Tsounis D, Villiotou V, Melpidou A, Pantsiou C, Argyrou A, Giannopoulou C, Grigoratou A, Rontogianni D, Mantzaris GJ, Papatheodoridis G. Oxidative imbalance increases the risk for colonic polyp and colorectal cancer development. World J Gastrointest Oncol 2022; 14(11): 2208-2223 [PMID: 36438709 DOI: 10.4251/wjgo.v14.i11.2208]
Corresponding Author of This Article
Dimitrios Tsounis, FEBG, MD, MSc, Chief Doctor, Consultant Physician-Scientist, Department of Gastroenterology, 251 General Hospital of Hellenic Air Force, P. Kanellopoulou Avenue 3, Athens 11525, Greece. dim.tsoun69@gmail.com
Research Domain of This Article
Gastroenterology & Hepatology
Article-Type of This Article
Case Control Study
Open-Access Policy of This Article
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/
World J Gastrointest Oncol. Nov 15, 2022; 14(11): 2208-2223 Published online Nov 15, 2022. doi: 10.4251/wjgo.v14.i11.2208
Table 1 Patients’ main characteristics
Αdenocarcinoma, n = 56
Colon polyps, n = 33
Controls, n = 81
Age in yr, n (%)
50-59
1 (1.8)
8 (24.2)
9 (11.1)
60-69
20 (35.7)
12 (36.4)
44 (54.3)
70-79
28 (50.0)
11 (33.3)
16 (19.8)
80-94
7 (12.5)
2 (6.1)
12 (14.8)
Sex
Men
35 (62.5)
21 (63.6)
44 (54.3)
Women
21 (37.5)
12 (36.4)
37 (45.7)
Smoking
Yes
50 (89.3)
17 (51.5)
68 (84.0)
No
6 (10.7)
16 (48.5)
13 (16.0)
Number of cigarettes/d
< 20
4 ± 8.0
3 ± 17.6
0 ± 0.0
20
10 ± 20.0
6 ± 35.3
20 ± 29.4
> 20
36 ± 72.0
8 ± 47.1
48 ± 70.6
Smoking duration in yr (mean ± SD)
37.7 ± 10.0
33.5 ± 9.1
40.3 ± 6.2
Table 2 Distribution (median 25-75 percentile) of antioxidants and oxidants compounds in the plasma by group
Αdenocarcinoma, n = 56
Colon polyps, n = 33
Controls, n = 81
Αntioxidants
Αntioxidant capacity in μmol/L
185.0 (177.0-190.0)
190.0 (182.0-196.2)
305.0 (298.0-324.0)
Vitamin Α in μg/L
391.5 (288.3-493.8)
572.0 (480.0-609.0)
380.0 (350.0-416.0)
Vitamin C in μg/L
4.7 (3.9-6.5)
6.0 (4.7-10.0)
6.0 (4.5-9.0)
Vitamin E in mg/L
3.5 (2.4-3.9)
3.8 (3.5-4.2)
3.7 (3.2-4.0)
Vitamin D in ng/mL
9.0 (6.7-13.0)
9.0 (6.8-20.5)
24.0 (20.0-26.0)
Se in μg/L
62.0 (45.5-78.8)
78.0 (72.0-80.0)
76.0 (69.5-80.0)
Zn in μg/L
626.5 (594.5-782.5)
800.0 (711.0-840.0)
809.0 (780.5-842.5)
B12 in pg/L
211.0 (159.3-297.0)
250.0 (220.0-355.0)
289.0 (200.0-340.0)
Folic acid in ng/L
4.3 (3.3-4.6)
4.2 (3.9-4.6)
4.0 (3.8-4.4)
Οxidants
Οxidant activity in μmol/L
368.8 (330.8-409.0)
378.0 (348.5-409.1)
172.0.0 (167.5-178.5)
Μalondialdehyde in μmol/L)
1.9 (1.6-2.4)
1.2 (0.9-2.0)
1.8 (1.7-1.9)
Fe2+ in μg/dL)
