title: Plasma lipid levels and colorectal adenoma risk.
abstract: OBJECTIVE
  Abnormalities in lipid levels have been associated with colorectal neoplasm risk; however, few studies have adjusted for use of cholesterol-lowering medications. The objective of this study was to determine the association of plasma lipid levels with adenoma risk while accounting for statin medication use.
  
  
  METHODS
  We included 254 subjects with advanced adenoma, 246 with single small adenoma, 179 with multiple small adenoma cases, and 403 control participants in the Tennessee Colorectal Polyp Study who also had plasma lipid measurements performed. Data on the use of statin medications were available for 83.4% of these participants. The association between plasma lipids and adenoma risk was evaluated using logistic regression models.
  
  
  RESULTS
  Participants in the highest quartile of HDL cholesterol (range 52-106 mg/dl) had an adjusted odds ratio of 0.49 (95% CI 0.23, 1.07), 0.35 (95% CI 0.13, 0.91), and 0.22 (95% CI 0.09, 0.54) for single small, multiple small, and advanced adenomas compared to the lowest quartile (range 12-34 mg/dl), respectively. Participants with the highest quartile of triglyceride levels (range 178-721 mg/dl) had an adjusted odds ratio of 2.40 (95% CI 1.26, 4.55), 1.67 (95% CI 0.66, 4.23), and 2.79 (95% CI 1.25, 6.23) for single small, multiple small, and advanced adenoma, respectively, compared to the lowest quartile (range 40-84 mg/dl). When restricted to individuals with known statin medication use, adjusting for statin use did not appreciably affect these results.
  
  
  CONCLUSIONS
  We found a direct association between triglyceride plasma levels and an inverse association between plasma HDL cholesterol levels and adenoma risk. Both effects were not appreciably changed when accounting for the regular use of statin medication.
authors.affiliation: Florida State University College of Medicine, Tallahassee, FL, USA.
authors.forename: John-Anthony
authors.initials: JA
authors.lastname: Coppola
authors.forename: Martha J
authors.initials: MJ
authors.lastname: Shrubsole
authors.forename: Qiuyin
authors.initials: Q
authors.lastname: Cai
authors.forename: Walter E
authors.initials: WE
authors.lastname: Smalley
authors.forename: Qi
authors.initials: Q
authors.lastname: Dai
authors.forename: Reid M
authors.initials: RM
authors.lastname: Ness
authors.forename: Sergio
authors.initials: S
authors.lastname: Fazio
authors.forename: Wei
authors.initials: W
authors.lastname: Zheng
authors.forename: Harvey J
authors.initials: HJ
authors.lastname: Murff
mesh_terms: D000236:Adenoma / Q000097:blood* / Q000453:epidemiology; D000368:Aged; D008076:Cholesterol, HDL / Q000097:blood*; D015179:Colorectal Neoplasms / Q000097:blood* / Q000453:epidemiology; D005260:Female; D006801:Humans; D008055:Lipids / Q000097:blood*; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D016017:Odds Ratio; D013714:Tennessee / Q000453:epidemiology
chemical_list: D008076:Cholesterol, HDL; D008055:Lipids