摘要
目的 探讨结肠腺瘤发生的危险因素及其与糖尿病的相关性分析.方法 回顾性分析2018年5月至2021年8月首都医科大学附属北京友谊医院平谷医院收治的205例接受结肠镜检查的受试者临床资料.经结肠镜检查确诊为结肠腺瘤共86例,设为结肠腺瘤组,另119例阴性受检者设为非结肠腺瘤组.采用二元Logistic回归模型分析结肠腺瘤发生的危险因素;并根据有无合并糖尿病将结肠腺瘤组分为合并糖尿病组(n=55)和非糖尿病组(n=31),对比合并糖尿病组和非糖尿病组的病理类型、腺瘤最大径、高级别上皮内瘤变占比.采用二元或多因素Logistic回归模型分析病理特征与糖尿病的关系.结果 结肠腺瘤组与非结肠腺瘤组受试者性别、高血压史比较,差异均无统计学意义(P＞0.05),年龄、体重指数、吸烟史、饮酒史、糖尿病史、胃肠道息肉/肿瘤家族史、高胆固醇血症、代谢综合征比较,差异均有统计学意义(P＜0.05).二元Logistic回归分析显示,年龄＞50岁、体重指数＞28 kg/m2、吸烟、饮酒或已戒酒、糖尿病史、胃肠道息肉/肿瘤家族史、伴有高胆固醇血症及代谢综合征为影响结肠腺瘤发生的独立危险因素(P＜0.05).合并糖尿病组病理类型中含绒毛拮构的腺瘤占比、瘤最大径中＞10 mm占比、高级别上皮内瘤变占比均高于非糖尿病组,差异均有统计学意义(P＜0.05).多因素Logistic回归分析显示,合并糖尿病是影响结肠腺瘤病理类型、结肠腺瘤最大径的危险因素(P＜0.05),二元Logistic回归分析显示,合并糖尿病是促进结肠腺瘤增生的危险因素(P＜0.05).结论 年龄、体重指数、吸烟、饮酒或已戒酒、糖尿病史、胃肠道息肉/肿瘤家族史、伴有高胆固醇血症及代谢综合征为影响结肠腺瘤发生的危险因素,且糖尿病在一定程度上促进了结肠腺瘤的发生、发展.
Abstract
Objective To explore the risk factors of colon adenoma and its correlation with diabetes mellitus.Methods The clinical data of 205 subjects who underwent colonoscopy in Beijing Friendship Hospital Pinggu Hospital,Capital Medical University from May 2018 to August 2021 were retrospectively analyzed.A total of 86 cases were diagnosed as colorectal adenoma by colonoscopy,which was established as the colorec-tal adenoma group,and the other 119 negative subjects were set up as the non-colorectal adenoma group,and the binary Logistic regression model was used to analyze the risk factors of colorectal adenoma;and according to the presence or absence of diabetes mellitus,the colorectal adenoma group was divided into the diabetic group(n=55)and the non-diabetic group(n=31),the pathological type,the maximum diameter of ade-noma,and the high-grade intraepithelial neoplasia between the diabetic group and the non-diabetic group were compared,the relationship be-tween pathological characteristics and diabetes mellitus was analyzed using binary or multivariate Logistic regression model.Results There were no statistically significant differences between the colorectal adenoma group and the non-colorectal adenoma group in gender and history of hyper-tension(P＞0.05),there were statistically significant differences on age,body mass index,smoking history,drinking history,diabetes mellitus history,gastrointestinal polyp/tumor family history,in the comparison of hypercholesterolemia and metabolic syndromet(P＜0.05).Binary Logistic regression analysis showed that age＞50 years old,body mass index＞28 kg/m2,smoking,drinking or abstaining from alcohol,history of diabetes mellitus,family history of gastrointestinal polyps/tumor,associated with hypercholesterolemia and metabolic syndrome were the independ-ent risk factors for the occurrence of colorectal adenoma(P＜0.05).The proportion of pathological types of combined diabetes mellitus group of adenoma with villous structure,the proportion of tumor larger than 10 mm in the largest diameter,and the proportion of high-grade intraepithelial neoplasia in hyperplasia were higher than those in the non-diabetic group,the differences were statistically significant(P＜0.05).Multivariate Logistic regression analysis showed that diabetes mellitus was a risk factor that affected the pathological type of colorectal adenoma and the maxi-mum diameter of colorectal adenoma(P＜0.05).Binary Logistic regression analysis showed that diabetes mellitus was a risk factor that promoted colorectal adenoma proliferation(P＜0.05).Conclusion Age,body mass index,smoking,drinking or abstaining from alcohol,history of dia-betes mellitus,family history of gastrointestinal polyps/tumors,associated with hypercholesterolemia and metabolic syndrome are the risk factors for the occurrence of colorectal adenoma,and diabetes mellitus promotes the occurrence and development of colonic adenoma to a certain extent.
维普
万方数据