Low serum pancreatic amylase levels as a novel latent risk factor for colorectal adenoma in non-alcohol drinkers

J Gastroenterol Hepatol. 2022 Apr;37(4):660-668. doi: 10.1111/jgh.15748. Epub 2021 Dec 13.

Abstract

Background and aim: Obesity, insulin resistance, and metabolic alterations increase the risk of colorectal cancer and adenoma (CRA). Non-alcoholic fatty liver disease (NAFLD) or pancreatic disease (NAFPD) shares many risk factors with CRA that may have significant roles in its development; however, the relationship between CRA and NAFLD/NAFPD remains unclear.

Methods: This cross-sectional study recruited 712 eligible participants without current drinking who had undergone total colonoscopy as part of a health checkup. These participants were classified into a CRA group (n = 236) and a control group (n = 439), which consisted of individuals without CRA and a history of polyp resection. NAFLD and NAFPD were diagnosed based on abdominal ultrasonography findings.

Results: Non-alcoholic fatty liver disease was observed more frequently in individuals with CRA than in the control group (55.9% vs 41.6%, P < 0.01). There was no significant association between NAFPD and CRA; however, serum pancreatic amylase (P-amylase) levels were significantly lower in individuals with CRA. Although NAFLD was one of the factors increasing the presence of CRA (odds ratio [OR], 1.50; 95% confidence interval [CI], 1.07-2.10), low P-amylase levels were significantly associated with the presence of CRA (OR, 1.73; 95% CI, 1.04-2.88) independent of age, sex, current smoking, obesity, metabolic alterations including insulin resistance, and NAFLD.

Conclusions: Low serum P-amylase levels were a possible independent risk factor for CRA in the present study. The latent pancreatic exocrine-endocrine-gut relationship was considered a novel pathway involved in obesity-related CRA development, in non-alcoholic individuals.

Keywords: colorectal cancer; non-alcoholic fatty liver disease; non-alcoholic fatty pancreas disease; obesity; pancreatic dysfunction.

MeSH terms

  • Adenoma* / epidemiology
  • Adenoma* / etiology
  • Amylases
  • Colorectal Neoplasms* / epidemiology
  • Colorectal Neoplasms* / etiology
  • Cross-Sectional Studies
  • Humans
  • Non-alcoholic Fatty Liver Disease* / etiology
  • Risk Factors

Substances

  • Amylases