Retrospective Study
Copyright ©The Author(s) 2017. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastroenterol. Nov 21, 2017; 23(43): 7756-7764
Published online Nov 21, 2017. doi: 10.3748/wjg.v23.i43.7756
Gastric xanthelasma and metabolic disorders: A large retrospective study among Chinese population
Yi Chen, Xin-Jue He, Min-Jian Zhou, You-Ming Li
Yi Chen, Xin-Jue He, Min-Jian Zhou, You-Ming Li, Department of Gastroenterology, the First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou 310003, Zhejiang Province, China
Author contributions: Chen Y and He XJ contributed equally to this work; Chen Y and Zhou MJ designed the research; Chen Y and He XJ performed the research; Chen Y and He XJ analyzed data; Chen Y and Li YM wrote the paper.
Supported by Science Foundation of Health Bureau of Zhejiang Province, No. 2017183691 (to Chen Y).
Institutional review board statement: This manuscript was approved Department of Gastroenterology, the First Affiliated Hospital, College of Medicine, Zhejiang University for its conduction.
Informed consent statement: All study participants, or their legal guardian, provided informed written consent prior to study enrollment.
Conflict-of-interest statement: All authors have no any conflict of interest to declare.
Data sharing statement: All data of this study was shown and available in manuscript.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Correspondence to: You-Ming Li, Professor, Department of Gastroenterology, The First Affiliated Hospital, College of Medicine, Zhejiang University, 866 Yuhangtang Road, Hangzhou 310003, Zhejiang Province, China. zlym@zju.edu.cn
Telephone: +86-571-87235632 Fax: +86-571-87235632
Received: July 3, 2017
Peer-review started: July 3, 2017
First decision: August 10, 2017
Revised: August 25, 2017
Accepted: September 13, 2017
Article in press: September 13, 2017
Published online: November 21, 2017
Abstract
AIM

To gain knowledge of xanthelasma, a large population-based study was conducted.

METHODS

Patients who underwent upper gastrointestinal endoscopy at the First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, China during Jan 2009 to Nov 2016 were included. General characteristics as well as clinical data were collected, including blood routine, serum biochemical analysis, endoscopic findinds, histological evaluation and comorbiditie. Statistical analyses was performed using SPSS 20.0 software for Windows (IBM Inc., Chicago, IL, United States) using Student’s t-test, Mann-Whitney U test, χ2 test, univariable and multivariable logistic analysis. 2-tailed P value less than 0.05 was considered to be statistically significant.

RESULTS

A total of 176006 endoscopies were retrieved and we included 1370 xanthelasma participants (703 men, 667 women) in this study. Prevalence of xanthelasma was 0.78% with average age of 56.6 ± 11.2 years. Chief complaint of xanthelasma consisted abdominal pain (24.2%), up-abdominal discomfort (14.1%), abdominal distention (10.1%), dyspepsia (9.1%), et al. Most xanthelasma occurred as single lesion in gastric antrum. Xanthelasma patients witnessed higher Helicobacter pylori (H. pylori) infection rate, more of other gastric lesions including atrophy, intestinal metaplasia and dysplasia (P < 0.01). In xanthelasma patients, serum carcinoembryonic antigen, triglyceride, fasting glucose, neutrophil, neutrophil-to-lymphocyte ratio were significantly higher, and high density lipoprotein-cholesterol, lymphocyte was lower (P < 0.05). Xanthelasma accompanied with more fatty liver disease and hepatic cyst, but fewer gallbladder polyp (P < 0.05). In logistic regression, it revealed that fasting plasma glucose (OR = 3.347, 1.170-9.575, P < 0.05), neutrophil (OR = 1.617, 1.003-2.605, P < 0.05), and carcinoembryonic antigen (OR = 2.011, 1.236-3.271, P < 0.01) were all independent risk factors in xanthelasma.

CONCLUSION

Current study described a large xanthelasma cohort in Chinese population, revealed its relationship with H. pylori infection, carcinogenesis, metabolic dysfunction and inflammation as well.

Keywords: Gastric xanthelasma, Helicobacter pylori infection, Gastric dysplasia, Metabolic disorder

Core tip: Xanthelasma was a relatively rare endoscopic finding, characterized by accumulation of lipid in histiocytic foam cells in mucosa. Current study described a large xanthelasma cohort in Chinese population and revealed its relationship with Helicobacter pylori infection, atrophy, intestinal metaplasia, dysplasia, and metabolic disorder, indicating role of xanthelasma in both carcinogenesis and metabolic dysfunction.