Adenomatous Colon Polyps in Diabetes: Increased Prevalence in Patients with Chronic Kidney Disease and Its Association with Parathyroid Hormone

• Published in: Annals of clinical and laboratory science Vol. 46; no. 6; pp. 608 - 615
• Main Authors: Chowdhury, Deepshikha Nag, Botros, Youssef, DeBari, Vincent A, Baddoura, Walid, Chandran, Chandra B
• Format: Journal Article
• Language: English
• Published: United States 01.12.2016
• Subjects: Adenomatous Polyps - complications; Adenomatous Polyps - epidemiology; Adenomatous Polyps - metabolism; Aged; Calcium - metabolism; Colonic Polyps - complications; Colonic Polyps - epidemiology; Colonic Polyps - metabolism; Demography; Diabetes Mellitus - metabolism; Female; Humans; Logistic Models; Male; Multivariate Analysis; Odds Ratio; Parathyroid Hormone - metabolism; Phosphorus - metabolism; Prevalence; Probability; Renal Insufficiency, Chronic - complications; Renal Insufficiency, Chronic - metabolism; adenomas; parathyroid hormone; chronic kidney disease; colon polyps; Diabetes mellitus
• ISSN: 1550-8080

Previous studies have shown a higher prevalence of malignancy in patients with diabetes mellitus (DM) and chronic kidney disease (CKD). The purpose of this study was to investigate the prevalence of adenomatous colon polyps (ACP) as they occur in subjects with DM and coexisting CKD. This is a retrospective cohort study of patients with DM (n=565) who had undergone colonoscopy between 2000-2010. The cohort was further bifurcated into those with CKD (n=296) and those with normal renal function (n=269). Presence or absence of ACP was measured in both groups. Concentrations of serum parathyroid hormone (PTH), Calcium (Ca), and phosphorous (P) were recorded for the CKD group. The levels of these variables in patients with ACP (n=171) were compared with the levels from those without ACP (n=175). Nonparametric statistical methods were applied with statistical significance suggested by p<0.05 (two-sided). The presence of CKD in this cohort demonstrated a significant association with ACP (OR: 2.96; 95% CI: 2.02 to 4.34; p<0.0001). We did not detect a statistically significant difference in P or Ca between the groups. There was, however, a statistically significant difference in PTH; for the group with ACP, PTH: 387.7±351.3 ng/L vs. 172.2±196.7 ng/L; p<0.0001. This data suggests that CKD is associated with ACP in subjects with DM and those with ACP exhibit higher PTH levels when compared to those without ACP.