Hyperglycemia combined Helicobacter pylori infection increases risk of synchronous colorectal adenoma and carotid artery plaque

// Kuang-Chun Hu 1, 2, 3, 4, 8 , Ming-Shiang Wu 4, 5 , Cheng-Hsin Chu 1, 3 , Horng-Yuan Wang 1, 2, 3 , Shee-Chan Lin 1, 3 , Helen L. Po 6 , Ming-Jong Bair 7 , Chuan-Chuan Liu 2 , Tung-Hung Su 5 , Chi-Ling Chen 4 , Chun-Jen Liu 4, 5 and Shou-Chuan Shih 1, 2, 3, 8 1 Division of Gastroenterology, Department of Internal Medicine, MacKay Memorial Hospital, Taipei, Taiwan 2 Healthy Evaluation Center, MacKay Memorial Hospital, Taipei, Taiwan 3 MacKay Medicine, Nursing and Management College, Taipei, Taiwan 4 Graduate Institute of Clinical Medicine, National Taiwan University College of Medicine, Taipei, Taiwan 5 Department of Internal Medicine, National Taiwan University Hospital, National Taiwan University College of Medicine, Taipei, Taiwan 6 Department of Neurology, MacKay Memorial Hospital, Taipei, Taiwan 7 Gastroenterology Division, Department of Internal Medicine, MacKay Memorial Hospital, Taitung Branch, Taiwan 8 MacKay Medical College, Taipei, Taiwan Correspondence to: Shou-Chuan Shih, email: shihshou@gmail.com Keywords: synchronous, colorectal adenoma, carotid artery plaque, hyperglycemia, Helicobacter pylori Received: July 12, 2017      Accepted: September 23, 2017      Published: October 26, 2017 ABSTRACT Background: Cardiovascular disease and colorectal cancer have severe consequences to human health and may occur simultaneously or sequentially. Carotid artery plaque is a predictor of cardiovascular disease, and colorectal adenoma is a premalignant lesion of colorectal cancer. We investigated the core risk factors of carotid artery plaque and colorectal adenoma. Results: In total, 2361 subjects were enrolled. In multivariate analysis, age ≥ 60 years, male sex, BMI > 27, LDL > 130 mg/dL, HbA 1c ≥ 6.5%, hs-CRP > 0.3 mg/L and H. pylori infection were independent risk factors for synchronous colorectal adenoma and carotid artery plaque formation. In the H. pylori -positive and -negative groups, the proportions and odds ratio (OR) for synchronous colon adenoma and carotid artery plaque increased with increasing HbA1c. OR for synchronous colon adenoma and carotid artery plaque was significantly higher in the participants with HbA 1c levels of 5.7%–6.4% and HbA1c ≥ 6.5% than in those with normal HbA 1c in the H. pylori -negative group. The OR was more significant increased for H. pylori -positive patients when HbA 1c level ≥ 6.5% was 15.87 (95% CI 8.661–29.082, p 40 years who underwent bidirectional gastrointestinal endoscopy and carotid artery ultrasound examination on the same day or within 12 months of endoscopy examination from January 2006 to December 2015 were reviewed. All subjects had a gastric biopsy specimen tested for Helicobacter pylori . Conclusions: Hyperglycemia combined with H. pylori infection was an increased risk factor for synchronous colorectal adenoma and carotid artery plaque formation. Diabetes control and H. pylori eradication may be warranted in higher prevalence areas.