Kim Bun, Kim Byung Chang, Nam Su Youn, Nam Ji Hyung, Ryu Kum Hei, Park Bum Joon, Sohn Dae Kyung, Hong Chang Won, Han Kyung Su, Kim Hyun Bum
a Center for Colorectal Cancer , National Cancer Center , Goyang , Korea.
b Center for Cancer Prevention and Detection , National Cancer Center , Goyang , Korea.
Nutr Cancer. 2017 Jul;69(5):739-745. doi: 10.1080/01635581.2017.1324632. Epub 2017 Jun 1.
Whether obesity accelerates adenoma recurrence is not yet clear; therefore, we analyzed the risk factors for adenoma occurrence at follow-up colonoscopy, with a focus on visceral adiposity. In total, 1516 subjects underwent index colonoscopy, computed tomography, and questionnaire assessment from February to May 2008; 539 subjects underwent follow-up colonoscopy at the National Cancer Center at least 6 mo after the index colonoscopy. The relationships between the presence of adenoma at follow-up colonoscopy and anthropometric obesity measurements, including body mass index (BMI), waist circumference (WC), visceral adipose tissue (VAT) volume, and subcutaneous adipose tissue (SAT) volume, were analyzed. 188 (34.9%) had adenomatous polyps at follow-up colonoscopy. Multivariate analysis revealed that VAT volume ≥ 1000 cm and BMI ≥ 30 kg/m were related to the presence of adenoma at follow-up colonoscopy (VAT volume 1000-1500 cm: odds ratio [OR] = 2.13(95% confidence interval, CI = 1.06-4.26), P = 0.034; VAT volume ≥ 1000 cm: OR = 2.24(95% CI = 1.03-4.88), P = 0.043; BMI ≥ 30 kg/m: OR = 4.22(95% CI = 1.12-15.93), P = 0.034). In contrast, BMI 25-29.9 kg/m, SAT volume, and WC were not associated with the presence of adenoma at follow-up colonoscopy. In conclusion, excess VAT can contribute to the development and growth of new colorectal adenomas, and is a better predictor of colorectal adenoma occurrence at follow-up colonoscopy than BMI, WC, and SAT volume.
肥胖是否会加速腺瘤复发尚不清楚；因此，我们分析了随访结肠镜检查时腺瘤发生的危险因素，重点关注内脏脂肪。2008年2月至5月，共有1516名受试者接受了首次结肠镜检查、计算机断层扫描和问卷调查评估；539名受试者在首次结肠镜检查至少6个月后在国家癌症中心接受了随访结肠镜检查。分析了随访结肠镜检查时腺瘤的存在与人体测量肥胖指标之间的关系，这些指标包括体重指数（BMI）、腰围（WC）、内脏脂肪组织（VAT）体积和皮下脂肪组织（SAT）体积。188名（34.9%）受试者在随访结肠镜检查时患有腺瘤性息肉。多变量分析显示，VAT体积≥1000 cm和BMI≥30 kg/m²与随访结肠镜检查时腺瘤的存在有关（VAT体积1000 - 1500 cm：优势比[OR]=2.13（95%置信区间，CI = 1.06 - 4.26），P = 0.034；VAT体积≥1000 cm：OR = 2.24（95% CI = 1.03 - 4.88），P = 0.043；BMI≥30 kg/m²：OR = 4.22（95% CI = 1.12 - 15.93），P = 0.034）。相比之下，BMI 25 - 29.9 kg/m²、SAT体积和WC与随访结肠镜检查时腺瘤的存在无关。总之，过多的VAT会促使新的结直肠腺瘤发展和生长，并且在随访结肠镜检查中，它比BMI、WC和SAT体积更能预测结直肠腺瘤的发生。
