Predicting the occurrence of cancer-associated colorectal polyp using a metabolic risk score

This study was conducted with the aim of developing a metabolic risk score to help identify patients who are likely to have a cancer-associated polyp (CAP) on colonoscopy, based on a metabolic syndrome-related clinical profile. The clinical history and anthropometric and metabolic profiles of patients who came for a screening colonoscopy at our institute between June, 2010 and December, 2012 were prospectively collected. The data were analyzed for their association with the occurrence of CAP. Subsequently, six parameters were selected in order to construct a metabolic risk score that correlated with the presence of CAP. A total of 286 subjects (132 males and 154 females), with an age range of 19-85 years, were included in this study. The colonoscopy detected polyps in 56 cases (19.6%). Anthropometric parameters that were significantly associated with CAP included a body mass index (BMI) of >23.4 kg/m² and a waist circumference of >32 inches in females. Laboratory profiles that were significantly associated with CAP were fasting blood sugar (FBS) >110 mg%, hemoglobin A1C (HbA1C) >7%, aspartate transaminase (SGOT) >40 IU/l, alanine transaminase (SGPT) >50 IU/l and uric acid >7 mg%. When a metabolic risk score was constructed, it was observed that moderate (2-3) and high risk (4-6) was significantly associated with CAP [odds ratio (OR)=4.9, 95% confidence interval (CI): 2.0-12.0 and OR=13.7, 95% CI: 4.4-43.0, respectively]. The association between the risk score and CAP was stronger in the subgroup of patients aged <65 years, in whom the moderate and high metabolic risk groups exhibited ORs of 5.6 (95% CI: 1.8-17.9) and 39.0 (95% CI: 8.2-186.6), respectively. In conclusion, this study demonstrated that it is possible to use a metabolic profile to construct a reliable scoring method to identify patients at higher risk of having CAP who should be fast-tracked for a colonoscopy.