Lee Hang Lak, Son Byoung Kwan, Lee Oh Young, Jeon Yong Chul, Han Dong Soo, Sohn Ju Hyun, Yoon Byung Chul, Choi Ho Soon, Hahm Joon Soo, Lee Min Ho, Lee Dong Hoo, Kee Chun Suk
Department of Internal Medicine, Hanyang University Hospital, Seoul, Korea.
Korean J Gastroenterol. 2007 Mar;49(3):147-51.
BACKGROUND/AIMS: Abdominal obesity and hyperinsulinemia or insulin resistance are of interest in connection with colon carcinogenesis. We conducted a prospective case controlled study for the evaluation of relationship between abdominal obesity, insulin resistance, and colorectal adenoma.
Fifty patients with colorectal adenoma and fifty healthy subjects were included in this study. Total colonoscopic examinations were performed in all the subjects. Fasting blood sugar (FBS), insulin, homeostasis model assessment (HOMA-IR), triglyceride (TG), cholesterol (CROL), BMI (body mass index), WHR (waist hip ratio), percent body fat (PBF) and obesity degree (OD) were measured. HOMA-IR was considered to represent insulin resistance. Diabetic patients were excluded from this study.
There were no differences in sex, serum insulin, FBS, HOMA-IR, TG, CROL between adenoma and control group. Subjects with high BMI, WHR, percent body fat, and obesity were more likely to have colonic adenoma. Multiple logistic regression analysis after adjusting confounding factors, had revealed that WHR was the most important independent risk factor for colon adenoma.
Abdominal obesity was most closely related to colonic adenoma. However, insulin resistance was not related to colonic adenoma. A larger case controlled study is needed.
背景/目的:腹部肥胖与高胰岛素血症或胰岛素抵抗与结肠癌发生相关。我们进行了一项前瞻性病例对照研究,以评估腹部肥胖、胰岛素抵抗与结直肠腺瘤之间的关系。
本研究纳入50例结直肠腺瘤患者和50例健康受试者。所有受试者均接受全结肠镜检查。测量空腹血糖(FBS)、胰岛素、稳态模型评估(HOMA-IR)、甘油三酯(TG)、胆固醇(CROL)、体重指数(BMI)、腰臀比(WHR)、体脂百分比(PBF)和肥胖程度(OD)。HOMA-IR被视为代表胰岛素抵抗。糖尿病患者被排除在本研究之外。
腺瘤组和对照组在性别、血清胰岛素、FBS、HOMA-IR、TG、CROL方面无差异。BMI、WHR、体脂百分比和肥胖程度高的受试者更易患结肠腺瘤。在调整混杂因素后的多因素逻辑回归分析显示,WHR是结肠腺瘤最重要的独立危险因素。
腹部肥胖与结肠腺瘤关系最为密切。然而,胰岛素抵抗与结肠腺瘤无关。需要进行更大规模的病例对照研究。