64.0 (49.3-92.3)
110.0 (90.0-127.0)
68.0 (51.0-95.0)
Table 3 Percent change (and 95%CIs respectively) in the levels of serum antioxidant and oxidant substances compared to the control group
Colon polyps
Colon adenocarcinoma
% Change (95%CI)
% Change (95%CI)
Antioxidants
Antioxidant capacity
-40.1 (-41.6 to -38.5)
-40.7 (-41.8 to -39.5)
Vitamin Α
32.2 (20.8 to 44.7)
0.1 (-6.9 to 7.6)
Vitamin C
-3.1 (-15.8 to 11.6)
-12.7 (-21.9 to -2.4)
Vitamin E
4.2 (-5.0 to 14.2)
-12.3 (-18.4 to -5.7)
Vitamin D
-46.0 (-54.9 to -35.4)
-56.8 (-62.6 to -50.2)
Se
1.7 (-6.3 to 10.4)
-19.4 (-24.5 to -14.0)
Zn
-6.7 (-12.9 to 0.0)
-20.2 (-24.5 to -15.7)
B12
6.0 (-11.7 to 27.2)
-15.0 (-26.5 to -1.8)
Folic acid
2.1 (-6.9 to 12.0)
-8.2 (-14.7 to -1.3)
Oxidants
Oxidant activity
120.1 (111.7 to 128.9)
113.4 (106.8 to 120.2)
Malondialdehyde
-31.6 (-39.8 to -22.3)
10.1 (-0.6 to 21.9)
Fe2+
43.5 (22.2 to 68.5)
-8.9 (-19.8 to 3.5)
Table 4 Results from multiple logistic regression models (odds ratios and 95%CIs) for the risk of colon adenocarcinoma in comparison to the control group1
Odds ratio
95%CI
P value
Antioxidants
Vitamin Α, per 99.6 μg/L
1.20
0.77-1.88
0.430
Vitamin C, per 2.8 μg/L
0.71
0.44-1.15
0.168
Vitamin E, per 0.7 mg/L
0.57
0.39-0.84
0.004
Vitamin D, per 8.2 ng/mL
0.04
0.02-0.12
< 0.001
Se, per 13.6 μg/L
0.35
0.22-0.55
< 0.001
Zn, per 128.5 μg/L
0.16
0.09-0.31
< 0.001
B12, per 157.1 pg/L
0.80
0.51-1.26
0.337
Folic acid, per 38.1 ng/L
0.77
0.54-1.11
0.170
Oxidants
Malondialdehyde, per 0.5 μmol/L
2.09
1.27-3.45
0.004
Fe2+, per 33.9 μg/dL
0.73
0.47-1.13
0.154
Table 5 Multiple logistic regression results (odds ratios and 95%CIs) for the risk of colon polyp development in comparison to the control group1
Odds ratio
95%CI
P value
Antioxidants
Vitamin Α, per 99.6 μg/L
8.84
3.76-20.74
< 0.001
Vitamin C, per 2.8 μg/L
0.99
0.58-1.70
0.982
Vitamin E, per 0.7 mg/L
1.51
0.87-2.63
0.141
Vitamin D, per 8.2 ng/mL
0.27
0.15-0.48
< 0.001
Se, per 13.6 μg/L
1.68
0.82-3.42
0.157
Zn, per 128.5 μg/L
0.39
0.16-0.94
0.036
B12, per 157.1 pg/L
1.51
0.92-2.46
0.103
Folic acid, per 38.1 ng/L
1.42
0.74-2.72
0.299
Οxidants
Malondialdehyde, per 0.5 μmol/L
0.35
0.20-0.60
< 0.001
Fe2+, per 33.9 μg/dL
2.58
1.53-4.33
< 0.001
Citation: Tsounis D, Villiotou V, Melpidou A, Pantsiou C, Argyrou A, Giannopoulou C, Grigoratou A, Rontogianni D, Mantzaris GJ, Papatheodoridis G. Oxidative imbalance increases the risk for colonic polyp and colorectal cancer development. World J Gastrointest Oncol 2022; 14(11): 2208-2223