A new marker for measuring the malignant potential of colorectal polyps: Fasting glucose/serum leukocyte ratio

INTRODUCTION: Metabolic and inflammatory processes have been increasingly implicated in colorectal carcinogenesis. Fasting blood glucose and leukocyte count are routinely available laboratory parameters that may reflect these mechanisms. This study aimed to investigate the association between fasting glucose levels, glucose-to-leukocyte ratio, and colorectal polyp size as a surrogate marker of polyp-related risk.
METHODS: A total of 422 patients who underwent colonoscopic polypectomy were retrospectively analyzed. Fasting glucose, leukocyte count, and glucose-to-leukocyte ratio were evaluated using individual patient-level data. Correlation analyses, multivariate linear regression, and receiver operating characteristic (ROC) curve analyses were performed.
RESULTS: A significant positive correlation was observed between fasting glucose and polyp size (r=0.41, p<0.001), while leukocyte count alone was not significantly associated (p=0.28). The glucose-to-leukocyte ratio also demonstrated a significant correlation with polyp size (r=0.36, p<0.001). In multivariate analysis, fasting glucose (β=0.39, p<0.001) and glucose-to-leukocyte ratio (β=0.27, p=0.006) remained independently associated with polyp size. ROC analysis showed moderate discriminative ability for fasting glucose (AUC=0.71) and glucose-to-leukocyte ratio (AUC=0.75) in identifying larger polyps (≥10 mm).
DISCUSSION AND CONCLUSION: Fasting glucose and the glucose-to-leukocyte ratio were associated with colorectal polyp size, with the combined parameter demonstrating slightly improved discriminative performance. These findings suggest that simple, routinely available laboratory markers may provide additional information regarding polyp-related risk; however, further prospective studies incorporating histopathological parameters are required.

Keywords: Colorectal polyp, fasting glucose, leukocyte, inflammation, metabolic factors