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中华胃肠内镜电子杂志

中华胃肠内镜电子杂志 ›› 2024, Vol. 11 ›› Issue (03) : 186 -190. doi: 10.3877/cma.j.issn.2095-7157.2024.03.009

论著

老年人结直肠腺瘤与血脂及非酒精性脂肪肝的相关性研究
李娟1,†(), 廖江涛1, 吴聃1   
  1. 1. 410016　长沙，湖南省人民医院(湖南师范大学附属第一医院)消化内科
  • 收稿日期:2024-05-28 出版日期:2024-08-15
  • 通信作者: 李娟
  • 基金资助:
    长沙市2017年指导性科技计划项目(ZD1702030)

Correlation of colorectal adenomas in the elderly with serum lipids and non-alcoholic fatty liver disease

Juan Li1,†(), Jiangtao Liao1, Dan Wu1   

  1. 1. Department of Gastroenterology, Hunan Provincial People′s Hospital(The First Affiliated Hospital of Hunan Normal University), Changsha 410016, China
  • Received:2024-05-28 Published:2024-08-15
  • Corresponding author: Juan Li
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李娟, 廖江涛, 吴聃. 老年人结直肠腺瘤与血脂及非酒精性脂肪肝的相关性研究[J]. 中华胃肠内镜电子杂志, 2024, 11(03): 186-190.

Juan Li, Jiangtao Liao, Dan Wu. Correlation of colorectal adenomas in the elderly with serum lipids and non-alcoholic fatty liver disease[J]. Chinese Journal of Gastrointestinal Endoscopy(Electronic Edition), 2024, 11(03): 186-190.

目的

分析老年人结直肠腺瘤与血脂水平及非酒精性脂肪肝(NAFLD)的关系，为筛查及预防结直肠腺瘤提供依据。

方法

选取2019年6月至2022年12月湖南省人民医院(湖南师范大学附属第一医院)消化内科内镜中心行结肠镜检查的老年患者(年龄≥65岁)，结肠镜结合病理诊断，结直肠腺瘤患者为试验组，未见结直肠腺瘤为对照组。试验组109例，男54例、女55例；对照组111例，男49例、女62例。对比两组患者在血清总胆固醇(TC)、低密度脂蛋白(LDL)、高密度脂蛋白(HDL)、甘油三酯(TG)、空腹血糖水平以及是否患有NAFLD有无统计学差异。

结果

试验组(109例)，TC、LDL、TG、空腹血糖水平均较高于对照组(111例)，存在统计学差异(P<0.05)。试验组NAFLD患者39例，对照组NAFLD患者共12例，试验组患有NAFLD者比例较高于对照组，存在统计学差异(P<0.05)。

结论

高总胆固醇水平、高空腹血糖水平以及患有NAFLD可能为老年人患结直肠腺瘤的高风险因素。

关键词: 结直肠腺瘤, 血脂, 非酒精性脂肪肝
Objective

This study analyze the correlation between colorectal adenomas in the elderly, serum lipid levels, and non-alcoholic fatty liver disease (NAFLD), thereby providing evidence for the screening and prevention of colorectal adenomas.

Methods

Selected elderly patients (aged ≥65 years) who underwent colonoscopy at the Endoscopy Center of The Department of Gastroenterology, Hunan Provincial People′s Hospital (The First Affiliated Hospital of Hunan Normal University), from June 2019 to December 2022.Patients diagnosed with colorectal adenomas by colonoscopy and pathology were assigned to the experimental group, while those without adenomas served as the control group.The experimental group consisted of 109 cases, with 54 males and 55 females; the control group comprised 111 cases, with 49 males and 62 females.Compare whether there are any statistical differences in serum total cholesterol (TC), low-density lipoprotein(LDL), High-Density Lipoprotein(HDL), triglycerides (TG), fasting blood glucose, and whether they have NAFLD in the two groups.

Results

In the experimental group(n=109 cases), the levels of TC, LDL, TG, and fasting blood glucose were all significantly higher compared to the control group (n=111), with statistically significant differences (P< 0.05). There were 39 cases of NAFLD in the experimental group compared to 12 cases of NAFLD in the control group.The proportion of NAFLD in the experimental group was higher than that in the control group, with a statistically significant difference (P< 0.05).

Conclusion

Elevated levels of total cholesterol, fasting blood glucose, and having NAFLD may be significant risk factors for the development of colorectal adenomas in the elderly population.

Key words: Colorectal adenomas, Serum lipids, Non-alcoholic fatty liver disease
表1 两组患者一般资料比较[例(%)，±s]
资料 试验组 对照组 χ2值 P值
年龄(岁) 70.94±5.22 70.33±4.33 0.502 0.616
性别        
女 55(25.0) 62(28.2) 0.643 0.422
男 54(24.5) 49(22.3)    
表2 两组患者甘油三酯、总胆固醇及血肌酐对比(±s)
指标 试验组 对照组 t值 P值
甘油三酯(mmol/L) 1.83±0.85 1.43±0.75 －3.652 <0.001
总胆固醇(mmol/L) 4.88±0.77 4.50±0.92 －3.358 0.001
血肌酐(μmol/L) 75.94±24.12 68.58±19.76 －2.477 0.014
表3 两组患者低密度脂蛋白及空腹血糖、BMI对比(±s)
指标 试验组 对照组 Z值 P值
低密度脂蛋白(mmol/L) 2.91±0.74 2.66±0.77 －2.038 0.042
空腹血糖(mmol/L) 5.54±0.85 5.20±0.97 －3.423 0.001
BMI(kg/m2) 23.23±2.98 23.43±2.85 －1.427 0.154
图1 试验组及对照组NALFD患者例数分布情况
表4 两组患者统计结果[例(%)]
指标 试验组 对照组 χ2值 P值
有NAFLD 39(35.8) 12(10.8) 19.254 <0.001
无NAFLD 70(64.2) 99(89.2)    
图2 两组中各因素OR值及P值
表5 结直肠腺瘤的多因素logistic回归分析
变量 B值 S.E Wald χ2值 OR(95%CI) P值
甘油三酯(mmol/L) 0.376 0.23 2.661 1.456(0.927～2.286) 0.103
总胆固醇(mmol/L) 0.939 0.371 6.394 2.558(1.235～5.297) 0.011
低密度脂蛋白(mmol/L) －0.656 0.42 2.434 0.519(0.228～1.183) 0.119
血肌酐(μmol/L) 0.017 0.008 4.58 1.017(1.001～1.032) 0.032
空腹血糖(mmol/L) 0.43 0.187 5.286 1.538(1.066～2.219) 0.021
NAFLD 1.17 0.393 8.853 3.222(1.491～6.963) 0.003
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