Yamaji Yutaka, Mitsushima Toru, Koike Kazuhiko
Department of Gastroenterology, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan.
Department of Gastroenterology, Kameda Medical Center Makuhari, Chiba, Japan.
Dig Liver Dis. 2014 Oct;46(10):943-9. doi: 10.1016/j.dld.2014.05.012. Epub 2014 Jun 19.
Although both colorectal neoplasms and atherosclerosis may be induced by visceral fat accumulation, no association between these factors has yet been elucidated.
Among Japanese participants in our colonoscopic screening and annual surveillance programs, asymptomatic subjects were investigated. Visceral fat area was measured by computed tomography, and the ankle-brachial index and pulse-wave velocity (markers of systemic atherosclerosis) were also estimated. Colorectal findings during screening were investigated in association with these parameters.
Nine hundred and seven subjects (males: 71.9%; mean age: 57.3±8.7 years) were enrolled. Colorectal adenomas were identified during colorectal screening of 407 subjects (44.9%). The prevalence of all colorectal adenoma and advanced neoplasia increased with an elevated pulse-wave velocity from 32.2% (advanced neoplasia, 2.6) to 62.1% (8.4%) in higher quartiles (p<0.001 and p=0.003). The risk of advanced neoplasia was higher in subjects with an abnormal ankle-brachial index (33% vs. 4.6%, p<0.001). Upon multivariate analysis, visceral fat area and pulse-wave velocity were associated with all adenoma, and the ankle-brachial index with advanced neoplasia.
The risk of colorectal adenoma was strongly associated with visceral fat area and markers of atherosclerosis. Colorectal adenoma and atherosclerosis may share a common pathogenesis and the same populations are at high-risk.
尽管结直肠肿瘤和动脉粥样硬化都可能由内脏脂肪堆积诱发，但这些因素之间的关联尚未阐明。
在参与我们结肠镜筛查和年度监测项目的日本参与者中，对无症状受试者进行调查。通过计算机断层扫描测量内脏脂肪面积，并评估踝臂指数和脉搏波速度（全身动脉粥样硬化的标志物）。研究筛查期间的结直肠检查结果与这些参数的关系。
共纳入907名受试者（男性：71.9%；平均年龄：57.3±8.7岁）。在407名受试者（44.9%）的结直肠筛查中发现了结直肠腺瘤。随着脉搏波速度升高，所有结直肠腺瘤和进展期肿瘤的患病率从较低四分位数的32.2%（进展期肿瘤为2.6%）升至较高四分位数的62.1%（8.4%）（p<0.001和p=0.003）。踝臂指数异常的受试者发生进展期肿瘤的风险更高（33%对4.6%，p<0.001）。多因素分析显示，内脏脂肪面积和脉搏波速度与所有腺瘤相关，而踝臂指数与进展期肿瘤相关。
结直肠腺瘤的风险与内脏脂肪面积和动脉粥样硬化标志物密切相关。结直肠腺瘤和动脉粥样硬化可能具有共同的发病机制，相同人群处于高危状态。
