title: Metabolic factors accelerate colorectal adenoma recurrence.
abstract: BACKGROUND
  Metabolic factors have been reported to increase the prevalence of colorectal adenomas, however, whether metabolic factors might also accelerate the recurrence after removal of adenomas has not yet been discussed. In this retrospective multicenter study, we clarified the risk factors for adenoma recurrence focusing on metabolic factors.
  
  
  METHODS
  We analyzed the medical records of 43,195 patients who had undergone colonoscopy between January 2005 and December 2011 at 5 hospitals in Japan. Of these, the data of 1111 patients who had undergone removal of adenomas at the first screening colonoscopy, and then been followed up by colonoscopy 1 year and 2 years later were analyzed.
  
  
  RESULTS
  The following 8 factors were demonstrated with a multivariate analysis as being associated with colorectal adenomas recurrence: for adenoma-related factors, 5 factors (villous features, grade of dysplasia, location and size of the largest removed adenoma, and number of the removed adenomas) were identified; for metabolic factors and other factors, 3 factors (age, body mass index (BMI), and fasting blood glucose (FBG)) were identified. A risk score (0-10 points) was developed based on these 8 factors. The risk of adenoma recurrence increased as the risk score increased. When the risk score was ≥3 (3-10) points, the odds ratio relative to <3 (0-2) points was 7.07 (95% CIs 5.30-9.43).
  
  
  CONCLUSIONS
  In addition to adenoma-related factors (villous features, grade of dysplasia, location, size and number), 3 factors (age, BMI and FBG) were demonstrated to influence the recurrence rate of colorectal adenoma. When the risk score was ≥3, the risk of recurrence was significantly elevated.
authors.forename: Leo
authors.initials: L
authors.lastname: Taniguchi
authors.forename: Takuma
authors.initials: T
authors.lastname: Higurashi
authors.forename: Takashi
authors.initials: T
authors.lastname: Uchiyama
authors.forename: Yoshinobu
authors.initials: Y
authors.lastname: Kondo
authors.forename: Eri
authors.initials: E
authors.lastname: Uchida
authors.forename: Shiori
authors.initials: S
authors.lastname: Uchiyama
authors.forename: Fumitake
authors.initials: F
authors.lastname: Jono
authors.forename: Jun
authors.initials: J
authors.lastname: Hamanaka
authors.forename: Hitoshi
authors.initials: H
authors.lastname: Kuriyama
authors.forename: Yasuo
authors.initials: Y
authors.lastname: Hata
authors.forename: Hiroki
authors.initials: H
authors.lastname: Endo
authors.forename: Hirokazu
authors.initials: H
authors.lastname: Takahashi
authors.forename: Hajime
authors.initials: H
authors.lastname: Nagase
authors.forename: Nobuyuki
authors.initials: N
authors.lastname: Matsuhashi
authors.affiliation: Division of Gastroenterology, Yokohama City University School of Medicine, 3-9 Fukuura, Kanazawa-ku, 236-0004 Yokohama, Kanagawa, Japan. nakajima-tky@umin.ac.jp.
authors.forename: Atsushi
authors.initials: A
authors.lastname: Nakajima
mesh_terms: D000236:Adenoma / Q000378:metabolism* / Q000473:pathology*; D000367:Age Factors; D000368:Aged; D001786:Blood Glucose / Q000378:metabolism; D015992:Body Mass Index; D003113:Colonoscopy; D015179:Colorectal Neoplasms / Q000378:metabolism* / Q000473:pathology*; D005260:Female; D006801:Humans; D050152:Intra-Abdominal Fat / Q000378:metabolism; D008297:Male; D009364:Neoplasm Recurrence, Local; D012189:Retrospective Studies; D012307:Risk Factors
chemical_list: D001786:Blood Glucose