肌肉减少症与晚期结直肠肿瘤风险增加相关。
Sarcopenia is associated with an increased risk of advanced colorectal neoplasia.
作者信息
Park Youn Su, Kim Ji Won, Kim Byeong Gwan, Lee Kook Lae, Lee Jae Kyung, Kim Joo Sung, Koh Seong-Joon
机构信息
Division of Gastroenterology, Department of Internal Medicine, Seoul National University Boramae Hospital, Seoul National University College of Medicine, 5 Gil 20, Boramae-Road, Dongjak-Gu, Seoul, 156-707, South Korea.
Department of Internal Medicine and Liver Research Institute, Seoul National University, Seoul, 110-744, South Korea.
出版信息
Int J Colorectal Dis. 2017 Apr;32(4):557-565. doi: 10.1007/s00384-016-2738-8. Epub 2016 Dec 24.
BACKGROUND/AIMS: Although sarcopenia is associated with an increased risk for mortality after the curative resection of colorectal cancer, its influence on the development of advanced colonic neoplasia remains unclear.
METHODS
This study included 1270 subjects aged 40 years or older evaluated with first-time screening colonoscopy at Seoul National University Boramae Health Care Center from January 2010 to February 2015. Skeletal muscle mass was measured with a body composition analyzer (direct segmental multifrequency bioelectrical impedance analysis method). Multiple logistic regression analysis was performed to determine whether sarcopenia is associated with advanced colorectal neoplasia.
RESULTS
Of 1270 subjects, 139 (10.9%) were categorized into the sarcopenia group and 1131 (89.1%) into the non-sarcopenia group. In the non-sarcopenia group, 55 subjects (4.9%) had advanced colorectal neoplasia. However, in the sarcopenia group, 19 subjects (13.7%) had advanced colorectal neoplasia, including 1 subject with invasive colorectal cancer (0.7%). In addition, subjects with sarcopenia had a higher prevalence of advanced adenoma (P < 0.001) than those without sarcopenia. According to the multiple logistic regression analysis adjusted for variable confounders, age (odds ratio 1.062, 95% confidence interval 1.032-1.093; P < 0.001), male sex (odds ratio 1.749, 95% confidence interval 1.008-3.036; P = 0.047), and sarcopenia (odds ratio 2.347, 95% confidence interval 1.311-4.202; P = 0.004) were associated with an advanced colorectal neoplasia.
CONCLUSION
Sarcopenia is associated with an increased risk of advanced colorectal neoplasia.
背景/目的：尽管肌肉减少症与结直肠癌根治性切除术后死亡风险增加相关，但其对晚期结肠肿瘤发生的影响仍不明确。
方法
本研究纳入了2010年1月至2015年2月在首尔国立大学博拉梅医疗中心接受首次筛查结肠镜检查的1270名40岁及以上的受试者。使用身体成分分析仪（直接节段多频生物电阻抗分析方法）测量骨骼肌质量。进行多因素逻辑回归分析以确定肌肉减少症是否与晚期结直肠肿瘤相关。
结果
1270名受试者中，139名（10.9%）被归入肌肉减少症组，1131名（89.1%）被归入非肌肉减少症组。在非肌肉减少症组中，55名受试者（4.9%）患有晚期结直肠肿瘤。然而，在肌肉减少症组中，19名受试者（13.7%）患有晚期结直肠肿瘤，其中1名患有浸润性结直肠癌（0.7%）。此外，肌肉减少症患者的晚期腺瘤患病率高于无肌肉减少症的患者（P<0.001）。根据针对可变混杂因素进行调整的多因素逻辑回归分析，年龄（比值比1.062，95%置信区间1.032 - 1.093；P<0.001）、男性（比值比1.749，95%置信区间1.008 - 3.036；P = 0.047）和肌肉减少症（比值比2.347，95%置信区间1.311 - 4.202；P = 0.004）与晚期结直肠肿瘤相关。
结论
肌肉减少症与晚期结直肠肿瘤风险增加相关。
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