Gui SY, Tang RX, Huang X, Yang GQ, Yang J. Association between type 2 diabetes mellitus and colorectal adenoma: A retrospective study with insights into Wnt/β-Catenin/TCF7L2 pathway activation. World J Gastrointest Surg 2026; 18(2): 113476 [DOI: 10.4240/wjgs.v18.i2.113476]
Corresponding Author of This Article
Jing Yang, PhD, Chief Physician, Department of Endocrinology, Shenzhen Nanshan People’s Hospital, Affiliated Nanshan Hospital of Shenzhen University, No. 89 Taoyuan Road, Nanshan District, Shenzhen 518052, Guangdong Province, China. yangjing.med@email.szu.edu.cn
Research Domain of This Article
Gastroenterology & Hepatology
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Retrospective Study
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Feb 27, 2026 (publication date) through Feb 26, 2026
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Publication Name
World Journal of Gastrointestinal Surgery
ISSN
1948-9366
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Baishideng Publishing Group Inc, 7041 Koll Center Parkway, Suite 160, Pleasanton, CA 94566, USA
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Gui SY, Tang RX, Huang X, Yang GQ, Yang J. Association between type 2 diabetes mellitus and colorectal adenoma: A retrospective study with insights into Wnt/β-Catenin/TCF7L2 pathway activation. World J Gastrointest Surg 2026; 18(2): 113476 [DOI: 10.4240/wjgs.v18.i2.113476]
World J Gastrointest Surg. Feb 27, 2026; 18(2): 113476 Published online Feb 27, 2026. doi: 10.4240/wjgs.v18.i2.113476
Association between type 2 diabetes mellitus and colorectal adenoma: A retrospective study with insights into Wnt/β-Catenin/TCF7L2 pathway activation
Shu-Yan Gui, Ruo-Xi Tang, Xing Huang, Guo-Qiang Yang, Jing Yang
Shu-Yan Gui, Ruo-Xi Tang, Xing Huang, Guo-Qiang Yang, Jing Yang, Department of Endocrinology, Shenzhen Nanshan People’s Hospital, Affiliated Nanshan Hospital of Shenzhen University, Shenzhen 518052, Guangdong Province, China
Author contributions: Gui SY designed the research and wrote the original manuscript; Gui SY, Tang RX, Huang X and Yang GQ contributed to conceiving the research and analyzing data; Yang J conducted the analysis and provided guidance for the research. All authors reviewed and approved the final manuscript.
Supported by the Outstanding Team Fund of the Nanshan District Health System - Shenzhen City, No. NSZD2025004; and the Major Science and Technology Plan Project of Nanshan District - Shenzhen City, No. NSZD2025016 and No. NSZD2024017.
Institutional review board statement: This study was a retrospective analysis, the data were de-identified, and it was collected retrospectively, so no Institutional Review Board certification was required.
Informed consent statement: Data was de-identified and retrospectively collected, and therefore informed consent was not required from each patient.
Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.
Data sharing statement: No additional data are available.
Received: October 14, 2025 Revised: November 17, 2025 Accepted: December 22, 2025 Published online: February 27, 2026 Processing time: 134 Days and 22 Hours
Abstract
BACKGROUND
Previous studies have confirmed the association of type 2 diabetes mellitus with the occurrence of colorectal polyps and adenomas. However, the current research results concerning the extent and specific effect of type 2 diabetes mellitus on the occurrence and development of colorectal adenomas remain inconsistent.
AIM
To identify and investigate the association between type 2 diabetes mellitus and colorectal adenoma pathogenesis.
METHODS
This retrospective case-control study reviewed all colonoscopies and definite pathology diagnoses performed in patients admitted to the Department of Gastroenterology, Nanshan People’s Hospital, from January 2015 to December 2017. Colorectal epithelium samples from colorectal adenomas were categorized into two groups: Patients with diabetes mellitus (A + D group; n = 20) and those with no diabetes mellitus (A + ND group; n = 20). The control group (NA + ND) comprised samples from patients without colorectal adenomas or hyperglycemia (n = 10). Carcinoembryonic antigen and insulin-like growth factor-1 levels were analyzed in each group. The expression of transcription factor 7 like 2 (TCF7L2), β-catenin, and Ki67 was detected using immunohistochemistry.
RESULTS
Type 2 diabetes mellitus was significantly associated with colorectal adenomas (odds ratio = 2.263, 95% confidence interval = 1.252-4.09, P = 0.007). Compared with the A + ND or NA + ND group, carcinoembryonic antigen and insulin-like growth factor-1 levels and TCF7L2, β-catenin, and Ki67 expressions were significantly higher in the A + D group (all P < 0.05).
CONCLUSION
The results of this small-scale retrospective cohort study indicate a significant association between type 2 diabetes mellitus and colorectal adenomas. The clinical sample experimental evidence in this study indicates that the increased activity and expression of Wnt/β-catenin/TCF7L2 is one of the mechanisms of type 2 diabetes mellitus and colorectal adenomas.
Core Tip: This small-scale retrospective cohort study confirmed that type 2 diabetes mellitus is a significant independent risk factor for colorectal adenomas. The results of this study indicate that Wnt/β-catenin/transcription factor 7 like 2 pathway activation is considered a common molecular pathological basis in the association of type 2 diabetes mellitus with colorectal adenoma occurrence and development. The results of this study support the inclusion of colonoscopy screening in the routine clinical management pathway for patients with type 2 diabetes mellitus.
