Morita Takako, Tabata Shinji, Mineshita Masamichi, Mizoue Tetsuya, Moore Malcolm A, Kono Suminori
Department of Preventive Medicine, Faculty of Medical Sciences, Kyushu University, Fukuoka 812-8582, Japan.
Asian Pac J Cancer Prev. 2005 Oct-Dec;6(4):485-9.
The metabolic syndrome, a cluster of metabolic abnormalities linked to insulin resistance, has attracted much interest as a risk factor for cardiovascular disease and type 2 diabetes. Hyperinsulinemia is also a postulated biological risk factor for colorectal carcinogenesis. We therefore here examined the relation between the metabolic syndrome and colorectal adenoma development. The study subjects were 756 cases of colorectal adenoma and 1751 controls with no polyps who underwent total colonoscopy during the period January 1995 to March 2002 at two Self Defense Forces (SDF) hospitals in Japan. The metabolic syndrome was defined with reference to abdominal obesity in combination with any two of the following conditions: elevated triglycerides (150 mg/dL); lowered HDL cholesterol (<40 mg/dL); elevated blood pressure (systolic blood pressure 130 mmHg and/or diastolic blood pressure 85 mmHg); and raised fasting glucose (110 mg/dL). Abdominal obesity was defined as a waist circumference of 85 cm or more(Japanese criterion) or 90 cm (Asian criterion). Statistical adjustment was made for age, hospital, and rank in the SDF. The metabolic syndrome was found to be associated with a moderately increased risk of colorectal adenomas whether either of the Japanese and Asian criteria was used; adjusted odds ratios with the Japanese and Asian criteria were 1.38 (95% confidence interval [CI] 1.13-1.69) and 1.48 (95% CI 1.13-1.93), respectively. Increased risk was more evident for proximal than distal colon or rectal adenomas, and was almost exclusively observed for large lesions (5 mm in diameter). Thus the metabolic syndrome appears to be an important entity with regard to the prevention of colorectal cancer, as well as cardiovascular disease and type 2 diabetes.
代谢综合征是一组与胰岛素抵抗相关的代谢异常，作为心血管疾病和2型糖尿病的危险因素已引起广泛关注。高胰岛素血症也是结直肠癌发生的一个假定生物学危险因素。因此，我们在此研究了代谢综合征与结肠腺瘤发生之间的关系。研究对象为1995年1月至2002年3月期间在日本两家自卫队医院接受全结肠镜检查的756例结肠腺瘤患者和1751例无息肉的对照者。代谢综合征的定义是参照腹部肥胖并结合以下任何两种情况：甘油三酯升高（150mg/dL）；高密度脂蛋白胆固醇降低（<40mg/dL）；血压升高（收缩压130mmHg和/或舒张压85mmHg）；空腹血糖升高（110mg/dL）。腹部肥胖定义为腰围85cm或以上（日本标准）或90cm（亚洲标准）。对年龄、医院和自卫队中的军衔进行了统计调整。无论采用日本标准还是亚洲标准，均发现代谢综合征与结肠腺瘤风险适度增加相关；采用日本标准和亚洲标准的校正比值比分别为1.38（95%置信区间[CI]1.13 - 1.69）和1.48（95%CI 1.13 - 1.93）。近端结肠腺瘤或直肠腺瘤的风险增加比远端更明显，且几乎仅在大病变（直径5mm）中观察到。因此，代谢综合征似乎是预防结直肠癌以及心血管疾病和2型糖尿病的一个重要因素。
