Kwon Jin-Hyun, Ko Hae-Jin, Youn Chang-Ho, Choi Hye-In
Department of Family Medicine, Kyungpook National University School of Medicine, Daegu, Korea.
J Obes Metab Syndr. 2017 Mar;26(1):28-35. doi: 10.7570/jomes.2017.26.1.28. Epub 2017 Mar 30.
The goal of this study was to determine the relations between the risk of colorectal neoplasia and obesity markers: body mass index (BMI), waist circumference (WC), and waist-to-height ratio (WHtR).
The subjects who underwent screening colonoscopies at a Kyungpook National University Hospital in Daegu from July to December 2010 were enrolled. We defined colorectal neoplasia as tubular adenoma, advanced adenoma, or cancer. We performed a logistic regression analysis to investigate the correlations between obesity and colorectal neoplasia and a receiver operating characteristic (ROC) curve analysis to determine the cut-off obesity marker values for detecting colorectal neoplasia.
Among the total of 268 subjects, 83 (31.0%) subjects had colorectal neoplasia. Subjects with neoplasia had higher BMI, WC, and WHtR than the subjects without any neoplasia. The adjusted odds ratio (aOR) of WHtR ≥0.5 with the association of neoplasia was 1.927 (95% confidence interval [CI], 1.041-3.569) in the total subjects. In women, the obesity markers of WC ≥85 cm (aOR 4.611; 95% CI, 10.166-18.240) and WHtR ≥0.5 (aOR 1.747; 95% CI, 1.149-19.617) were significantly related to neoplasia; however, there was no significant result in men. The ROC analysis showed the optimal cut-off values of BMI as >23.14 kg/m (=0.002), WHtR as >0.50 (<0.001), and WC as>82.5 cm (=0.650) in men and >77 cm in women (<0.001).
Obesity is significantly associated with the increased risk of colorectal neoplasia. WC and WHtR have more significant correlations with neoplasia; thus, obese people should undergo regular colonoscopy screenings to detect colorectal neoplasia.
本研究的目的是确定结直肠肿瘤发生风险与肥胖标志物之间的关系，这些肥胖标志物包括体重指数（BMI）、腰围（WC）和腰高比（WHtR）。
纳入2010年7月至12月在大邱庆北国立大学医院接受结肠镜筛查的受试者。我们将结直肠肿瘤定义为管状腺瘤、高级别腺瘤或癌症。我们进行了逻辑回归分析以研究肥胖与结直肠肿瘤之间的相关性，并进行了受试者工作特征（ROC）曲线分析以确定检测结直肠肿瘤的肥胖标志物临界值。
在总共268名受试者中，83名（31.0%）受试者患有结直肠肿瘤。患有肿瘤的受试者的BMI、WC和WHtR高于没有任何肿瘤的受试者。在所有受试者中，WHtR≥0.5与肿瘤发生的校正比值比（aOR）为1.927（95%置信区间[CI]，1.041 - 3.569）。在女性中，WC≥85 cm（aOR 4.611；95% CI，10.166 - 18.240）和WHtR≥0.5（aOR 1.747；95% CI，1.149 - 19.617）这些肥胖标志物与肿瘤发生显著相关；然而，在男性中未得出显著结果。ROC分析显示，男性中BMI的最佳临界值为>23.14 kg/m²（=0.002），WHtR为>0.50（<0.001），WC为>82.5 cm（=0.650），女性中WC为>77 cm（<0.001）。
肥胖与结直肠肿瘤发生风险增加显著相关。WC和WHtR与肿瘤发生的相关性更显著；因此，肥胖人群应定期接受结肠镜筛查以检测结直肠肿瘤。
