Parameters of Glucose and Lipid Metabolism Affect the Occurrence of Colorectal Adenomas Detected by Surveillance Colonoscopies.

PURPOSE: Limited data are available regarding the associations between parameters of glucose and lipid metabolism and the occurrence of metachronous adenomas. We investigated whether these parameters affect the occurrence of adenomas detected on surveillance colonoscopy. MATERIALS AND METHODS: This longitudinal study was performed on 5289 subjects who underwent follow-up colonoscopy between 2012 and 2013 among 62171 asymptomatic subjects who underwent an initial colonoscopy for a health check-up between 2010 and 2011. The risk of adenoma occurrence was assessed using Cox proportional hazards modeling. RESULTS: The mean interval between the initial and follow-up colonoscopy was 2.2±0.6 years. The occurrence of adenomas detected by the follow-up colonoscopy increased linearly with the increasing quartiles of fasting glucose, hemoglobin A1c (HbA1c), insulin, homeostasis model assessment of insulin resistance (HOMA-IR), and triglycerides measured at the initial colonoscopy. These associations persisted after adjusting for confounding factors. The adjusted hazard ratios for adenoma occurrence comparing the fourth with the first quartiles of fasting glucose, HbA1c, insulin, HOMA-IR, and triglycerides were 1.50 [95% confidence interval (CI), 1.26-1.77; p(trend)<0.001], 1.22 (95% CI, 1.04-1.43; p(trend)=0.024), 1.22 (95% CI, 1.02-1.46; p(trend)=0.046), 1.36 (95% CI, 1.14-1.63; p(trend)=0.004), and 1.19 (95% CI, 0.99-1.42; p(trend)=0.041), respectively. In addition, increasing quartiles of low-density lipoprotein-cholesterol and apolipoprotein B were associated with an increasing occurrence of adenomas. CONCLUSION: The levels of parameters of glucose and lipid metabolism were significantly associated with the occurrence of adenomas detected on surveillance colonoscopy. Improving the parameters of glucose and lipid metabolism through lifestyle changes or medications may be helpful in preventing metachronous adenomas.

Plasma CRP, apolipoprotein A-1, apolipoprotein B and Lpa levels according to thyroid function status.

BACKGROUND: Altered lipid profile is a well-known manifestation of thyroid dysfunction. Recently, serum Lp(a) and C-reactive protein (CRP) have emerged as new cardiovascular risk factors, but studies on changes of these markers with respect to thyroid function status have produced variable results. To better understand the effects of thyroid dysfunction on the development of atherosclerosis, we investigated plasma CRP and lipid profiles such as apoA1, apoB, and Lp(a) in cases with differing severities of thyroid dysfunction. METHODS: Fifty four patients with hyperthyroidism, 35 patients with subclinical hyperthyroidism, 33 patients with overt hypothyroidism, 190 patients with subclinical hypothyroidism and 100 age- and sex-matched healthy control subjects were evaluated. Serum high sensitivity (hs)-CRP and Lp(a) were measured by immunonephelometry. RESULTS: No significant differences were found in serum hs-CRP, Lp(a), HDL-C or ApoA1 in different thyroid function groups. Serum total cholesterol and LDL-C levels were significantly lower in cases of hyperthyroidism than in cases of overt hypothyroidism, subclinical hypothyroidism or subclinical hyperthyroidism, or in healthy control subjects (p <0.01). Serum triglyceride levels were higher in overt hypothyroidism than in hyperthyroidism or healthy controls (p <0.05). Serum apoB levels were significantly lower in hyperthyroidism than in overt hypothyroidism, subclinical hypothyroidism or in healthy control subjects (p <0.01). These differences were consistently significant after adjustment for age and BMI. CONCLUSIONS: Serum CRP and Lp(a) levels, risk factors for atherosclerosis, were not found to be significantly affected by the degree of thyroid dysfunction. Increased risk of atherosclerosis in hypothyroidism does not appear to be associated with non-traditional cardiovascular risk factors, such as serum CRP, Lp(a) or apoA1 levels.

High sensitivity C-reactive protein as an independent risk factor for essential hypertension.

BACKGROUND: C-reactive protein (CRP), one of the hepatic acute phase reactants, has been associated with decreased endothelium-dependent relaxation, a potential risk factor for hypertension. However, the relationship between CRP and hypertension has not been well elucidated. The aim of this study is to assess whether circulating levels of CRP are independently related to essential hypertension. METHODS: We evaluated the relationship between high sensitivity CRP with blood pressure (BP) and several cardiovascular risk factors in a cross-sectional survey of 8347 apparently healthy Korean persons. The CRP was measured by nephelometry. RESULTS: The subjects consisted of 4813 men and 3534 women, aged >/=20 years. Mean (SD) age and CRP level of the population were 47.1 (11.5) years and 1.12 (1.72) mg/L. Overall hypertension prevalence was 34%. There was a significant positive association between BP and the CRP level (P <.0001). After adjustment for age, sex, fasting blood sugar, triglyceride, low-density lipoprotein, body mass index, waist-hip ratio, high-density lipoprotein, the prevalence of hypertension by CRP was 1.267 (95% confidence interval [CI] 1.079-1.487, P =.004), 1.253 (95% CI 1.062-1.477, P =.007), and 1.451 (95% CI 1.231-1.711, P <.001) times higher in subjects in the second, third, and fourth quartiles of CRP, as compared to subjects in the first quartile. CONCLUSIONS: Our results suggest that the CRP level may be an independent risk factor for the development of hypertension in Korean persons. However, because of the cross-sectional nature of our study, this finding should be confirmed in prospective cohort studies, aimed at elucidating the role of CRP in the prediction, diagnosis, and management of hypertension.

Circulating IL-8 and IL-10 in euthyroid sick syndromes following bone marrow transplantation.

It is generally agreed that euthyroid sick syndromes (ESS) are associated with an increased production of cytokines. However, there has been scarce data on the relationship thyroid hormone changes and cytokines among the patients undergoing bone marrow transplantation (BMT). Because interleukin-8 (IL-8) has been identified as a potent proinflammatory and interleukin-10 (IL-10) as an antiinflammatory cytokine, we studied the relation between thyroid hormone parameters and these cytokines following BMT. We studied 80 patients undergoing allogeneic BMT. Serum T3 decreased to nadir at post-BMT 3 weeks. Serum T4 was the lowest at the post-BMT 3 months. Serum TSH sharply decreased to nadir at 1 week and gradually recovered. Serum free T4 significantly increased during 3 weeks and then returned to basal level. Mean levels of serum IL-8 significantly increased at 1 week after BMT. Mean levels of serum IL-10 significantly increased until 4 weeks after BMT. No significant correlation was found between serum thyroid hormone parameters and cytokines (IL-8, IL-10) after adjusting steroid doses during the entire study period. In conclusion, ESS developed frequently following allogeneic BMT and cytokine levels were increased in post-BMT patients. However, no significant correlation was found between serum thyroid hormone parameters and these cytokines.