Kuang-Chun Hu1,2,3,4,5, Ming-Shiang Wu4,6, Cheng-Hsin Chu1,3, Horng-Yuan Wang1,2,3, Shee-Chan Lin1,3, Sung-Chen Liu7, Chuan-Chuan Liu2, Tung-Hung Su4,6, Chi-Ling Chen4, Chun-Jen Liu4,6, Shou-Chuan Shih1,2,3,5. 1. Division of Gastroenterology, Department of Internal Medicine, MacKay Memorial Hospital, Taipei 10449, Taiwan. 2. Health Evaluation Center, MacKay Memorial Hospital, Taipei 10449, Taiwan. 3. MacKay Medicine, Nursing and Management College, Taipei 11260, Taiwan. 4. Graduate Institute of Clinical Medicine, National Taiwan University College of Medicine, Taipei 10051, Taiwan. 5. MacKay Medical College, Taipei 25245, Taiwan. 6. Department of Internal Medicine, National Taiwan University Hospital, National Taiwan University College of Medicine, Taipei 10051, Taiwan. 7. Division of Endocrinology, Department of Internal Medicine, Diabetes Center, MacKay Memorial Hospital, Taipei 10449, Taiwan.
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.
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. pyloriinfection 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. pyloriinfection, 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. pyloriinfection and elevated HbA1c is associated with an increased risk of colon adenoma.
Authors: Mohammad Shoaib Hamrah; Mohammad Hassan Hamrah; Hideki Ishii; Susumu Suzuki; Mohammad Hussain Hamrah; Ahmad Edris Hamrah; Ahmad Elias Dahi; Kyosuke Takeshita; Mohammad Hashem Hamrah; Akbar Fotouhi; Junichi Sakamoto; Toyoaki Murohara Journal: Asian Pac J Cancer Prev Date: 2018-04-25