2型糖尿病患者合并结直肠息肉的危险因素分析

Risk Factors of Colorectal Polyps in Patients with Type 2 Diabetes Mellitus

目的:分析2型糖尿病(T2DM)患者合并结直肠息肉的危险因素。方法:选择经肠镜检查确诊为结直肠息肉的患者192例,其中合并T2DM的患者96例,比较有无T2DM患者(T2DM组和对照组)的性别、年龄、体重指数(BMI)、空腹血糖(FBG)、血脂、合并症以及肠息肉发生的部位、数量和病理类型等特点,采用Logistic回归分析法探索可能影响结直肠息肉病理类型的危险因素。结果:肠息肉患者中男性比例偏高。同对照组相比,T2DM组患者平均年龄和合并高脂血症、高血压病、冠心病的比例偏高(P<0.05或P<0.01),BMI、FBG、甘油三酯(TG)和低密度脂蛋白胆固醇(LDL-C)水平均也明显升高(P<0.05或P<0.01)。T2DM组患者结肠和直肠同时检出息肉的比例明显高于对照组,单纯结肠息肉的检出率明显低于对照组,差异有统计学意义(P<0.05);且T2DM组患者多发性息肉比例高于对照组(P<0.05),腺瘤性息肉的比例亦明显高于对照组(P<0.05)。二元Logistic回归分析结果显示,年龄>65岁、FBG、高血压病和T2DM病程可能是结直肠息肉的危险因素。结论:T2DM可能与结直肠息肉关系密切,对于T2DM病史较长的老年患者,当长期空腹血糖控制不佳,且合并有高血压病等危险因素时,腺瘤性息肉发生风险可能会增加,该类患者应加强肠镜筛查以期早发现、早治疗,避免病情进展。

Objective:To analyze the risk factors of colorectal polyps in type 2 diabetes mellitus(T2DM)patients.Methods:A total of 192 patients with colorectal polyps diagnosed by enteroscopy were selected,including 96 patients with T2DM.The characteristics of gender,age,body mass index(BMI),fasting blood glucose(FBG),blood lipid,complications,and the location,quantity and pathological type of intestinal polyps in patients with or without T2DM(T2DM group or control group)were compared,Logistic regression analysis was used to explore the risk factors that may affect the pathological types of colorectal polyps.Results:The proportion of male patients with intestinal polyp was higher.Compared with the control group,the average age and the proportion of hyperlipidemia,hypertension and coronary heart disease in T2DM group were higher(P<0.05 or P<0.01),and the levels of BMI,FBG,triglyceride(TG)and low density lipoprotein cholesterol(LDL-C)were also significantly higher(P<0.05 or P<0.01).The detection rate of colorectum polyp in T2DM group was significantly higher than that in the control group,and the detection rate of simple colon polyps was significantly lower than that in control group(P<0.05).The proportion of multiple polyps in T2DM group was higher than that in control group(P<0.05),and the proportion of adenomatous polyps was also significantly higher than that in control group(P<0.05).Binary Logistic regression analysis showed that age>65 years old,FBG,hypertension and the course of T2DM may be the risk factors of colorectal polyps.Conclusion:T2DM may be closely related to colorectal polyps.For elderly patients with a long history of T2DM,the risk of adenomatous polyps may increase when long-term fasting blood glucose control is poor and the risk factors such as hypertension are combined.Colonoscopy screening should be strengthened for such patients in order to detect and treat early,so as to avoid the disease progression.