CALLY is not associated with colorectal polyps risk: a systematic evaluation and mechanism exploration controlling for traditional factors and Traditional Chinese Medicine constitution
- 1Department of Gastroenterology, The Eighth Clinical Medical College of Guangzhou University of Chinese Medicine
- 2Department of Gastroenterology, Foshan Hospital of Traditional Chinese Medicine
Abstract
Background: Globally, colorectal cancer (CRC) ranks as the third most common malignancy in terms of incidence. Colorectal polyps (CP) are the most common precancerous lesions of CRC, making the timely identification of their risk factors critically important. Although the CALLY index has theoretical promise as a tool for stratifying the risk of CP occurrence, its clinical utility remains unvalidated and warrants rigorous empirical assessment. Traditional risk factor models primarily focus on measurable biological indicators, often overlooking differences in an individual's overall functional state. Incorporating traditional Chinese medicine constitution (TCMC) is expected to enable the development of more comprehensive risk prediction models. Therefore, this study aims to validate whether CALLY is an independent risk factor for CP and to conduct preliminary exploration of its potential biological mechanisms, based on systematic control of traditional medical risk factors and TCMC.
Methods: This study is a retrospective cross-sectional study that enrolled 452 hospitalized patients undergoing colonoscopy between October and December 2025. By constructing a stepwise-adjusted logistic regression model, conducting interaction analyses, testing mediating effects, and performing sensitivity analyses, we systematically investigated the relationship between CALLY and CP and its potential mechanisms.
Results: Multivariate logistic regression analysis revealed no significant statistical association between CALLY quartile groups and CP risk (all comparisons P > 0.05). In contrast, male gender (OR: 0.56; 95%CI: 0.33–0.93; P < 0.05), advanced age (OR: 1.04; 95%CI: 1.02–1.06; P < 0.01), diabetes (OR: 3.82; 95%CI: 1.45–10.06; P < 0.01) and gastric polyps (GP, OR: 2.11; 95%CI: 1.26–3.53; P < 0.01) were consistently identified as independent risk factors. Regarding TCMC, the phlegm-dampness constitution showed a statistically significant but imprecise association (OR: 14.33; 95%CI: 3.60–57.05; P < 0.01). Mediation analysis further indicated that neither triglycerides nor high-density lipoprotein cholesterol played a significant mediating role in the association between CALLY and CP ( P -values for direct, indirect, and total effects all > 0.05).
Conclusions: Among hospitalized gastroenterology patients, CALLY is not an independent risk marker for CP and is not recommended as a routine screening indicator for this population for the time being. Risk assessment for such patients should focus on their gender, age, diabetes and gastric polyps. The phlegm-dampness constitution should be considered a preliminary finding due to the small subgroup size and wide confidence intervals; its role as a stable risk factor requires independent validation in larger prospective cohorts.
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BibTeX
@article{zhang2026cally,
title = {{CALLY is not associated with colorectal polyps risk: a systematic evaluation and mechanism exploration controlling for traditional factors and Traditional Chinese Medicine constitution}},
author = {Kui Zhang and Xiaokun Wu and Fang Lin and Boyuan Chen and Yubin Han},
journal = {Frontiers in Public Health},
year = {2026},
month = oct,
doi = {10.3389/fpubh.2026.1953202},
url = {https://www.frontiersin.org/articles/10.3389/fpubh.2026.1953202/full},
note = {CC BY 4.0},
}
RIS
TY - JOUR
TI - CALLY is not associated with colorectal polyps risk: a systematic evaluation and mechanism exploration controlling for traditional factors and Traditional Chinese Medicine constitution
AU - Kui Zhang
AU - Xiaokun Wu
AU - Fang Lin
AU - Boyuan Chen
AU - Yubin Han
PY - 2026
DA - 2026/10/21
JO - Frontiers in Public Health
DO - 10.3389/fpubh.2026.1953202
UR - https://www.frontiersin.org/articles/10.3389/fpubh.2026.1953202/full
AB - Background: Globally, colorectal cancer (CRC) ranks as the third most common malignancy in terms of incidence. Colorectal polyps (CP) are the most common precancerous lesions of CRC, making the timely identification of their risk factors critically important. Although the CALLY index has theoretical promise as a tool for stratifying the risk of CP occurrence, its clinical utility remains unvalidated and warrants rigorous empirical assessment. Traditional risk factor models primarily focus on measurable biological indicators, often overlooking differences in an individual's overall functional state. Incorporating traditional Chinese medicine constitution (TCMC) is expected to enable the development of more comprehensive risk prediction models. Therefore, this study aims to validate whether CALLY is an independent risk factor for CP and to conduct preliminary exploration of its potential biological mechanisms, based on systematic control of traditional medical risk factors and TCMC. Methods: This study is a retrospective cross-sectional study that enrolled 452 hospitalized patients undergoing colonoscopy between October and December 2025. By constructing a stepwise-adjusted logistic regression model, conducting interaction analyses, testing mediating effects, and performing sensitivity analyses, we systematically investigated the relationship between CALLY and CP and its potential mechanisms. Results: Multivariate logistic regression analysis revealed no significant statistical association between CALLY quartile groups and CP risk (all comparisons P > 0.05). In contrast, male gender (OR: 0.56; 95%CI: 0.33–0.93; P < 0.05), advanced age (OR: 1.04; 95%CI: 1.02–1.06; P < 0.01), diabetes (OR: 3.82; 95%CI: 1.45–10.06; P < 0.01) and gastric polyps (GP, OR: 2.11; 95%CI: 1.26–3.53; P < 0.01) were consistently identified as independent risk factors. Regarding TCMC, the phlegm-dampness constitution showed a statistically significant but imprecise association (OR: 14.33; 95%CI: 3.60–57.05; P < 0.01). Mediation analysis further indicated that neither triglycerides nor high-density lipoprotein cholesterol played a significant mediating role in the association between CALLY and CP ( P -values for direct, indirect, and total effects all > 0.05). Conclusions: Among hospitalized gastroenterology patients, CALLY is not an independent risk marker for CP and is not recommended as a routine screening indicator for this population for the time being. Risk assessment for such patients should focus on their gender, age, diabetes and gastric polyps. The phlegm-dampness constitution should be considered a preliminary finding due to the small subgroup size and wide confidence intervals; its role as a stable risk factor requires independent validation in larger prospective cohorts.
SN - 2296-2565
ER -