Division of Biostatistics, Graduate School of Public Health, Seoul National University, Seoul 110-799, Korea.
Chin Med J (Engl). 2011 Nov;124(22):3711-5.
Few studies have used body mass index (BMI), waist-to-hip ratio (WHR) and waist circumference (WC) at the same time to investigate the association between obesity and colorectal adenoma. This study examined the strength of association between colorectal adenoma and obesity using not only BMI, but also WHR and WC.
Subjects of this study included 1322 asymptomatic patients who underwent colonoscopy for cancer screening from January 2006 to June 2008. Anthropometric measurements, blood test results, and a self-administered questionnaire from each subject were analyzed.
Four hundred and fourteen adenoma cases were identified in 1322 subjects. Using univariate analysis, the prevalence of adenoma was associated with BMI and WHR and was higher among the abdominal obesity group using WC guidelines of the Korean Society for the Study of Obesity, but not using WC guidelines of the International Diabetes Federation. In multiple Logistic regression analysis, general obesity (BMI ≥ 25 kg/m(2)) increased the risk of colorectal adenoma (odds ratio (OR), 1.43; 95% confidence interval (CI), 1.05 - 1.94). Also, abdominal obesity by the WC cutoffs and the highest WHR percentile group (WHR ≥ 0.95) were significantly associated with adenoma. Among three measures of obesity, however, only BMI had a persistent association with adenoma after adjusting reciprocally for BMI, WC, and WHR (OR, 1.30; 95%CI, 1.02 - 1.80; and 1.49; 1.06 - 2.10, adjusted for WC and WHR, respectively).
The data suggest that general obesity is associated with an increased risk of colorectal adenoma.
很少有研究同时使用体重指数（BMI）、腰臀比（WHR）和腰围（WC）来探讨肥胖与结直肠腺瘤之间的关系。本研究不仅使用 BMI，还使用 WHR 和 WC 来研究肥胖与结直肠腺瘤之间的关联强度。
本研究的对象包括 2006 年 1 月至 2008 年 6 月因癌症筛查而行结肠镜检查的 1322 例无症状患者。对每位患者的人体测量指标、血液检查结果和自填问卷进行分析。
在 1322 名受试者中，共发现 414 例腺瘤病例。单因素分析显示，腺瘤的患病率与 BMI 和 WHR 相关，且根据韩国肥胖研究学会的 WC 标准，腹部肥胖组的患病率较高，但根据国际糖尿病联合会的 WC 标准，该组患病率并不高。多变量 Logistic 回归分析显示，普通肥胖症（BMI≥25kg/m2）增加了结直肠腺瘤的风险（比值比（OR），1.43；95%置信区间（CI），1.05-1.94）。此外，WC 切点和最高 WHR 百分位数组（WHR≥0.95）的腹型肥胖与腺瘤显著相关。然而，在这三种肥胖衡量标准中，只有 BMI 在相互调整 BMI、WC 和 WHR 后与腺瘤仍有持续关联（OR，1.30；95%CI，1.02-1.80；和 1.49；1.06-2.10，分别调整 WC 和 WHR）。
数据表明，普通肥胖症与结直肠腺瘤风险增加相关。
