title: Association of type 2 diabetes and colon adenomas.
abstract: BACKGROUND
  Type 2 diabetes mellitus (DM) is associated with hyperinsulinemia, which may lead to increased risk of carcinogenesis by increasing insulin-like growth factor-1 level. In this study, we sought to determine the association between type 2 DM and colon adenomas.
  
  
  METHODS
  In this retrospective case-control study, all the colonoscopies performed in an urban medical center during a 3-year period were reviewed. Patients with adenomatous polyps were considered as cases (n = 261). Age- and sex-matched controls with a 2:1 ratio were selected (n = 522). Among diabetic subjects, the association of different anti-diabetic medications and HbA1C level with high-risk adenoma features was analyzed.
  
  
  RESULTS
  Type 2 DM was significantly associated with colon adenomas (odds ratio (OR) = 1.45, 95% confidence interval (CI) = 1.05-2.01, p = 0.024). Exposure to insulin (OR = 1.734, 95% CI = 1.13-2.65, p = 0.013) and thiazolidinediones (OR = 2.83, 95% CI = 1.28-6.26, p = 0.01) was associated with developing adenomas. Neither the type of antidiabetic medication nor the level of HbA1C was a predictor for high-risk adenomas. Smoking (OR = 1.47, 95% CI = 1.07-2.02, p = 0.02), use of aspirin (OR = 1.59, 95% CI = 1.15-2.20, p = 0.005), and statins (OR = 1.54, 95% CI = 1.13-2.10, p = 0.007) appeared to increase the risk of adenomas.
  
  
  CONCLUSIONS
  This study shows a significant association between type 2 DM and colon adenomas. Establishing this association may lead to inclusion of diabetic patients in the high-risk group for developing colorectal cancer.
authors: Division of Gastroenterology, Seton Hall University School of Health and Medical Sciences, South Orange, NJ, USA. rodney_eddi@yahoo.com
authors: Rodney
authors: R
authors: Eddi
authors: Arya
authors: A
authors: Karki
authors: Anish
authors: A
authors: Shah
authors: Vincent A
authors: VA
authors: DeBari
authors: Joseph R
authors: JR
authors: DePasquale
mesh_terms: D000236:Adenoma / Q000209:etiology*; D000368:Aged; D016022:Case-Control Studies; D003110:Colonic Neoplasms / Q000209:etiology*; D003924:Diabetes Mellitus, Type 2 / Q000150:complications*; D005260:Female; D006442:Glycated Hemoglobin / Q000032:analysis; D006801:Humans; D007004:Hypoglycemic Agents / Q000009:adverse effects; D007328:Insulin / Q000009:adverse effects; D008297:Male; D012189:Retrospective Studies
chemical_list: D006442:Glycated Hemoglobin; D007004:Hypoglycemic Agents; D007328:Insulin; C517652:hemoglobin A1c protein, human