Association between serum HbA1c levels and adenomatous polyps in patients with the type 2 diabetes mellitus

Abstract

Aim: This study aimed to determine whether serum hemoglobin A1c (HbA1c) levels are associated with colonic adenomatous polyps (APs) in patients with type 2 diabetes mellitus.

Methods: Four hundred sixty-four patients (262 men and 202 women) with type 2 diabetes mellitus and colorectal adenomas admitted to the Central Hospital of Wuhan University from June 2003 to December 2011 were enrolled. The patients' average age was 66.4 (range 36-78) years. The patients were divided into poorly controlled (HbA1c<7.5%) and well-controlled (HbA1c≥7.5%) groups. Prevalence of diabetes, family history of diabetes and colorectal cancer, Body Mass Index, smoking and drinking history, and use of aspirin and exogenous insulin were recorded and compare.

Results: Patients with poorly controlled diabetes had a significantly higher incidence of right-sided and more advanced APs. In addition, patients with poorly controlled disease were more likely to have positive history of smoking and use higher doses of insulin than well-controlled patients (P<0.05 for all comparisons). A multivariate analysis demonstrated that poorly-controlled diabetes independently predicted a more advanced lesion at the time of presentation, higher body mass index, and a use of higher doses of insulin.

Conclusion: Poor glycemic control in patients with the type 2 diabetes mellitus independently predicts higher tendency to develop APs and an increased risk of colorectal cancer.