Abstract
Background and aimsResting heart rate is an independent predictor of colorectal cancer (CRC) development and CRC-related mortality. However, little is known about the relationship between resting heart rate and colorectal adenoma development. We aimed to investigate this association in a population who underwent screening colonoscopy.MethodsAmong 39,021 patients who underwent both electrocardiogram and screening colonoscopy during routine health examinations at the Seoul National University Bundang Hospital, Health Promotion Center, Korea from January 2014 to July 2019, 1,344 patients had advanced adenoma. We performed 1:1 propensity score (PS) matching to establish a control group that mitigated the confounding effects of age and sex. We performed multivariate logistic regression analyses to identify the independent risk factors of advanced adenoma development.ResultsResting heart rate was significantly higher in the advanced adenoma group than in the control group. The prevalence of advanced polyp increased across the quartiles of resting heart rate. Patients with higher resting heart rates were more likely to be older, smokers, and have increased blood pressure and DM and less likely to engage in active exercises than those with lower resting heart rates. Patients with higher resting heart rates had higher serum glucose, triglyceride, hemoglobin A1C, and insulin levels and lower high-density lipoprotein cholesterol levels. Patients with resting heart rate in the highest quartile (≥71 bpm) still showed significantly increased odds ratio (OR) of advanced adenoma development (OR: 1.379, 95% confidence interval: 1.099–1.731, p = 0.006).ConclusionsHigh resting heart rate was a meaningful independent risk factor of advanced adenoma development.
Highlights
Colorectal advanced adenoma is defined as a colorectal polyp with a diameter >1 cm, or presence of 3 adenomas per patient, and/or villous component, and/or severe dysplasia, predicting an increased likelihood of malignant transformation [1]
Resting heart rate was significantly higher in the advanced adenoma group than in the control group
Patients with higher resting heart rates were more likely to be older, smokers, and have increased blood pressure and diabetes mellitus (DM) and less likely to engage in active exercises than those with lower resting heart rates
Summary
Colorectal advanced adenoma is defined as a colorectal polyp with a diameter >1 cm, or presence of 3 adenomas per patient, and/or villous component, and/or severe dysplasia, predicting an increased likelihood of malignant transformation [1]. Advanced adenoma has been regarded as a surrogate for colorectal cancer (CRC) in the adenoma-carcinoma pathway. Screening colonoscopy is recommenced for identifying and removing adenomas, advanced adenomas. The development of CRC could be prevented by identifying the risk factors for advanced adenoma and actively performing screening colonoscopy for high-risk patients. Advanced adenoma development is strongly associated with old age, male sex, family history of CRC, cigarette smoking, obesity, and hyperglycemia in the previous studies [3,4,5]. Resting heart rate is an independent predictor of colorectal cancer (CRC) development and CRC-related mortality. Little is known about the relationship between resting heart rate and colorectal adenoma development. We aimed to investigate this association in a population who underwent screening colonoscopy
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