Study Of Risk Factors Associated With Detection Of Colorectal Polyps In The Elderly

Objective:To screen risk factors associated with the development of colorectal polyps in the elderly by studying the basic information,lifestyle habits,biochemical indicators,and other characteristics of elderly patients who underwent colonoscopy in our hospital within the last year and to analyze the possible effects of related risk factors on the detection and prognosis of colorectal polyps in people over 60 years of age according to risk factor stratification.Methods:By studying patients who underwent colonoscopy in our hospital between November 2021 and November 2022,a total of 489 patients aged 60 years or older who met the observation criteria for colonoscopy in our hospital were screened and divided into 287 cases in the colorectal polyp group and 202 cases in the no-polyp group according to the presence or absence of intestinal polyp formation reported by colonoscopy.The patients were analyzed for gender,age,height,weight,BMI,purpose of performing colonoscopy,history of non-steroidal drug use(≥ three months),history of long-term metformin use(≥ three months),history of long-term PPI use(≥ three months),Hypertension,Diabetes mellitus,Gallbladder-related diseases,Non-alcoholic fatty liver disease;biochemical indexes: Hemoglobin,Uric acid,Albumin,Fasting blood glucose,Lipoprotein(a),Total cholesterol,Triglyceride,High-density lipoprotein cholesterol,Low-density lipoprotein cholesterol;polyp size,number,location,and pathological type.The above data were collected and organized for statistical analysis using SPSS 24.0.Results:1.489 patients were included in this study,including 287 cases in the colorectal polyp group cases and 202 cases in the control group.The mean age was 68.1±5.74 years,and there were 281 males(57.5%)and 208 females(42.5%).A total of 472 polyps were detected,and the polyp detection rate was 58.7%;331 adenomas were detected,and the adenoma detection rate was 39.9%;140 advanced adenomas were detected,and the detection rate was 23.5%.Thirty-six were single polyps,accounting for 12.5%;251 were multiple polyps,accounting for 87.5%;148 had polyps ≥1 cm,and139 had polyps <1 cm;from the location of colorectal polyps In terms of distribution characteristics,the sigmoid colon was the preferred site 136/472(28.8%),followed by the transverse colon(92/472,19.5%),rectum(85/472,18.0%),ascending colon(78/472,16.5%),descending colon(62/472,13.1%)and cecum(19/472,4.0%).Among the patients who underwent colonoscopy,140(28.6%)were asymptomatic health checkups,and 349(71.4%)were symptomatic.In the colorectal polyp group,patients underwent colonoscopies mainly for abdominal pain(80/304,26.3%).2.The polyp group differed from the control group in terms of gender,abdominal obesity,history of smoking,history of alcohol consumption,hypertension,gallbladderrelated disease,NAFLD,history of long-term NSAID use,history of long-term PPI use,HGB,UA,TG,HDL-C(P < 0.05).There were no between-group differences in age,BMI ≥ 28 kg/m2,diabetes,HUA,history of long-term metformin use,ALB,FBG,LP(a),TC,and LDL-C from the control group(Ρ > 0.05).3.The results of multifactorial logistic regression analysis showed that males,drinking history,NAFLD,and elevated triglyceride levels(TG ≥ 2.26 mmol/L)were independent risk factors for developing colorectal polyps.the OR values were 2.945(95% CI = 1.572-5.514),2.124(95% CI = 1.206-3.743),2.886(95% CI = 1.678-4.964),2.945(95% CI = 1.572-5.514).4.Colorectal polyp groups were classified according to the characteristics of polyps(size,number,distribution site,pathological type)were organized to compare the effects of relevant independent risk factors on the characteristics of colon and rectal polyps.Among the patients with elevated TG levels,the prevalence of polyps in the left colon and rectum was 98.2%,while the Right colon was 25.5%.The percentage of solitary polyps in the group with elevated TG levels(23.6%)was significantly higher than that of solitary polyps in the control group(9.9%),with a statistically significant difference(P=0.00).There was a group difference in the size of polyps with or without a history of alcohol consumption(P=0.015),with non-drinking patients more likely to have small polyps(53.3%)and drinking patients more likely to have large polyps(62.2%).There were no between-group differences in gender and NAFLD in terms of characteristics of polyps(Ρ > 0.05).Conclusions:1.Male,drinking history,NAFLD,and elevated triglyceride levels(TG ≥ 2.26mmol/L)are independent risk factors for the detection of colorectal polyps.2.According to the features of the 472 colorectal polyps that have been examined,adenomas and advanced adenomas both frequently occur in the sigmoid colon.Colorectal polyps were mainly distributed in the sigmoid and transverse colon,mostly adenomatous polyps,and tended to be more frequent.3.History of alcohol consumption was more common in patients with large polyps(≥1cm);the proportion of single polyps was higher in patients with high triglyceride levels,and polyps were more likely to be distributed in the left colon and rectum.Gender and NAFLD had little effect on the characteristics of polyps(polyp size,number,distribution site,and pathological type).4.Patients with colorectal polyps detected by colonoscopy were more likely to have complaints of abdominal pain and other discomforts before colonoscopy,and asymptomatic physical examinations for colonoscopy were more likely not to find polyps.