title: Glycated hemoglobin A1c is superior to fasting plasma glucose as an independent risk factor for colorectal neoplasia.
abstract: OBJECTIVE
  To investigate which glycemic index is more strongly associated with colorectal neoplasia.
  
  
  METHODS
  This cross-sectional study enrolled 2,776 participants in a comprehensive health management program which included measurement of fasting plasma glucose and HbA1c, along with screening colonoscopy. Primary outcome was colorectal adenoma with or without dysplasia. Risk factors for colorectal neoplasia were determined by the multivariate regression analysis, which evaluated the interrelationship among different glycemic indices in a hierarchical way.
  
  
  RESULTS
  Colorectal neoplasms were found in 605 (21.79%) examinees, 68 (2.45%) of whom had high-risk tumors. Glycemic indices including diagnosis of diabetes mellitus, fasting plasma glucose, and HbA1c were all associated with colorectal tumors in the univariate analysis. However, HbA1c outperformed the other two markers as an independent risk factor (adjusted odds ratio, 1.22; 95% confidence interval, 1.10-1.36%) for colorectal neoplasia. Moreover, only HbA1c remained independently associated with colorectal tumor after patients with established diagnosis of diabetes (n = 132) were excluded. We also identified age, male gender, and smoking were independent risk factors for colorectal neoplasia.
  
  
  CONCLUSIONS
  HbA1c as compared with fasting plasma glucose is more strongly and independently associated with colorectal neoplasia. Further research is warranted to elucidate the value of HbA1c in stratifying risk of colorectal cancer.
authors: Department of Internal Medicine, E-Da Hospital, I-Shou University, Kaohsiung, Taiwan.
authors: Yao-Chun
authors: YC
authors: Hsu
authors: Han-Mo
authors: HM
authors: Chiu
authors: Jyh-Ming
authors: JM
authors: Liou
authors: Chun-Chao
authors: CC
authors: Chang
authors: Jaw-Town
authors: JT
authors: Lin
authors: Hui-Hsiung
authors: HH
authors: Liu
authors: Ming-Shiang
authors: MS
authors: Wu
mesh_terms: D000236:Adenoma / Q000097:blood / Q000175:diagnosis / Q000378:metabolism; D000328:Adult; D001786:Blood Glucose / Q000378:metabolism*; D003113:Colonoscopy / Q000379:methods; D015179:Colorectal Neoplasms / Q000097:blood* / Q000175:diagnosis* / Q000378:metabolism; D003430:Cross-Sectional Studies; D003920:Diabetes Mellitus / Q000097:blood / Q000175:diagnosis; D005215:Fasting / Q000097:blood*; D005260:Female; D006442:Glycated Hemoglobin / Q000378:metabolism*; D038321:Glycemic Index; D006801:Humans; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D012307:Risk Factors
chemical_list: D001786:Blood Glucose; D006442:Glycated Hemoglobin; C517652:hemoglobin A1c protein, human