Skip to main content
SpringerLink
Log in

Associations Between Parameters of Glucose and Lipid Metabolism and Risk of Colorectal Neoplasm

  • Original Article
  • Published:
Digestive Diseases and Sciences Aims and scope Submit manuscript

Abstract

Background

Diabetes and dyslipidemia have been linked to an increased risk of colorectal neoplasm (CRN). However, previous studies evaluating these associations have shown inconsistent results, and large-scale studies are few in number.

Aim

To investigate the associations between the parameters of glucose and lipid metabolism and the presence of CRN.

Methods

A cross-sectional study was performed on 38,490 Korean adults aged ≥30 years undergoing their first colonoscopy as part of routine preventive health care between 2010 and 2011.

Results

The prevalence of overall CRN increased with increasing levels of glucose, hemoglobin A1c (HbA1c), insulin, homeostasis model assessment of insulin resistance (HOMA-IR), triglycerides, total cholesterol, low-density lipoprotein cholesterol (LDL-C), and apolipoprotein B (ApoB) and with decreasing level of apolipoprotein A1 (ApoA1). The adjusted prevalence ratios for overall CRN comparing the fourth with the first quartiles of fasting glucose, HbA1c, insulin, HOMA-IR, triglycerides, total cholesterol, LDL-C, ApoB, and ApoA-1 were 1.83 (95 % CI 1.62–2.06), 1.17 (95 % CI 1.03–1.33), 1.09 (95 % CI 0.97–1.23), 1.22 (95 % CI 1.08–1.37), 1.31 (95 % CI 1.16–1.48), 1.19 (95 % CI 1.07–1.33), 1.38 (95 % CI 1.23–1.54), 1.30 (95 % CI 1.14–1.47), and 0.85 (95 % CI 0.76–0.95), respectively. There was also a significant association between higher levels of glucose, LDL-C, and ApoB with a higher prevalence of advanced CRN. Moreover, the risk of CRN increased further in cases in which the parameters of glucose metabolism and lipid metabolism worsened simultaneously.

Conclusions

The levels of parameters of glucose and lipid metabolism are significantly associated with the prevalence of CRN. Altered glucose and lipid metabolism may contribute to the development of CRN.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2

Similar content being viewed by others

References

  1. Ferlay J, Shin HR, Bray F, et al. Estimates of worldwide burden of cancer in 2008: GLOBOCAN 2008. Int J Cancer. 2010;127:2893–2917.

    Article  CAS  PubMed  Google Scholar 

  2. Kim ER, Kim YH. Clinical application of genetics in management of colorectal cancer. Intest Res. 2014;12:184–193.

    Article  PubMed Central  PubMed  Google Scholar 

  3. Sung JJ, Lau JY, Young GP, et al. Asia Pacific consensus recommendations for colorectal cancer screening. Gut. 2008;57:1166–1176.

    Article  CAS  PubMed  Google Scholar 

  4. Cha JM. Colonoscopy quality is the answer for the emerging issue of interval cancer. Intest Res. 2014;12:110–116.

    Article  PubMed Central  PubMed  Google Scholar 

  5. Cha JM. Would you recommend screening colonoscopy for the very elderly? Intest Res. 2014;12:275–280.

    Article  PubMed Central  PubMed  Google Scholar 

  6. Wu L, Yu C, Jiang H, et al. Diabetes mellitus and the occurrence of colorectal cancer: an updated meta-analysis of cohort studies. Diabetes Technol Ther. 2013;15:419–427.

    Article  PubMed  Google Scholar 

  7. Luo W, Cao Y, Liao C, et al. Diabetes mellitus and the incidence and mortality of colorectal cancer: a meta-analysis of 24 cohort studies. Colorectal Dis. 2012;14:1307–1312.

    Article  CAS  PubMed  Google Scholar 

  8. Wang YY, Lin SY, Lai WA, et al. Association between adenomas of rectosigmoid colon and metabolic syndrome features in a Chinese population. J Gastroenterol Hepatol. 2005;20:1410–1415.

    Article  PubMed  Google Scholar 

  9. Kim BC, Shin A, Hong CW, et al. Association of colorectal adenoma with components of metabolic syndrome. Cancer Causes Control. 2012;23:727–735.

    Article  PubMed  Google Scholar 

  10. Stocks T, Lukanova A, Bjorge T, et al. Metabolic factors and the risk of colorectal cancer in 580,000 men and women in the metabolic syndrome and cancer project (Me-Can). Cancer. 2011;117:2398–2407.

    Article  PubMed  Google Scholar 

  11. Liu CS, Hsu HS, Li CI, et al. Central obesity and atherogenic dyslipidemia in metabolic syndrome are associated with increased risk for colorectal adenoma in a Chinese population. BMC Gastroenterol. 2010;10:51.

