Metabolic Optimization in Colorectal Neoplasia Prevention
Menée à partir de données portant sur 2 331 patients atteints d'une stéatose hépatique associée à un dysfonctionnement métabolique et ayant subi une polypectomie (durée moyenne de suivi : 4 ans ; âge moyen : 56,7 ans ; 74,9 % d'hommes), cette étude analyse l'effet d'une réduction des facteurs de risque cardiométaboliques (obésité abdominale, hypertriglycéridémie, taux de cholestérol HDL, hypertension artérielle et glycémie à jeun) sur le risque de néoplasie colorectale métachrone
Colorectal cancer (CRC) remains a leading cause of cancer-related death worldwide, accounting for substantial morbidity and mortality despite advances in screening and treatment. In parallel, prevalence of metabolic syndrome, defined by having 3 of 5 conditions—abdominal obesity, high blood pressure, impaired fasting glucose, hypertriglyceridemia, and reduced high-density lipoprotein cholesterol—has risen steadily, with an estimated 1.54 billion adults affected globally, and is a major driver of long-term disability. Increasingly, these 2 epidemics intersect: patients with CRC and coexisting metabolic syndrome experience higher risks of both all-cause and CRC-specific mortality compared with those without metabolic dysfunction. Indeed, metabolic risk factors and their upstream drivers are associated with cardiometabolic disease as well as colorectal carcinogenesis and tumor progression. As the burden of metabolic dysfunction continues to rise, clinicians are encountering a growing population of patients whose metabolic health may meaningfully shape cardiovascular, hepatic, and colorectal health trajectories. The intersection of metabolic disease and CRC raises an important and clinically actionable question: if metabolic dysfunction contributes to neoplasia development and worse outcomes, can metabolic optimization reduce the risk of metachronous neoplasia after baseline colonoscopy with polypectomy? The study by Chang et al addresses this question.
JAMA Network Open , éditorial en libre accès, 2026