Objective <p>Colorectal adenomatous polyps are well-recognized precancerous lesions of colorectal cancer. Early identification and clinial intervention are crucial for reducing the risk of colorectal cancer. This study aimed to systematically investigate the diagnostic value of lipid and systemic inflammatory markers in colorectal adenomatous polyps and to construct a predictive diagnostic model, thereby providing assistance for early clinical identification.</p> Methods <p>This retrospective study includes 220 patients with colorectal adenomatous polyps who underwent endoscopic mucosal resection (EMR) or endoscopic submucosal dissection (ESD) in the Department of Gastroenterology at the Fourth Affiliated Hospital of Anhui Medical University between January 1, 2023 and December 31, 2023. Concurrently, 220 healthy controls undergoing physical examinations at the hospital's physical examination center during the same period are enrolled. This study aimed to analyze the diagnostic value of lipid indicators (cholesterol, triglycerides, high-density lipoprotein and low-density lipoprotein) and systemic inflammatory markers (NLR, PLR, MLR, SII, SIRI and AISI) in colorectal adenomatous polyps and to construct a diagnostic model to facilitate clinical diagnosis.</p> Results <p>Baseline data analysis revealed statistically significant differences between the adenoma group and the control group in terms of gender, age, body mass index (BMI), cholesterol (TC), triglycerides (TG), high-density lipoprotein (HDL), low-density lipoprotein (LDL) and systemic inflammatory markers (NLR, PLR, MLR, SII, SIRI and AISI). Univariate and multivariate logistic regression analyses identified male, age, TC, TG and NLR as serving as valuable diagnostic indicators in colorectal adenomatous polyps, with TG showing the highest diagnostic value. The diagnostic nomogram model was constructed using the aforementioned five independent predictors among the variables examined to demonstrate robust discrimination, calibration and clinical utility.</p> Conclusion <p>Abnormal lipid metabolism and systemic inflammatory status serve as valuable diagnostic indicators in colorectal adenomatous polyps. The diagnostic model integrating metabolic and inflammatory markers exhibits certain diagnostic predictive efficacy,which can serve as providing auxiliary support for non-invasive, early screening of colorectal adenomatous polyps.</p>