Lee H J, Lee J Y, Lee M J, Kim H-K, Kim N, Kim G-U, Lee J-S, Park H W, Chang H-S, Yang D-H, Choe J, Byeon J-S
Division of Gastroenterology, Health Screening and Promotion Center, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.
Division of Endocrinology, Health Screening and Promotion Center, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.
Colorectal Dis. 2020 Oct;22(10):1293-1303. doi: 10.1111/codi.15103. Epub 2020 Jun 4.
This study aimed to evaluate an association between colorectal neoplasm (CRN) and skeletal muscle mass using three widely accepted skeletal muscle mass indices (SMIs) in a large population at average risk.
We performed a cross-sectional study using a screening colonoscopy database of 33 958 asymptomatic subjects aged 40-75 years. Appendicular skeletal muscle mass (ASM) was measured using a bioelectrical impedance analyser. ASM adjusted for height squared (ASM/ht ), weight (ASM/wt) and body mass index (ASM/BMI) were used as indices for muscle mass. Logistic regression models were used to evaluate the association between SMIs and CRN.
In a multivariable-adjusted model, the risk of an advanced CRN increased linearly with decreasing quartiles for all three SMIs. The adjusted odds ratios (ORs) for advanced CRN in quartiles 1, 2 and 3 of ASM/wt compared with that in quartile 4 were 1.279, 1.196 and 1.179, respectively (P = 0.017); for ASM/BMI, ORs were 1.307, 1.144 and 1.091, respectively (P = 0.002); and for ASM/ht , ORs were 1.342, 1.169 and 1.062, respectively (P = 0.002). The risk of distally located advanced CRN was higher in quartile 1 than in quartile 4 for all three SMIs (ASM/wt, OR = 1.356; ASM/BMI, OR = 1.383; ASM/ht , OR = 1.430).
Our study demonstrated that low skeletal muscle mass was consistently associated with the presence of advanced CRN in a population at average risk regardless of the operational definition of the SMI, and it was particularly associated with distal advanced CRN.
本研究旨在使用三种广泛认可的骨骼肌质量指数（SMIs），在平均风险的大样本人群中评估结直肠肿瘤（CRN）与骨骼肌质量之间的关联。
我们使用了一个包含33958名年龄在40 - 75岁无症状受试者的结肠镜筛查数据库进行横断面研究。使用生物电阻抗分析仪测量四肢骨骼肌质量（ASM）。将ASM除以身高平方（ASM/ht）、体重（ASM/wt）和体重指数（ASM/BMI）作为肌肉质量指数。使用逻辑回归模型评估SMIs与CRN之间的关联。
在多变量调整模型中，对于所有三种SMIs，晚期CRN的风险随着四分位数的降低呈线性增加。与第4四分位数相比，ASM/wt的第1、2和3四分位数中晚期CRN的调整优势比（ORs）分别为1.279、1.196和1.179（P = 0.017）；对于ASM/BMI，ORs分别为1.307、1.144和1.091（P = 0.002）；对于ASM/ht，ORs分别为1.342、1.169和1.062（P = 0.002）。对于所有三种SMIs，第1四分位数中远端晚期CRN的风险高于第4四分位数（ASM/wt，OR = 1.356；ASM/BMI，OR = 1.383；ASM/ht，OR = 1.430）。
我们的研究表明，在平均风险人群中，无论SMI的操作定义如何，低骨骼肌质量始终与晚期CRN的存在相关，并且尤其与远端晚期CRN相关。