    Article  PubMed Central  CAS  PubMed  Google Scholar 

  12. Keku TO, Lund PK, Galanko J, et al. Insulin resistance, apoptosis, and colorectal adenoma risk. Cancer Epidemiol Biomark Prev. 2005;14:2076–2081.

    Article  CAS  Google Scholar 

  13. Rampal S, Yang MH, Sung J, et al. Association between markers of glucose metabolism and risk of colorectal adenoma. Gastroenterology. 2014;147:78.e73–87.e73.

    Article  Google Scholar 

  14. Vidal AC, Lund PK, Hoyo C, et al. Elevated C-peptide and insulin predict increased risk of colorectal adenomas in normal mucosa. BMC Cancer. 2012;12:389.

    Article  PubMed Central  CAS  PubMed  Google Scholar 

  15. Ortiz AP, Thompson CL, Chak A, et al. Insulin resistance, central obesity, and risk of colorectal adenomas. Cancer. 2012;118:1774–1781.

    Article  PubMed Central  CAS  PubMed  Google Scholar 

  16. Misciagna G, De Michele G, Guerra V, et al. Serum fructosamine and colorectal adenomas. Eur J Epidemiol. 2004;19:425–432.

    Article  CAS  PubMed  Google Scholar 

  17. Yamada K, Araki S, Tamura M, et al. Relation of serum total cholesterol, serum triglycerides and fasting plasma glucose to colorectal carcinoma in situ. Int J Epidemiol. 1998;27:794–798.

    Article  CAS  PubMed  Google Scholar 

  18. Yang MH, Rampal S, Sung J, et al. The association of serum lipids with colorectal adenomas. Am J Gastroenterol. 2013;108:833–841.

    Article  CAS  PubMed  Google Scholar 

  19. Bayerdorffer E, Mannes GA, Richter WO, et al. Decreased high-density lipoprotein cholesterol and increased low-density cholesterol levels in patients with colorectal adenomas. Ann Intern Med. 1993;118:481–487.

    Article  CAS  PubMed  Google Scholar 

  20. van Duijnhoven FJ, Bueno-De-Mesquita HB, Calligaro M, et al. Blood lipid and lipoprotein concentrations and colorectal cancer risk in the European Prospective Investigation into Cancer and Nutrition. Gut. 2011;60:1094–1102.

    Article  PubMed  Google Scholar 

  21. Shikata K, Ninomiya T, Kiyohara Y. Diabetes mellitus and cancer risk: review of the epidemiological evidence. Cancer Sci. 2013;104:9–14.

    Article  CAS  PubMed  Google Scholar 

  22. Platz EA, Hankinson SE, Rifai N, et al. Glycosylated hemoglobin and risk of colorectal cancer and adenoma (United States). Cancer Causes Control. 1999;10:379–386.

    Article  CAS  PubMed  Google Scholar 

  23. Tsilidis KK, Brancati FL, Pollak MN, et al. Metabolic syndrome components and colorectal adenoma in the CLUE II cohort. Cancer Causes Control. 2010;21:1–10.

    Article  PubMed Central  PubMed  Google Scholar 

  24. Yun KE, Chang Y, Jung HS, et al. Impact of body mass index on the risk of colorectal adenoma in a metabolically healthy population. Cancer Res. 2013;73:4020–4027.

    Article  CAS  PubMed  Google Scholar 

  25. Lieberman DA, Rex DK, Winawer SJ, et al. Guidelines for colonoscopy surveillance after screening and polypectomy: a consensus update by the US Multi-Society Task Force on Colorectal Cancer. Gastroenterology. 2012;143:844–857.

    Article  PubMed  Google Scholar 

  26. Martinez ME, Baron JA, Lieberman DA, et al. A pooled analysis of advanced colorectal neoplasia diagnoses after colonoscopic polypectomy. Gastroenterology. 2009;136:832–841.

    Article  PubMed Central  PubMed  Google Scholar 

  27. Saini SD, Kim HM, Schoenfeld P. Incidence of advanced adenomas at surveillance colonoscopy in patients with a personal history of colon adenomas: a meta-analysis and systematic review. Gastrointest Endosc. 2006;64:614–626.

    Article  PubMed  Google Scholar 

  28. Lieberman DA, Weiss DG, Harford WV, et al. Five-year colon surveillance after screening colonoscopy. Gastroenterology. 2007;133:1077–1085.

