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目的:探究胰岛素抵抗及糖脂代谢相关分子与结直肠息肉的关系。方法:选取2019年6月至2020年9月在山东省肿瘤医院接受肠镜检查的健康体检者262例，采用酶联免疫吸附试验(ELISA)检测其血清血管细胞黏附分子1(VCAM-1)、血清成纤维细胞生长因子19(FGF19)、胰岛素样生长因子1(IGF-1)及空腹血糖、空腹血胰岛素水平，计算胰岛素抵抗指数(HOMA-IR)，分析结直肠息肉的发生、病理类型、大小、数目的影响因素。结果:262例受检者中，无息肉检出116例，检出腺瘤性息肉113例，炎性息肉33例。息肉组HOMA-IR、VCAM-1及FGF19分别为2.904±1.754、(334.415±139.573)ng/ml和(135.865±98.470)pg/ml，均高于无息肉组[分别为2.369±1.306、(302.480±99.946)ng/ml和(110.694±76.044)ng/ml,均n P<0.05]。多因素Logistic回归分析显示，性别(n OR＝4.269，95%n CI为1.963～9.405)和FGF19(77.0～131.4 pg/ml：n OR＝2.385，95%n CI为1.155～4.926)为结直肠息肉发生的独立影响因素；性别(n OR＝3.799，95%n CI为1.650～8.748)和FGF19(77.0～131.4 pg/ml：n OR＝2.290，95%n CI为1.072～4.891)是结直肠腺瘤性息肉发生的独立影响因素，性别(n OR＝6.725，95%n CI为1.853～24.410)和空腹血糖(≥6.5 mmol/L：n OR＝0.047，95%n CI为0.009～0.245)是炎性息肉发生的独立影响因素；性别(n OR＝3.539，95%n CI为1.293～9.689)为单发息肉发生的独立影响因素，性别(n OR＝5.063，95%n CI为2.048～12.515)、FGF19(77.0～131.4 pg/ml：n OR＝2.502，95%n CI为1.102～5.681)和空腹血糖(≥6.5 mmol/L：n OR＝0.282，95%n CI为0.095～0.839)是多发息肉的独立影响因素；性别(n OR＝3.416，95%n CI为1.134～10.289)和空腹胰岛素(≥9.4 μU/ml：n OR＝9.480，95%n CI为1.485～60.521)为发生<0.5 cm结直肠息肉的独立影响因素，性别(n OR＝3.151，95%n CI为1.244～7.984)和空腹血糖(≥6.5 mmol/L：n OR＝0.310，95%n CI为0.102～0.941)为发生0.5～0.9 cm结直肠息肉的独立影响因素，性别(n OR＝22.649，95%n CI为4.154～123.485)、年龄(55～64岁：n OR＝4.473，95%n CI为1.070～18.704；≥65岁：n OR＝5.815, 95%n CI为1.300～26.009)、体质指数(≥28 kg/mn 2：n OR＝5.310，95%n CI为1.224～23.032)和FGF19(77.0～131.4 pg/ml：n OR＝7.474，95%n CI为1.903～29.351)为发生≥1.0 cm结直肠息肉的独立影响因素。按性别分层后，对于男性受检者，血清FGF19为结直肠息肉(77.0～131.4 pg/ml：n OR＝6.109，95%n CI为1.688～22.104)和腺瘤性息肉(77.0～131.4 pg/ml：n OR＝6.401，95%n CI为1.717～23.864)发生的独立影响因素。对于女性受检者，年龄(55～64岁：n OR＝3.783，95%n CI为1.052～13.611)和VCAM-1(≥352.8 ng/ml：n OR＝4.341，95%n CI为1.142～16.493)为结直肠息肉发生的独立影响因素，年龄(55～64岁：n OR＝5.743，95%n CI为1.205～27.362；≥65岁：n OR＝6.885，95%n CI为1.143～41.467)、VCAM-1(≥352.8 ng/ml：n OR＝6.313，95%n CI为1.415～28.159)和IGF-1(≥7.6 ng/ml：n OR＝5.621，95%n CI为1.069～29.543)为结直肠腺瘤性息肉发生的独立影响因素。n 结论:结直肠息肉及腺瘤性息肉的发生与胰岛素抵抗及糖脂代谢有关，血清FGF19是结直肠息肉及腺瘤性息肉发生的独立影响因素，是结直肠息肉及腺瘤性息肉潜在的血清学诊断标志物和治疗靶点。“,”Objective:To explore the relationship between insulin resistance, glucose and lipid metabolism related molecules and colorectal polyps.Methods:A total of 262 healthy people who underwent colonoscopy in Shandong cancer hospital from June 2019 to September 2020 were selected. The levels of serum vascular cell adhesion molecule-1 (VCAM-1), fibroblast growth factor 19 (FGF19), insulin like growth factor (IGF-1), fasting blood glucose and fasting blood insulin were detected by enzyme-linked immunosorbent assay (ELISA). Insulin resistance index (HOMA-IR) was calculated, and the influencing factors of occurrence, pathological type, size and number of polyps were analyzed.Results:Among 262 cases, 116 cases were polyp free, 113 cases were adenomatous polyp and 33 cases were inflammatory polyp. HOMA-IR, VCAM-1 and FGF19 in polyp group were 