Metabolic and inflammatory indices in colorectal adenoma: A real-world colonoscopy cohort study

doi:10.4251/wjgo.123498

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World Journal of Gastrointestinal Oncology

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1948-5204

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Baishideng Publishing Group Inc, 7041 Koll Center Parkway, Suite 160, Pleasanton, CA 94566, USA

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Retrospective Cohort Study

Copyright: ©Author(s) 2026. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution-NonCommercial (CC BY-NC 4.0) license. No commercial re-use. See permissions. Published by Baishideng Publishing Group Inc.

World J Gastrointest Oncol. Oct 15, 2026; 18(10): 123498
Published online Oct 15, 2026. doi: 10.4251/wjgo.123498

Metabolic and inflammatory indices in colorectal adenoma: A real-world colonoscopy cohort study

Yunus Halil Polat, Başak Çakal, İrem Biçer Oral, Sefa Yılmaz

Yunus Halil Polat, Başak Çakal, İrem Biçer Oral, Department of Gastroenterology, Ankara Training and Research Hospital, Ankara 06370, Türkiye

Sefa Yılmaz, Department of Internal Medicine, Ankara Training and Research Hospital, Ankara 06370, Türkiye

Author contributions: Polat YH conceived and designed the study, acquired the data, performed the statistical analyses, interpreted the data, drafted the manuscript, and supervised the study; Çakal B contributed to data acquisition, clinical interpretation, and critical revision of the manuscript; Oral İB contributed to data acquisition, literature review, and manuscript revision; Yılmaz S contributed to data acquisition, literature review, and critical revision of the manuscript; all authors have read and approved the final version of the manuscript.

AI contribution statement: AI tools (ChatGPT, OpenAI) were used solely for language editing and improvement of readability during manuscript preparation. All scientific content, study design, data collection, data analysis, interpretation of the results, and final manuscript revision were performed and approved by the authors, who take full responsibility for the integrity, accuracy, and originality of the manuscript.

Institutional review board statement: This study was conducted in accordance with the Declaration of Helsinki and was approved by the Ethics Committee of Ankara Training and Research Hospital (approval No. E-25-629; Date: September 25, 2025).

Informed consent statement: The requirement for informed consent was waived by the Ethics Committee because of the retrospective cohort nature of the study and the use of anonymized data.

Conflict-of-interest statement: All authors declare no conflict of interest in publishing the manuscript.

STROBE statement: The authors have read the STROBE Statement – checklist of items, and the manuscript was prepared and revised according to the STROBE Statement – checklist of items.

Data sharing statement: The datasets used and/or analyzed during the current study are available from the corresponding author on reasonable request.

Corresponding author: Yunus Halil Polat, MD, Department of Gastroenterology, Ankara Training and Research Hospital, Mehmet Akif Ersoy Mah, Yenimahalle, Ankara 06370, Türkiye. yunushpolat@gmail.com

Received: May 20, 2026
Revised: July 7, 2026
Accepted: July 28, 2026
Published online: October 15, 2026
Processing time: 122 Days and 3 Hours

Abstract

BACKGROUND

Colorectal adenomas are precursors of colorectal cancer and have been linked to metabolic and inflammatory dysregulation. The clinical relevance of laboratory-based indices for adenoma detection remains unclear.

AIM

To evaluate the association and comparative diagnostic performance of metabolic and inflammatory indices in patients with colorectal adenomas who underwent colonoscopy.

METHODS

This retrospective cohort colonoscopy-based study included adult patients who underwent complete colonoscopic examination. Patients were classified into adenoma and non-adenoma groups according to histopathological findings. Metabolic indices, including the triglyceride-glucose (TyG) index and the atherogenic index of plasma (AIP), and inflammatory indices, such as the neutrophil-to-lymphocyte ratio, systemic immune-inflammation index, and neutrophil-to-high-density lipoprotein ratio, were calculated. Group comparisons, receiver operating characteristic analyses, and age-adjusted and sex-adjusted logistic regression analyses were performed.

RESULTS

A total of 1570 patients were included in the final analysis cohort, and 395 patients (25.2%) had colorectal adenomas. TyG and AIP were significantly greater in patients with adenomas (P < 0.001). Receiver operating characteristic analyses showed modest discriminatory performance, with TyG having the highest area under the curve. After adjusting for age and sex, the TyG index and AIP remained significantly associated with the presence of adenoma, whereas the inflammatory indices did not retain statistical significance.

CONCLUSION

Metabolic indices, particularly the TyG index and AIP, are significantly associated with the presence of colorectal adenoma, whereas systemic inflammatory indices demonstrate limited diagnostic value. These findings support a potential role of metabolic dysregulation in early colorectal neoplasia.

Keywords: Colorectal adenoma; Triglyceride-glucose index; Atherogenic index of plasma; Insulin resistance; Colonoscopy; Risk stratification

Core Tip: Metabolic dysregulation has been increasingly implicated in colorectal neoplasia; however, the clinical utility of routinely available metabolic and inflammatory indices in colorectal adenoma detection remains uncertain. In this large real-world colonoscopy cohort, the triglyceride-glucose index and the atherogenic index of plasma were independently associated with colorectal adenoma presence after adjustment for age and sex, whereas systemic inflammatory indices demonstrated limited diagnostic value. These findings highlight the potential role of metabolic indices in colorectal adenoma risk stratification and support further prospective validation.