Relationship between the Metabolic Syndrome and Colorectal Polyps

BACKGROUND: With increased prevalence of colorectal cancer, it is important to establish the risk factors of colorectal cancer. The prevalence of the metabolic syndrome (MS) is also increasing. Insulin resistance may play an important role in the pathogenesis of MS and colorectal polyps. The aim of this study was to assess the relationship between MS and colorectal polyps. METHODS: A total 558 subjects underwent colonoscopic examination from April 2004 to July 2005 at the health promotion center of Bundang CHA Hospital. According to the National Cholesterol Education Program (NCEP) Adult Treatment Panel III definition of MS, the waist circumference, blood pressure (BP), fasting blood glucose (FBG), triglyceride (TG) and HDL cholesterol were measured. Alcohol consumption, smoking and other confounding factors were assessed by a self-administered questionnaire. RESULTS: The incidence of MS and colorectal polyps was 16.3% and 33.0%, respectively. In subjects with polyps, the number of men, smokers and drinkers were higher than in subjects without polyps. In subjects with polyps, BP, FBG and TG were also higher than in subjects without polyps. After adjustment for possible confounding factors, MS was associated with increased risk of colorectal polyps (odds ratio, 1.74; 95% confidence interval, 0.94~3.22). MS strongly increased the risk of colorectal polyps in men (odds ratio 2.19; 95% confidence interval, 1.07~4.45), but not in women. CONCLUSION: We concluded that MS is a risk factor for colorectal polyps in asymptomatic Korean adults and this suggests that insulin resistance may play an important role in the development of colorectal polyps.

A Case of Primary Aldosteronism with Rhabdomyolysis / 대한신장학회잡지

Primary aldosteronism is a clinical syndrome of muscle weakness, hypertension and hypokalemia due to excess secretion of mineralocorticoid by the adrenal gland. In primary adlosteronism, muscle weakness is often caused by excess secretion of aldosterone, however, to our knowledge there have been no case reports rhabdomyolysis due to severe hypokalemia in domestic cases. A fifty-eight year old female who presented with myalgia was admitted into the hospital. Initial laboratory values demonstrate marked hypokalemia with elevated creatinine kinase and LDH. Also, her urine myoglobin was positive and plasma renin activity level was decreased and serum aldosterone level was increased. Owing to a high clinical suspicion of primary aldosteronism, an abdominal CT scan was performed revealing 1.6 cm sized mass in the right adrenal gland. After surgery, her blood pressure was normalized and serum potassium level was maintained to normal range without potassium replacement therapy. She is now in outpatient care under close follow-up. We report a case of a patient with paralysis of both lower extremities and myalgia, who later found to have primary aldosteronism with rhabdomyolysis due to severe hypokalemia.