2.904±1.754, (334.415±139.573) ng/ml and (135.865±98.470) pg/ml, respectively, which were higher than 2.369±1.306, (302.480±99.946) ng/ml and(110.694±76.044) ng/ml in non-polyp group, respectively (n P<0.05). Multivariate Logistic regression analysis showed that the gender (n OR=4.269, 95%n CI: 1.963-9.405) and FGF19 (77.0-131.4 pg/ml: n OR=2.385, 95%n CI: 1.155-4.926) were independent factors of colorectal polyps. The gender (n OR=3.799, 95%n CI: 1.650-8.748) and FGF19 (77.0-131.4 pg/ml: n OR=2.290, 95%n CI: 1.072-4.891) were independent factors of colorectal adenomatous polyps. The gender(n OR=6.725, 95%n CI: 1.853-24.410) and fasting plasma glucose (≥6.5 mmol/L: n OR=0.047, 95%n CI: 0.009-0.245) were independent factors of colorectal inflammatory polyps. The gender (n OR=3.539, 95% n CI: 1.293-9.689) was an independent factor for the occurrence of single polyp. The gender (n OR=5.063, 95% n CI: 2.048-12.515), FGF19 (77.0-131.4 pg/ml: n OR=2.502, 95%n CI: 1.102-5.681), fasting plasma glucose (≥6.5 mmol/L: n OR=0.282, 95%n CI: 0.095-0.839) were independent factors of multiple polyps. The gender (n OR=3.416, 95% n CI: 1.134-10.289) and fasting insulin (≥9.4 μU/ml: n OR=9.480, 95% n CI: 1.485-60.521) were independent risk factors for colorectal polyps<0.5 cm. The gender (n OR=3.151, 95%n CI: 1.244-7.984) and fasting plasma glucose (≥6.5 mmol/L: n OR=0.310, 95%n CI: 0.102-0.941) were independent risk factors for colorectal polyps with the size of 0.5-0.9 cm. The gender (n OR=22.649, 95%n CI: 4.154-123.485), age (55 to 64 years old: n OR=4.473, 95%n CI: 1.070-18.704; ≥65 years old: n OR=5.815, 95%n CI: 1.300-26.009), BMI (≥28 kg/mn 2: n OR=5.310, 95%n CI: 1.224-23.032) and FGF19 (77.0-131.4 pg/ml: n OR=7.474, 95%n CI: 1.903-29.351) were independent factors for colorectal polyps with size ≥ 1.0 cm. Gender stratification analysis showed that FGF19 was an independent factor for the occurrence of male polyps (77.0-131.4 pg/ml: n OR=6.109, 95%n CI: 1.688-22.104) and adenomas (77.0-131.4 pg/ml: n OR=6.401, 95%n CI: 1.717-23.864). The age (55 to 64 years old: n OR=3.783, 95%n CI: 1.052-13.611) and VCAM-1 (≥352.8 ng/ml: n OR=4.341, 95%n CI: 1.142-16.493) were independent risk factors of female polyps. The age (55 to 64 years old: n OR=5.743, 95%n CI: 1.205-27.362, ≥65 years old: n OR=6.885, 95%n CI: 1.143-41.467), VCAM-1 (≥352.8 ng/ml: n OR=6.313, 95%n CI: 1.415-28.159) and IGF-1 (≥7.6 ng/ml: n OR=5.621, 95%n CI: 1.069-29.543) were independent factors of female adenoma.n Conclusions:The occurrences of colorectal polyps and adenomatous polyps are related to insulin resistance and glucose and lipid metabolism. Serum FGF19 is an independent influencing factor for the occurrence of colorectal polyps and adenomatous polyps, and is a potential serological diagnostic marker and therapeutic target for colorectal polyps and adenomatous polyps.