代谢综合征组分与结直肠腺瘤性息肉复发关系的研究

背景：研究显示一些代谢综合征（MS）组分为结直肠腺瘤性息肉的危险因素,然而关注MS组分在结直肠腺瘤性息肉复发中意义的研究尚少。目的：研究MS组分与结直肠腺瘤性息肉复发的关系。方法：纳入2003年1月～2009年1月于北京大学人民医院行内镜下结直肠息肉切除术、病理诊断为腺瘤性息肉并有2年以上复查资料的成年患者,采集其包括4项MS组分（肥胖、高血压、高血糖、血脂异常）在内的12项可疑危险因素,筛选复发相关因素,以之为自变量,以研究起点之后第1～3年期间的结肠镜复查结果为因变量,行多元logistic回归分析,计算OR值并换算为RR值。结果：共138例患者纳入研究,76例（55.1%）在研究起点之后第1～3年期间复发,4例复查时发现结直肠癌年龄、高血压病史、糖尿病病史、饮酒史和多发性腺瘤以及伴发MS组分的数量与复发相关（P〈0.05）。logistic回归分析显示MS组分（OR=2.308,P〈0.01：RR=1.342）和年龄（OR=1.040,P〈0.05;RR=1.018）为复发的独立危险因素。结论：伴发MS组分的结直肠腺瘤性息肉更易复发,提示可将MS组分纳入结直肠腺瘤性息肉治疗后复查的参考指标。

Study on Relationship between Major Components of Metabolic Syndrome and Recurrence of Colorectal Adenomatous Polyp

Background:Several studies suggested that some components of metabolic syndrome(MS) were risk factors for colorectal adenomatous polyp,however,there are few studies focusing on the significance of MS components in recurrence of colorectal adenomatous polyp.Aims:To investigate the relationship between major MS components and recurrence of colorectal adenomatous polyp.Methods:A series of adult subjects who had undergone endoscopic colorectal polypectomy from Jan.2003 to Jan.2009 at Peking University People’s Hospital and confirmed as adenomatous polyp pathologically were enrolled in this study.Those with surveillance data less than 2 years were excluded.Twelve suspected risk factors, including 4 major MS components(obesity,hypertension,hyperglycemia and dyslipidemia) were analyzed for identifying recurrence-associated factors.Taken the identified factors as independent variables,and the colonoscopic surveillance outcome 1-3 years after the defined initial point of the study as dependent variable,a multivariate logistic regression was conducted.A simple formula was used to estimate the RR for recurrence from the OR derived from logistic regression. Results:A total of 138 eligible subjects were finally enrolled in this study.The recurrence rate was 55.1%(76/138) during the surveillance interval of 1-3 years after the initial point.CRC were found in 4 patients in surveillance.Age, histories of hypertension and diabetes,alcohol drinking and multiple adenomas,as well as number of MS components were identified as recurrence-associated factors(P<0.05).Logistic regression revealed MS components(OR=2.308,P<0.01;RR= 1.342) and age(OR = 1.040,P<0.05;RR = 1.018) as independent risk factors for recurrence.Conclusions:Colorectal adenomatous polyp in patients having MS components has a high risk for recurrence,which indicates that MS components might be used as a referral in surveillance after removal of colorectal adenomatous polyp.