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Open AccessArticle

Association between Cardiovascular Risk and Diabetes with Colorectal Neoplasia: A Site-Specific Analysis

1
Department of Internal Medicine, General Hospital Oberndorf, Teaching Hospital of the Paracelsus Medical University Salzburg, 5110 Oberndorf, Austria
2
Department of Cardiology, University Heart Centre, University Hospital Zurich, 8091 Zürich, Switzerland
3
Suicide Prevention Research Program, Paracelsus Medical University, 5020 Salzburg, Austria
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Department of Suicide Prevention, University Clinic of Psychiatry and Psychotherapy I, Christian Doppler Clinic, 5020 Salzburg, Austria
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University Institute of Clinical Psychology, Christian Doppler Clinic, 5020 Salzburg, Austria
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Department of Gastroenterology and Hepatology, University Hospital of Zürich, 8091 Zürich, Switzerland
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Institute of Pharmacology and Toxicology, Paracelsus Medical University Salzburg, 5020 Austria
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Department of Internal Medicine I, Paracelsus Medical University Salzburg, 5020 Salzburg, Austria
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Obesity Research Group, Paracelsus Medical University Salzburg, 5020 Salzburg, Austria
*
Author to whom correspondence should be addressed.
These two authors contributed equally to this work.
J. Clin. Med. 2018, 7(12), 484; https://doi.org/10.3390/jcm7120484
Received: 18 October 2018 / Revised: 21 November 2018 / Accepted: 22 November 2018 / Published: 27 November 2018
(This article belongs to the Section Cardiology)
Several studies have shown site-specific differences in colorectal cancer (CRC) with respect to the risk factors. CRC was shown to be associated with cardiovascular risk (CVR) factors, but site-specific variations have not been investigated so far. This study aimed to assess the associations between the prevalence and subsite-specific differences of colorectal neoplasia and established CVR scores or known coronary artery disease (CAD) in a large asymptomatic European screening cohort (N = 2098). Participants underwent simultaneous screening colonoscopy and CVR evaluation, using the Framingham Risk Score and Heart Score. Lesions found in the colonoscopy were classified by location (proximal/distal colon or rectum). More neoplasias were found in the proximal versus the distal colon (p < 0.001). The Framingham Risk Score and Heart Score showed incremental risk for colorectal adenoma, across the tertiles in the proximal and the distal colon (p < 0.001). The prevalence of adenomas in the rectum was much lower, but also here, incremental risk could be shown for the Framingham Risk but not the Heart Risk Score tertiles. Prevalence of adenomas in the proximal colon was higher in subjects with type 2 diabetes (T2DM) (p = 0.006), but no association was found between adenomas and T2DM in the distal colon (p = 0.618) and the rectum (p = 0.071). Males had a higher CVR and more findings, in the screening colonoscopy, as compared to females, however, no site-specific differences were noted. Patients with known CAD and high CVR have an increased risk of colorectal neoplasia in both the proximal and distal colon. Patients with T2DM have a higher risk for neoplasia in the proximal colon. View Full-Text
Keywords: Framingham Risk Score (FRS); Heart Score (HS); site-specific colorectal neoplasia; cardiovascular risk Framingham Risk Score (FRS); Heart Score (HS); site-specific colorectal neoplasia; cardiovascular risk
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Niederseer, D.; Bracher, I.; Stadlmayr, A.; Huber-Schönauer, U.; Plöderl, M.; Obeid, S.; Schmied, C.; Hammerl, S.; Stickel, F.; Lederer, D.; Patsch, W.; Aigner, E.; Datz, C. Association between Cardiovascular Risk and Diabetes with Colorectal Neoplasia: A Site-Specific Analysis. J. Clin. Med. 2018, 7, 484.

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