Metabolic factors and colorectal adenoma

Background- Metabolic factors have been reported to increase the prevalence of colorectal adenomas, however, whether metabolic factors might also hasten the recurrence after removal of adenomas has't yet been discussed. In this retrospective multicenter study, we clarified the risk factors for adenoma recurrence focusing on metabolic factors. Methods- We analyzed the medical records of 43,195 patients who had undergone colonoscopy between January 2005 and December 2011 at 5 hospitals in Japan. The data of 1189 patients who had undergone removal of adenomas at the first screening colonoscopy, and then been followed up by colonoscopy 1 year and 2 years later were analyzed. Results- With multivariate analysis, the following 8 factors were identified as being associated with colorectal adenomas recurrence: body mass index(BMI), hypertension(HT), fasting blood glucose(FBG), low-density lipoprotein cholesterol(LDL-C), high-grade dysplasia, location of the largest adenoma, and the maximum size and number of the removed adenomas. We determined cutoff values for each of these 8 factors to predict the risk of adenoma recurrence. The risk of recurrence increased as the number of risk factors exceeding the cutoff values increased. When the number of risk factors was above 3(3-8), the odds ratio relative to less than 3(0-2) was 13.11 (95% CIs 9.24-18.60)Conclusions- Our findings revealed that in addition to adenoma-related factors (high-grade dysplasia, location, size, and number), several metabolic factors (BMI, HT, FBG, LDL-C) also influenced the risk of colorectal adenoma recurrence.