Clinicopathological Characteristics of Colorectal Adenoma in Type 2 Diabetes Mellitus and Risk Factors for Advanced Adenoma / 胃肠病学

ABSTRACT

Background: Colorectal adenoma is the precursor lesion of colorectal cancer, and diabetes mellitus is associated with an increased risk for colorectal cancer. Aims: To investigate the clinicopathological characteristics of colorectal adenoma in patients with type 2 diabetes mellitus (T2DM) and the risk factors for advanced adenoma. Methods: Seven hundred and eighty T2DM patients who underwent initial colonoscopy from January 2018 to December 2020 at the Second Affiliated Hospital of Zhejiang Chinese Medical University were enrolled retrospectively, including 227 patients with colorectal adenoma and 553 patients without colorectal polyps. Furthermore, 227 non-diabetic patients with colorectal adenoma who were 1:1 matched to T2DM-adenoma group for gender, age, body mass index (BMI) and smoking history were collected for a comparison study. The clinical and pathological characteristics of T2DM patients with colorectal adenoma were analyzed, and the risk factors for advanced adenoma were identified by univariate and multivariate analyses. Results: T2DM patients with colorectal adenoma were older than those without colorectal polyps, and male gender, tobacco smoking, and cholelithiasis/cholecystectomy were more frequently seen in T2DM-adenoma group (all P<0.05). The proportions of multiple adenomas and advanced adenoma in T2DM-adenoma group were greater than those in patients without T2DM (16.7% vs. 10.1%, and 21.6% vs. 14.1%, all P<0.05). Multivariate Logistic regression analysis identified that male gender (OR=1.299, 95% CI: 1.041-1.831, P=0.008), age (OR=1.129, 95% CI: 1.001-1.421, P=0.025), BMI (OR=1.118, 95% CI: 1.022-1.715, P=0.038) and T2DM (OR=1.408, 95% CI: 1.141-1.721, P=0.010) were the independent risk factors for advanced adenoma. Conclusions: Multiple colorectal adenomas and advanced adenoma are more likely to be detected in patients with T2DM. Male gender, age, BMI and T2DM are associated with the risk of advanced adenoma.