Among these, a recent study by Macarie et al. showed that hyperlipidemia is an independent risk factor for premalignant polyps [20].The studies supporting a positive association between higher serum lipid levels and polyp formation and recurrence suggest two possible underlying mechanisms: The first mechanism is that insulin resistance increases the transformation of colorectal polyps into premalignant types and recurrence rates by inhibiting apoptosis and enabling the expression of insulin-like growth factor-1 (IGF-1) [21]. The gene discussed is IGF1; the disease is hyperlipidemia.