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Decreased High-Density Lipoprotein Cholesterol and Increased Low-Density Cholesterol Levels in Patients with Colorectal Adenomas

Ekkehard Bayerdorffer, MD; Gerd Alexander Mannes, MD; Werner Oskar Richter, MD; Thomas Ochsenkuhn, MD; Gerhard Seeholzer, MD; Wolfgang Kopcke, PhD; Baldur Wiebecke, MD; and Gustav Paumgartner, MD
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From the University of Munich, Munich, Germany. Request for Reprints: Ekkehard Bayerdorffer, MD, Medical Department II, Klinikum Grosshadern, University of Munich, Marchioninistrasse 15, 8000 Munchen 70, Germany. Acknowledgments: The authors thank Ms. Christine Otahal for assisting in the organization of the study; Ms. Margit Judenberg for measuring serum lipoprotein levels; and Mr. Peter Kampe for carrying out the statistical calculations. Grant Support: In part by grants 1137/89 from the DFG (Deutsche Forschungsgemeinschaft); grant V/5-B III 147 from the Curt-Bohnewand-Fonds (University of Munich); and grant 52/88 from the Friedrich-Baur-Stiftung (University of Munich).


Copyright ©2004 by the American College of Physicians


Ann Intern Med. 1993;118(7):481-487. doi:10.7326/0003-4819-118-7-199304010-00001
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Objective: To study the relation between serum lipoprotein levels and the frequency of colorectal adenomas, the benign precursors of colorectal cancer.

Design: Cross-sectional.

Setting: University hospital in Germany.

Patients: The study included 822 of 1124 consecutive patients who underwent colonoscopy at our institution (302 patients were excluded because of malignant disease, chronic inflammatory bowel disease, familial polyposis, partial colectomy, or other chronic diseases). Of the 822 study patients, 194 had colorectal adenoma.

Measurements: Serum cholesterol fractions (high-density lipoprotein [HDL], low-density lipoprotein (LDL), and very low-density lipoprotein [VLDL]) and presence or absence of adenomas; univariate and logistic regression analyses were carried out to evaluate the association between serum HDL, LDL, and VLDL cholesterol levels and the frequency of colorectal adenoma.

Results: Univariate analysis of the total patient group showed that the HDL cholesterol level was inversely related to the frequency of colorectal adenoma (odds ratio, 0.36; 95% CI, 0.21 to 0.62) and that LDL and VLDL cholesterol levels were positively associated with adenoma frequency (odds ratio, 2.31 [CI, 1.36 to 3.92] and 1.72 [CI, 1.03 to 2.86], respectively). Univariate analysis of the subgroup of 89 patients with high-risk adenomas showed an inverse association between such adenomas and HDL cholesterol (odds ratio, 0.37; CI, 0.18 to 0.76). A logistic regression analysis that included age and body mass index showed an association between lipoprotein levels and the presence of adenomas. The relative strength (in descending order) of these associations was as follows: HDL, LDL, VLDL, and total serum cholesterol. A logistic regression analysis of patients with high-risk adenoma showed a significant association between such adenomas and the HDL cholesterol level.

Conclusions: Patients with colorectal adenomas have lower HDL cholesterol levels and higher LDL and VLDL cholesterol levels; these lipoproteins may have prognostic significance for the development of colorectal adenomas.

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