A Retrospective Look at The Relationship Between Metabolic Factors, Obesity, and Colorectal Adenomas in a Racially Diverse Community Hospital

Abstract

Purpose: The objective of this retrospective study is to examine the relationship between the prevalence of colonic adenomas and BMI and/or metabolic factors among our racially diverse population. Methods: After excluding patients with colon cancer, inflammatory bowel disease, family history of GI malignancy, we randomly reviewed the charts of a total of 779 patients who underwent screening colonoscopies from 2009 to 2011. Statistical analyses were preformed using Chi-Square for categorical variables and a t-test for continuous variables; and age-, gender- and race-adjusted odds ratios and their 95% confidence intervals (CIs) between BMI, metabolic disorders, smoking and alcohol with the presence of colonic adenomas were estimated using unconditional logistic regression models. Results: Colorectal adenomas were detected in 167 out of 779 (21.4%) patients undergoing screening colonoscopies. The predominant race in our patient population undergoing screening colonoscopies in respective order: hispanic (334), black (272), white (107), and other (58) (p<0.05) Black race represented the greatest percentage of patients found to have adenomatous polyps (40.2%), whereas the hispanic population was found to represent the greatest number in the non-adenomatous group (46.2%) (p<0.05). when comparing BMI groups 1 & 2, 2 & 3, and 1 & 3, no statistical significance was found between adenomas and increased BMI 1.41(95% CI, 0.84-2.39; p>0.05), 0.96(95% CI, 0.65-1.41; p>0.05), and 1.35(95% CI, 0.80-2.29; p>0.05) respectively. Metabolic factors (diabetes, hypertension, and dyslipidemia) failed to show any statistical significant correlation with adenoma presence 0.68(95% CI, 0.43-1.07;p>0.05) in those diagnosed with diabetes, 1.09(95% CI, 0.75-1.58; p>0.05) in hypertension, and 0.88(95% CI, 0.61-1.29; p>0.05) with dyslipidemia. Hispanics were found to have a less likelihood of having adenoma present on screening colonoscopy 0.52(95% CI, 0.31-0.88; p<0.05). There was no significant statistical difference between black and whites 0.75(CI 95%, 0.45-1.25; p>0.05), or other race compared to whites 0.62(CI 95%, 0.28-1.38; p>0.05). Smoking compared did appear to be correlated with colorectal adenoma 1.57(95% CI, 1.02-2.43; p<0.05). Conclusion: In our population we found evidence that BMI is not a risk factor for colonic adenoma. We also concluded that diabetes, dyslipidemia, and hypertension showed no statistical correlation with incidence of colorectal adenoma. We did not find either dose-response effect or association of individual components of metabolic factors. Our study did find an association between the risk of smoking and adenomas. When looking at race the Hispanics showed a lower incidence of colorectal adenoma presence than white population.Table: [531] Individual associations between metabolic factors, environmental factors and adenomaTable: [531] Association between prevalence of adenoma versus metabolic factors in Screening Colonoscopies