Hyperglycemia combined Helicobacter pylori infection increases risk of synchronous colorectal adenoma and carotid artery plaque.

Kuang-Chun Hu,Chuan-Chuan Liu,Ming-Shiang Wu,Chi-Ling Chen,Tung-Hung Su,Shee-Chan Lin,Horng-Yuan Wang,Cheng-Hsin Chu,Helen L Po,Ming-Jong Bair,Chun-Jen Liu,Shou-Chuan Shih

doi:10.18632/oncotarget.22094

Kuang-Chun Hu, Chuan-Chuan Liu + Show 10 more

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https://doi.org/10.18632/oncotarget.22094

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Abstract

BackgroundCardiovascular disease and colorectal cancer have severe consequences to human health and may occur simultaneously or sequentially. Carotid artery plaque is a predictor of cardiovascular disease, and colorectal adenoma is a premalignant lesion of colorectal cancer. We investigated the core risk factors of carotid artery plaque and colorectal adenoma.ResultsIn total, 2361 subjects were enrolled. In multivariate analysis, age ≥ 60 years, male sex, BMI > 27, LDL > 130 mg/dL, HbA1c ≥ 6.5%, hs-CRP > 0.3 mg/L and H. pylori infection were independent risk factors for synchronous colorectal adenoma and carotid artery plaque formation. In the H. pylori-positive and -negative groups, the proportions and odds ratio (OR) for synchronous colon adenoma and carotid artery plaque increased with increasing HbA1c. OR for synchronous colon adenoma and carotid artery plaque was significantly higher in the participants with HbA1c levels of 5.7%–6.4% and HbA1c ≥ 6.5% than in those with normal HbA1c in the H. pylori-negative group. The OR was more significant increased for H. pylori-positive patients when HbA1c level ≥ 6.5% was 15.87 (95% CI 8.661–29.082, p < 0.0001).Materials and MethodsThe records of 4669 subjects aged > 40 years who underwent bidirectional gastrointestinal endoscopy and carotid artery ultrasound examination on the same day or within 12 months of endoscopy examination from January 2006 to December 2015 were reviewed. All subjects had a gastric biopsy specimen tested for Helicobacter pylori.ConclusionsHyperglycemia combined with H. pylori infection was an increased risk factor for synchronous colorectal adenoma and carotid artery plaque formation. Diabetes control and H. pylori eradication may be warranted in higher prevalence areas.

Highlights

Over the last several decades, patients who had coronary artery disease have been found to be at increased risk of developing colon adenoma [1, 2]
Hyperglycemia combined with H. pylori infection was an increased risk factor for synchronous colorectal adenoma and carotid artery plaque formation
According to the colonoscopy and carotid artery ultrasound examination results, we separated the participants into three groups: (a) colon adenoma combined with carotid artery plaque formation, (b) either colon adenoma or carotid artery plaque, (c) no colon adenoma and no carotid artery plaque

Summary

Introduction

Over the last several decades, patients who had coronary artery disease have been found to be at increased risk of developing colon adenoma [1, 2]. The lifetime risk of acute myocardial infarction is 30% and of stroke is 40% in Westernized countries [3, 4] These two diseases are related to arthrosclerosis and are types of cardiovascular disease (CVD). From 2000 to 2010, age-adjusted mortality decreased by 30% for heart disease and by 36% for stroke in the United States [8] These findings may have been related to more public bans on smoking and lower target levels of low-density lipoprotein cholesterol and blood pressure that contributed to improved control of risk factors over time [9]. Carotid artery plaque is a predictor of cardiovascular disease, and colorectal adenoma is a premalignant lesion of colorectal cancer. We investigated the core risk factors of carotid artery plaque and colorectal adenoma

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