2017 -- Conference report inside the country
辛乃逸、陳泓裕、楊宜青、盧豐華、黃信恩、吳晉祥、張智仁：某台灣族群血壓狀態與大腸直腸息肉之相關性研究 台灣家庭醫學醫學會106年度學術研討會會刊 P101-102.
Nai-Yi Shin, Hung-Yu Chen, Yi-Ching Yang, Feng-Hua Lu, Hsin-En Huang, Jin-Shang Wu, Chih-Jen Chang: The Association between Blood Pressure Status and Colorectal Polyps in a Taiwanese Population
Background / Aims:
Colorectal cancer is the third most common cancer worldwide, especially in more developed countries. Colorectal adenomas can progress to malignant carcinoma based on the pathogenesis of adenoma-carcinoma sequence. People with metabolic syndrome may increase the risk of colorectal adenoma. However, studies showed that elevated blood pressure, one component of metabolic syndrome, was not found to be associated with colorectal adenoma, and they did not exclude subjects with medication for hypertension. Thus, this study was conducted to investigate the association of blood pressure status, including normal blood pressure, prehypertension and hypertension, with colorectal adenoma after excluding the confounding effect of anti-hypertensive agents.
A total of 8700 subjects with age 18 years or more were enrolled after excluding individuals with colorectal cancer, familial adenomatous polyposis, Peutz–Jeghers syndrome, colorectomy (not due to colorectal cancer), and anti-hypertensive medication or missing data. Hypertension was defined as blood pressure of ≥140/90 mm Hg or participants who reported a history of hypertension. Normal blood pressure was defined as blood pressure of <120/80 mm Hg without a history of hypertension. Prehypertension was defined as blood pressure of 120-139/80-89 mm Hg without a history of hypertension. We categorized colonoscopic findings into four subgroups: polyp-free, non-neoplastic polyps (including hyperplastic polyps, hamartomas, lymphoid aggregates, inflammatory polyps, xanthoma), non-advanced adenomatous polyps (including low-grade adenoma, such as tubular adenoma), and advanced adenomatous polyps (including tubulovillous adenoma, villous adenoma, high-grade dysplasia). The largest one was measured if there were two or more adenomatous polyps.
The subjects were divided into four groups, which including polyp-free (n = 6,773), non-neoplastic polyps (n = 806), non-advanced adenomatous polyps (n = 876), and advanced adenomatous polyps (n = 245). With adjustments for other variables, hypertension was positively related to non-advanced adenomatous polyps (OR: 1.40, 95% CI: 1.14–1.73) and advanced adenomatous polyps (OR: 1.93, 95% CI: 1.37–2.72). Prehypertension was associated with a higher risk of non-neoplastic polyps (OR: 1.20, 95% CI: 1.01–1.43) and non-advanced adenomatous polyps (OR: 1.42, 95% CI: 1.21–1.68), but not associated with advanced adenomatous polyps. Besides, age ≥65 years (OR: 9.87, 95% CI: 4.93–19.79), age 40–64.9 years (OR:4.42, 95% CI: 2.32–8.43), and male gender (OR:1.84, 95% CI: 1.34–2.51) were the independently associated factors of all types colon polyps. Diabetes was positively associated with non-advanced adenomatous polyps and advanced adenomatous polyps. Current smoking was significantly related to non-neoplastic polyps and regular exercise was inversely associated with non-neoplastic polyps and non-advanced adenomatous polyps. Conclusions: Hypertension was positively related to an increased risk of non-advanced and advanced adenomatous polyps, but not non-neoplastic polyps. In contrast, prehypertension was associated with a less advanced stage of colon polyps, including non-neoplastic polyps and non-advanced adenomatous polyps, but not associated with advanced adenomatous polyps.