:
Hsu, Y., Chiu, H., Liou, J. et al. Cancer Causes Control (2012) 23: 321. doi:10.1007/s10552-011-9880-y

Abstract

Objective

To investigate which glycemic index is more strongly associated with colorectal neoplasia.

Method

This cross-sectional study enrolled 2,776 participants in a comprehensive health management program which included measurement of fasting plasma glucose and HbA1c, along with screening colonoscopy. Primary outcome was colorectal adenoma with or without dysplasia. Risk factors for colorectal neoplasia were determined by the multivariate regression analysis, which evaluated the interrelationship among different glycemic indices in a hierarchical way.

Results

Colorectal neoplasms were found in 605 (21.79%) examinees, 68 (2.45%) of whom had high-risk tumors. Glycemic indices including diagnosis of diabetes mellitus, fasting plasma glucose, and HbA1c were all associated with colorectal tumors in the univariate analysis. However, HbA1c outperformed the other two markers as an independent risk factor (adjusted odds ratio, 1.22; 95% confidence interval, 1.10–1.36%) for colorectal neoplasia. Moreover, only HbA1c remained independently associated with colorectal tumor after patients with established diagnosis of diabetes (n = 132) were excluded. We also identified age, male gender, and smoking were independent risk factors for colorectal neoplasia.

Conclusion

HbA1c as compared with fasting plasma glucose is more strongly and independently associated with colorectal neoplasia. Further research is warranted to elucidate the value of HbA1c in stratifying risk of colorectal cancer.

Keywords

Glycated hemoglobinFasting plasma glucoseDiabetes mellitusColorectal neoplasia

Copyright information

© Springer Science+Business Media B.V. 2011