Takahashi Hirokazu, Takayama Tetsuji, Yoneda Kyoko, Endo Hiroki, Iida Hiroshi, Sugiyama Michiko, Fujita Koji, Yoneda Masato, Inamori Masahiko, Abe Yasunobu, Saito Satoru, Wada Koichiro, Nakagama Hitoshi, Nakajima Atsushi
Gastroenterology Division, Yokohama City University Graduate School of Medicine, Yokohama, Kanagawa 236-0004, Japan.
Cancer Sci. 2009 Jan;100(1):29-32. doi: 10.1111/j.1349-7006.2008.00994.x. Epub 2008 Oct 23.
The association between obesity and the risk of colorectal cancer (CRC) cannot be easily evaluated because CRC itself is associated with a gradual loss of bodyweight. Aberrant crypt foci (ACF) can be classified as dysplastic ACF or non-dysplastic ACF by magnifying colonoscopy, and dysplastic ACF are thought to be a biomarker of CRC. Ninety-four participants who underwent colonoscopy at Yokohama City University Hospital, Japan, were enrolled in the current study. We detected 557 ACF, including 67 dysplastic ACF (12.0%). Univariate regression analysis was conducted to determine correlations between the number of dysplastic ACF and various potential risk factors, including patient age, waist circumference, body mass index, visceral fat area (VFA), and plasma adiponectin level. The results of multiple regression analysis revealed that the number of dysplastic ACF correlated with age (correlation coefficient r=0.212, P=0.0383) and plasma adiponectin level (r=-0.201, P=0.0371), even after adjustments for sex, waist circumference, body mass index, and VFA. Our univariate correlation analysis data showed a significant correlation with the number of dysplastic ACF with VFA (r=0.238, P=0.0209), no correlation with subcutaneous fat area, and an inverse correlation with the plasma level of adiponectin (r=-0.258, P=0.0118). Thus, our results suggest that aging and visceral fat accumulation could correlate moderately with colorectal carcinogenesis. The novelty of our study lies in the finding that visceral fat accumulation and a low plasma adiponectin level may promote colorectal carcinogenesis; therefore, these obesity-related parameters may serve as novel targets for CRC prevention.
肥胖与结直肠癌（CRC）风险之间的关联难以轻易评估，因为CRC本身就与体重逐渐减轻有关。通过放大结肠镜检查，异常隐窝病灶（ACF）可分为发育异常的ACF或非发育异常的ACF，发育异常的ACF被认为是CRC的生物标志物。本研究纳入了94名在日本横滨市立大学医院接受结肠镜检查的参与者。我们检测到557个ACF，其中包括67个发育异常的ACF（12.0%）。进行单因素回归分析以确定发育异常的ACF数量与各种潜在风险因素之间的相关性，这些因素包括患者年龄、腰围、体重指数、内脏脂肪面积（VFA）和血浆脂联素水平。多元回归分析结果显示，即使在对性别、腰围、体重指数和VFA进行调整后，发育异常的ACF数量仍与年龄（相关系数r = 0.212，P = 0.0383）和血浆脂联素水平（r = -0.201，P = 0.0371）相关。我们的单因素相关性分析数据显示，发育异常的ACF数量与VFA显著相关（r = 0.238，P = 0.0209），与皮下脂肪面积无相关性，与血浆脂联素水平呈负相关（r = -0.258，P = 0.0118）。因此，我们的结果表明，衰老和内脏脂肪堆积可能与结直肠癌发生存在中度相关性。我们研究的新颖之处在于发现内脏脂肪堆积和低血浆脂联素水平可能促进结直肠癌发生；因此，这些与肥胖相关的参数可能成为预防CRC的新靶点。
