Division of Gastroenterology, Department of Internal Medicine, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Korea.
Yonsei Med J. 2020 Jul;61(7):579-586. doi: 10.3349/ymj.2020.61.7.579.
The impact of changes in body mass index and waist circumference on the development of metachronous colorectal neoplasia (CRN) after polypectomy has rarely been examined. We evaluated the association between changes in overall/abdominal obesity and metachronous CRN risk.
We studied patients who underwent ≥1 adenoma removal and surveillance colonoscopy. Patients were classified into the following four groups based on the changes in overall obesity from index to follow-up colonoscopy: non-obesity persisted (group 1), obesity to non-obesity (group 2), non-obesity to obesity (group 3), and obesity persisted (group 4). Patients were also divided into another four groups based on similar changes in abdominal obesity (groups 5-8).
The number of patients in groups 1, 2, 3, and 4 was 5074, 457, 643, and 3538, respectively, and that in groups 5, 6, 7, and 8 was 4229, 538, 656, and 2189, respectively. Group 4 had a significantly higher risk of metachronous CRN compared to groups 1 and 2. However, metachronous advanced CRN (ACRN) risk was not different among groups 1, 2, 3, and 4. Metachronous CRN risk in group 8 (abdominal obesity persisted) was higher than that in groups 5 (non-abdominal obesity persisted) and 7 (non-abdominal obesity to abdominal obesity), and tended to be higher than that in group 6 (abdominal obesity to non-abdominal obesity). Additionally, group 8 had a significantly higher risk of metachronous ACRN compared to groups 5, 6, and 7.
Changes in obesity affected the metachronous CRN risk. In particular, changes in abdominal obesity affected the metachronous ACRN risk.
体重指数和腰围变化对息肉切除后并发结直肠腺瘤（CRN）的影响很少被研究。本研究评估了整体/腹部肥胖变化与结直肠腺瘤复发风险之间的关系。
研究对象为接受了≥1 个腺瘤切除且行随访结肠镜检查的患者。根据从基线到随访结肠镜检查时整体肥胖的变化，患者被分为以下四组：非肥胖持续组（第 1 组）、肥胖至非肥胖组（第 2 组）、非肥胖至肥胖组（第 3 组）和肥胖持续组（第 4 组）。同样，根据腹部肥胖的类似变化，患者被分为另外四组（第 5-8 组）。
第 1、2、3 和 4 组的患者数量分别为 5074、457、643 和 3538 例，第 5、6、7 和 8 组的患者数量分别为 4229、538、656 和 2189 例。与第 1 组和第 2 组相比，第 4 组发生结直肠腺瘤复发的风险显著增加。然而，第 1、2、3 和 4 组之间进展期腺瘤复发（ACRN）的风险无差异。与第 5 组（非腹部肥胖持续）和第 7 组（非腹部肥胖至腹部肥胖）相比，第 8 组（腹部肥胖持续）发生结直肠腺瘤复发的风险更高，且高于第 6 组（腹部肥胖至非腹部肥胖），第 8 组发生 ACRN 的风险也显著高于第 5、6 和 7 组。
肥胖的变化影响了结直肠腺瘤的复发风险。特别是，腹部肥胖的变化影响了结直肠腺瘤进展期腺瘤的复发风险。
