Preventive Healthcare Center.
Department of Internal Medicine, Division of Gastroenterology, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Korea.
J Clin Gastroenterol. 2019 Aug;53(7):e284-e290. doi: 10.1097/MCG.0000000000001086.
We aimed to ascertain whether waist circumference (WC) is associated with risk of colorectal neoplasia (CRN), independent of body mass index (BMI).
Although several studies have reported the association between abdominal obesity, measured by WC, and CRN, it remains unclear whether their association is biased by BMI.
A cross-sectional study was performed on 154,552 asymptomatic examinees who underwent colonoscopy for a health check-up.
The mean age was 42.6 years, and the proportion of males was 65.2%. The prevalence rate of CRN in subjects in WC quartiles 1, 2, 3, and 4 was 15.6%, 18.1%, 20.4%, and 22.0% among men and 7.8%, 9.4%, 12.2%, and 15.8% among women, respectively. WC and BMI were independent risk factors for overall CRN and nonadvanced CRN in both men and women. In men, the association of BMI with advanced CRN was attenuated to null after adjusting for WC [Q2, Q3, and Q4 vs. Q1; odds ratios (95% confidence intervals), 0.93 (0.79-1.10), 0.85 (0.71-1.03), and 0.99 (0.80-1.22), respectively; Ptrend=0.822], whereas the association of WC with advanced CRN significantly persisted even after adjusting for BMI [Q2, Q3, and Q4 vs. Q1; 1.20 (1.02-1.42), 1.45 (1.20-1.75), and 1.64 (1.32-2.04), respectively; Ptrend<0.001]. In women, neither WC nor BMI was associated with the risk of advanced CRN.
Abdominal obesity is associated with an increased risk of advanced CRN, independent of overall obesity (BMI) in men. Our findings suggest that abdominal obesity is more strongly predictive of advanced CRN than overall obesity in men.
我们旨在确定腰围（WC）是否与结直肠肿瘤（CRN）风险相关，而与体重指数（BMI）无关。
尽管多项研究报告了通过 WC 测量的腹部肥胖与 CRN 之间的关联，但尚不清楚它们的关联是否受到 BMI 的影响。
对 154552 名无症状受检者进行了一项横断面研究，这些受检者因健康检查而行结肠镜检查。
平均年龄为 42.6 岁，男性比例为 65.2%。男性 WC 四分位数 1、2、3 和 4 组中 CRN 的患病率分别为 15.6%、18.1%、20.4%和 22.0%，女性分别为 7.8%、9.4%、12.2%和 15.8%。WC 和 BMI 是男性和女性总体 CRN 和非晚期 CRN 的独立危险因素。在男性中，在调整 WC 后，BMI 与晚期 CRN 的关联减弱至无统计学意义[第二、第三和第四四分位数与第一四分位数相比；比值比（95%置信区间），0.93（0.79-1.10）、0.85（0.71-1.03）和 0.99（0.80-1.22）；Ptrend=0.822]，而 WC 与晚期 CRN 的关联即使在调整 BMI 后仍显著持续[第二、第三和第四四分位数与第一四分位数相比；1.20（1.02-1.42）、1.45（1.20-1.75）和 1.64（1.32-2.04）；Ptrend<0.001]。在女性中，WC 和 BMI 均与晚期 CRN 风险无关。
男性中，腹部肥胖与晚期 CRN 风险增加相关，而与整体肥胖（BMI）无关。我们的研究结果表明，在男性中，腹部肥胖比整体肥胖更能预测晚期 CRN。
