The Distribution Of Syndrome Types In Patients With Colorectal Adenomatous Polyps And Their Correlation With Dyslipidemia

Background Colorectal cancer is the second most common malignant tumor in the world.Colorectal adenomas are precancerous lesions of colorectal cancer.Because of approximately 70%of colorectal cancers develop from colorectal adenomas,early diagnosis and treatment of colorectal adenomas are critical.In recent years,people have paid more attention to the relationship between adenoma and blood lipid,but there are still few studies on the specific blood lipid indicators.There are many studies on traditional Chinese medicine syndromes of large intestine polyps,but there are few studies on the association between colorectal adenoma syndromes and dyslipidemia.Objective The purpose of the study is to collect the clinical data of patients with colorectal adenoma and conduct statistical analysis,in order to explore valuable blood lipid indexes for risk stratification of colorectal adenoma and TCM syndrome differentiation,so as to provide more reference for the diagnosis and treatment of colorectal adenoma.Methods This study is a retrospective study.Collecting the general data,four diagnoses,blood lipid indicators,colonoscopy results and pathological diagnosis of patients who were hospitalized in Beijing Hospital of Traditional Chinese Medicine from 2014 to 2019 and were diagnosed with "colorectal adenoma".Analyzing the general condition of patients with adenoma,dividing adenomas into advanced adenomas and common adenomas according to the degree of risk of adenomas,and comparing basic data such as gender,age and blood lipid indexes of advanced adenomas and common adenomas.Describing the distribution of syndromes in patients with adenomas,and comparing the difference of lipids in patients with different syndromes.Dividing patients into dyslipidemia group and normal blood lipid group according to the level of blood lipid index,and comparing patients with dyslipidemia and normal blood lipid in the characteristics of adenoma and the distribution of syndrome types.Results1.General information Total of 461 patients with colorectal adenoma were enrolled in this study,including 257 males and 204 females,most of whom were over 40 years old,accounting for 94.5%.Among the 461 patients,141 were eligible for advanced adenoma and 320 were common adenoma,295 were eligible for dyslipidemia and 196 were normal blood lipid.2.Adenoma information Among the included 461 patients with adenoma,the number of polyps ≥3 was the most,accounting for 48.2%;the left colon was the most common site,accounting for 43.0%;the size was mostly below 1 cm,accounting for 85.7%.There was a correlation between the endoscopic type of adenoma and the pathological type(the correlation coefficient is 0.32,P<0.001).3.The relationship between adenoma risk stratification with basic information,lipids(1)Compared with common adenoma,there were more people with hypertension and diabetes in advanced adenoma(P<0.05).There were no statistically significant difference between the two groups in age,gender,history of smoking and alcohol.(2)There were statistically significant difference between common adenoma and advanced adenoma in TG(P<0.001)、LDL-C/HDL-C(P=0.02)、TG/HDL-C(P=0.002)、LCI(P=0.001)、AI(P=0.04)、AIP(P<0.001)、HCY(P=0.01)、apoB/apoA1(P=0.02).4.The distribution of syndrome types in patients with colorectal adenomatous polyps There were 4 types of syndromes,including 133 cases of large intestine damp-heat syndrome,115 cases of spleen deficiency and blood stasis syndrome,121 cases of qi stagnation and blood stasis syndrome,and 92 cases of dampness and blood stasis syndrome.There were no significant difference in the distribution of syndrome types in the number of polyps,endoscopic types,and pathological types.In patients with diarrhea,the proportion of spleen deficiency and stasis syndrome was the highest(28.80%),and the difference was statistically significant compared with those without diarrhea(P<0.05).The proportion of large intestine dampness and heat syndrome in constipation patients was the highest(32.90%),and the difference was statistically significant compared with that in non-constipation patients.5.The relationship between the distribution of syndrome types and blood lipids in patients with colorectal adenomatous polyps There were significant differences in TG(P=0.018<0.05),sdLDL-C(P=0.002<0.05),LDL-C/HDL-C(P=0.011<0.05),apoB/apoA1(P=0.029<0.05),TG/HDL-C(P=0.013<0.05),TC/HDL-C(P=0.006<0.05),AIP(P=0.028<0.05),AI(P=0.010<0.05)and LCI(P=0.004<0.05)among patients with different syndrome types.6.The relationship between dyslipidemia and the characteristics of adenoma,the distribution of syndrome types(1)Compared with the normal blood lipid group,the dyslipidemia group had no significant difference in endoscopic type,pathological type,and number of polyps.(2)Compared with the normal blood lipid group,the dyslipidemia group had the highest proportion of large intestine damp-heat syndrome(33.60%),and the normal blood lipid group had the highest proportion of spleen deficiency and blood stasis syndrome(28.30%).There was difference in the distribution of syndrome types,which was statistically significant(P<0.05).Among the patients with dyslipidemia,there were 196 cases of hypercholesterolemia,132 cases of hypertriglyceridemia,118 cases of high-low-density lipoproteinemia,58 cases of low-high-density lipoproteinemia.Among the four kinds of dyslipidemia,large intestine dampness-heat syndrome was the most common,and the difference was statistically significant compared with the control group(P<0.05).Conclusions1.There was a correlation between adenoma and dyslipidemia.The levels of TG,LDL-C/HDL-C.apoB/apoA1,TG/HDL-C,AIP,AI and LCI are different between advanced adenoma and common adenoma.2.The traditional Chinese medicine syndrome types of adenoma patients were correlated with lipid.The blood lipid indexes of different syndrome types were different.3.There were difference in the distribution of syndrome types between the dyslipidemia group and the normal blood lipid group.The syndrome of large intestine damp-heat was the most in the group of dyslipidemia,and the syndrome of spleen deficiency and blood stasis was the most in the control group.