Metabolic-Behavioral Risk Factors for Colorectal Adenomatous Polyps in Young Adults

Quan Zheng, Zaizai Li, Jiangtian Hu, Yukun Chu, Xiaolong Shi Department of Gastroenterology, the Fifth Affiliated Hospital of Zhengzhou University, Zhengzhou City, Henan, People’s Republic of ChinaCorrespondence: Zaizai Li, Department of Gastroenterology, the Fifth Affiliated Hospital of Zhengzhou University, Zhengzhou City, Henan, People’s Republic of China, Email [email protected]: This study aimed to identify risk factors associated with colorectal adenomatous polyps in young adults (≤ 40 years) to support early prevention and screening strategies for colorectal cancer.Methods: We conducted a study involving 805 young patients who underwent colonoscopy at the Endoscopy Center of The Fifth Affiliated Hospital of Zhengzhou University, China, from September 2023 to January 2025. Among them, 288 patients had at least one pathologically confirmed adenomatous polyp (cases), and 517 patients with no detected polyps served as controls. Data on demographics, lifestyle habits (smoking, alcohol use), metabolic parameters, and hematological indices were collected and analyzed.Results: Several factors were significantly associated with an increased risk of adenomatous polyps, including male sex, hypertension, diabetes, smoking, alcohol consumption, elevated body mass index, and reduced high-density lipoprotein cholesterol (HDL-C). Multivariate analysis further identified hypertension, alcohol use, and higher red blood cell count as independent risk factors. Conversely, female sex and higher HDL-C levels were found to be protective.Conclusion: The development of colorectal adenomatous polyps in young adults is strongly linked to modifiable risk factors such as hypertension and alcohol consumption, as well as elevated red blood cell counts. These findings highlight the importance of addressing cardiovascular and metabolic health, along with lifestyle modifications, in early screening and prevention programs for high-risk young individuals.Keywords: adenomatous, colorectal polyps, young adults, risk factors, colorectal cancer