Synergistic effect of hyperglycemia and Helicobacter pylori infection status on colorectal adenoma risk
Journal
Journal of Clinical Endocrinology and Metabolism
Journal Volume
102
Journal Issue
8
Pages
2744-2750
Date Issued
2017
Author(s)
Hu K.-C.
Chu C.-H.
Wang H.-Y.
Lin S.-C.
Liu S.-C.
Liu C.-C.
Shih S.-C.
Abstract
Context: Both Helicobacter pylori and type 2 diabetes mellitus are possible risk factors for colon adenoma. Objective: The purpose of this study was to assess the interaction between H. pylori and hyperglycemia status on the risk of colon adenoma. Design, Setting, and Participants: This was a cross-sectional, retrospective study conducted at the MacKay Memorial Hospital, Taiwan. The study included 3943 subjects aged >40 years undergoing bidirectional gastrointestinal endoscopy on the same day between July 2006 and June 2015. All subjects had a gastric biopsy specimen tested for H. pylori. Main Outcome Measure: Colon adenoma with and without H. pylori infection at different hemoglobin A1c (HbA1c) levels. Results: The prevalence of colorectal adenomas in patients who were H. pylori-positive and H. pylori-negative was 37.3% and 27.29%, respectively. Multivariate logistic regression analysis identified male sex, age, body mass index, H. pylori infection, and HbA1c?6.5% as independent risk factors for adenoma; use of hypoglycemic agents decreased this risk. The prevalence of adenoma was increased with elevated HbA1c levels regardless of H. pylori status. The odds ratio (OR) for adenoma was 1.44 (95% confidence interval [CI], 1.20 to 1.73) if H. pylori was present or 1.68 (95% CI, 1.05 to 2.70) in patients who were H. pylori-negative but had HbA1c ?7.0%. If both conditions were present, the OR was 4.79 (95% CI, 2.92 to 7.84). A 1%increase in HbA1c was associated with an increased prevalence of adenoma by 42.4% in H. pylori-positive subjects. Conclusions: The combination of H. pylori infection and elevated HbA1c is associated with an increased risk of colon adenoma. ? Copyright 2017 Endocrine Society.
SDGs
Other Subjects
hemoglobin A1c; antidiabetic agent; glycosylated hemoglobin; hemoglobin A1c protein, human; adult; age distribution; Article; body mass; cancer incidence; cancer risk; colon polyp; colonoscopy; colorectal adenoma; controlled study; cross-sectional study; disease association; female; first-degree relative; gastrointestinal endoscopy; Helicobacter infection; hemoglobin blood level; human; human tissue; hyperglycemia; major clinical study; male; polypectomy; prevalence; priority journal; retrospective study; sex difference; smoking; stomach biopsy; Taiwan; adenoma; Colorectal Neoplasms; Diabetes Mellitus, Type 2; Helicobacter Infections; Helicobacter pylori; hyperglycemia; metabolism; middle aged; multivariate analysis; odds ratio; Overweight; risk factor; statistical model; Adenoma; Adult; Body Mass Index; Colorectal Neoplasms; Cross-Sectional Studies; Diabetes Mellitus, Type 2; Endoscopy, Gastrointestinal; Female; Helicobacter Infections; Helicobacter pylori; Hemoglobin A, Glycosylated; Humans; Hyperglycemia; Hypoglycemic Agents; Logistic Models; Male; Middle Aged; Multivariate Analysis; Odds Ratio; Overweight; Prevalence; Retrospective Studies; Risk Factors; Sex Factors; Taiwan
Publisher
Oxford University Press
Type
journal article