Predicting colorectal adenoma recurrence: the role of systemic inflammatory markers and insulin resistance

BACKGROUND: Colorectal adenomas (CRA) exhibit high recurrence rates following endoscopic resection. Insulin resistance (IR) and chronic inflammation, increasingly prevalent due to unhealthy lifestyles, are key factors in CRA development. This study aimed to evaluate the predictive power of combining the inflammation score with the triglyceride-glucose (TyG) index for CRA recurrence. METHODS: We conducted a comprehensive analysis of the clinical characteristics of 847 CRA patients who underwent endoscopic resection. Postoperative recurrence of CRA was assessed using logistic regression analyses to determine odds ratios (ORs) and 95% confidence intervals (CIs). The receiver operating characteristic (ROC) curve analysis was utilized to predict the risk of CRA recurrence based on the inflammation score and TyG index. RESULTS: Among the 847 CRA included in the study, 126 experienced recurrences. Logistic regression analysis identified NLR (OR 2.641, 95% CI 1.982-3.549), TyG (OR 1.494, 95% CI 1.146-1.956), three or more adenomas (OR 2.182, 95% CI 1.431-3.322) and CRA larger than 10 mm (OR 1.917, 95% CI 1.267-2.921) as independent risk factors for CRA recurrence. ROC curves demonstrated the efficacy of NLR (AUC 0.701, 95% CI 0.652-0.750) and TyG (AUC 0.607, 95% CI 0.553-0.660) in predicting CRA recurrence. The combination of NLR, TyG and adenoma characteristics showed improved performance in predicting CRA recurrence (AUC 0.762, 95% CI 0.718-0.805). CONCLUSIONS: Elevated NLR and TyG were associated with an increased risk of CRA recurrence. The integration of NLR and TyG with CRA characteristics significantly enhanced the predictive power for CRA recurrence.