    Article  PubMed  Google Scholar 

  29. Cowey S, Hardy RW. The metabolic syndrome: A high-risk state for cancer? Am J Pathol. 2006;169:1505–1522.

    Article  PubMed Central  CAS  PubMed  Google Scholar 

  30. McKeown-Eyssen G. Epidemiology of colorectal cancer revisited: are serum triglycerides and/or plasma glucose associated with risk? Cancer Epidemiol Biomark Prev. 1994;3:687–695.

    CAS  Google Scholar 

  31. Esteve E, Ricart W, Fernandez-Real JM. Dyslipidemia and inflammation: an evolutionary conserved mechanism. Clin Nutr. 2005;24:16–31.

    Article  CAS  PubMed  Google Scholar 

  32. Hsu YC, Chiu HM, Liou JM, et al. Glycated hemoglobin A1c is superior to fasting plasma glucose as an independent risk factor for colorectal neoplasia. Cancer Causes Control. 2012;23:321–328.

    Article  PubMed  Google Scholar 

  33. Kim BJ, Kim YH, Sinn DH, et al. Clinical usefulness of glycosylated hemoglobin as a predictor of adenomatous polyps in the colorectum of middle-aged males. Cancer Causes Control. 2010;21:939–944.

    Article  PubMed  Google Scholar 

  34. Sasaki Y, Takeda H, Sato T, et al. Serum Interleukin-6, insulin, and HOMA-IR in male individuals with colorectal adenoma. Clin Cancer Res. 2012;18:392–399.

    Article  CAS  PubMed  Google Scholar 

  35. Wei EK, Ma J, Pollak MN, et al. C-peptide, insulin-like growth factor binding protein-1, glycosylated hemoglobin, and the risk of distal colorectal adenoma in women. Cancer Epidemiol Biomark Prev. 2006;15:750–755.

    Article  CAS  Google Scholar 

  36. Nishii T, Kono S, Abe H, et al. Glucose intolerance, plasma insulin levels, and colon adenomas in Japanese men. Jpn J Cancer Res. 2001;92:836–840.

    Article  CAS  PubMed  Google Scholar 

  37. Otani T, Iwasaki M, Ikeda S, et al. Serum triglycerides and colorectal adenoma in a case–control study among cancer screening examinees (Japan). Cancer Causes Control. 2006;17:1245–1252.

    Article  PubMed  Google Scholar 

  38. Sun ZJ, Huang YH, Wu JS, et al. The association of serum lipids with the histological pattern of rectosigmoid adenoma in Taiwanese adults. BMC Gastroenterol. 2011;11:54.

    Article  PubMed Central  CAS  PubMed  Google Scholar 

  39. Saydah SH, Platz EA, Rifai N, et al. Association of markers of insulin and glucose control with subsequent colorectal cancer risk. Cancer Epidemiol Biomark Prev. 2003;12:412–418.

    CAS  Google Scholar 

Download references

Conflict of interest

None.

Author information

Authors and Affiliations

  1. Department of Internal Medicine, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, 108, Pyung-Dong, Jongro-Ku, Seoul, 110-746, Korea

    Yoon Suk Jung, Jung Ho Park, Hong Joo Kim, Yong Kyun Cho, Chong Il Sohn, Woo Kyu Jeon, Byung Ik Kim, Kyuyong Choi & Dong Il Park

  2. Department of Occupational and Environmental Medicine, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Korea

    Seungho Ryu & Yoosoo Chang

  3. Center for Cohort Studies, Total Healthcare Center, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Korea

    Seungho Ryu, Yoosoo Chang & Kyung Eun Yun

Authors
  1. Yoon Suk Jung
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Seungho Ryu
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Yoosoo Chang
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Kyung Eun Yun
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Jung Ho Park
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Hong Joo Kim
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. Yong Kyun Cho
    View author publications

    You can also search for this author in PubMed Google Scholar

  8. Chong Il Sohn
    View author publications

    You can also search for this author in PubMed Google Scholar

  9. Woo Kyu Jeon
    View author publications

    You can also search for this author in PubMed Google Scholar

  10. Byung Ik Kim
    View author publications

    You can also search for this author in PubMed Google Scholar

  11. Kyuyong Choi
    View author publications

    You can also search for this author in PubMed Google Scholar

  12. Dong Il Park
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Dong Il Park.

Electronic supplementary material

Below is the link to the electronic supplementary material.

Supplementary material 1 (DOCX 22 kb)

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Jung, Y.S., Ryu, S., Chang, Y. et al. Associations Between Parameters of Glucose and Lipid Metabolism and Risk of Colorectal Neoplasm. Dig Dis Sci 60, 2996–3004 (2015). https://doi.org/10.1007/s10620-015-3713-x

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s10620-015-3713-x

Keywords

Search

Navigation