Oh Tae-Hoon, Byeon Jeong-Sik, Myung Seung-Jae, Yang Suk-Kyun, Choi Kwi-Sook, Chung Jun-Won, Kim Benjamin, Lee Don, Byun Jae Ho, Jang Se Jin, Kim Jin-Ho
Department of Internal Medicine, Inje University College of Medicine, Sanggye Paik Hospital, Seoul, Korea.
J Gastroenterol Hepatol. 2008 Mar;23(3):411-7. doi: 10.1111/j.1440-1746.2007.05125.x. Epub 2007 Aug 27.
Obesity as a risk factor for colorectal neoplasm (CRN) is controversial. In the present study, we evaluated visceral obesity as a risk factor for CRN.
We prospectively enrolled 200 consecutive, asymptomatic adults (male : female = 133:67, mean age, 50.9 +/- 8.5 years) undergoing both colonoscopy and abdominopelvic computed tomography (CT) scan for routine health evaluations. The presence or absence and the characteristics of CRN were determined during colonoscopy. The amount of visceral adipose tissue (VAT) and subcutaneous adipose tissue was measured by an abdominopelvic CT scan. Body mass index, waist circumference, and percentage of body fat were measured. Blood pressure and other blood markers for assessing the metabolic syndrome were also investigated.
Of the 200 patients, 53 (26.5%) had CRN. Old age, smoking, metabolic syndrome, and a high fasting plasma glucose level were associated with an increased risk of CRN. VAT (P < 0.01) and waist circumference (P = 0.01) were significantly higher in those with CRN. A multivariate analysis of the risks of CRN showed an odds ratio of 4.07 (95% confidence interval: 1.01-16.43, P = 0.03) for those with VAT over 136.61 cm(2) relative to those with VAT under 67.23 cm(2). Waist circumference, metabolic syndrome, and fasting plasma glucose levels were not independent risk factors for CRN in the multivariate analysis.
Increased VAT is an independent risk factor for CRN. Further large scale studies are needed to clarify the causal relationship between VAT and CRN.
肥胖作为结直肠肿瘤（CRN）的一个危险因素存在争议。在本研究中，我们评估了内脏肥胖作为CRN的一个危险因素。
我们前瞻性地纳入了200名连续的无症状成年人（男:女 = 133:67，平均年龄50.9±8.5岁），他们因常规健康评估接受结肠镜检查和腹盆腔计算机断层扫描（CT）。在结肠镜检查期间确定CRN的有无及其特征。通过腹盆腔CT扫描测量内脏脂肪组织（VAT）和皮下脂肪组织的量。测量体重指数、腰围和体脂百分比。还调查了血压及其他用于评估代谢综合征的血液标志物。
200例患者中，53例（26.5%）患有CRN。老年、吸烟、代谢综合征和高空腹血糖水平与CRN风险增加相关。CRN患者的VAT（P < 0.01）和腰围（P = 0.01）显著更高。对CRN风险的多因素分析显示，VAT超过136.61 cm²的患者相对于VAT低于67.23 cm²的患者，优势比为4.07（95%置信区间：1.01 - 16.43，P = 0.03）。在多因素分析中，腰围、代谢综合征和空腹血糖水平不是CRN的独立危险因素。
VAT增加是CRN的一个独立危险因素。需要进一步的大规模研究来阐明VAT与CRN之间的因果关系。
