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体脂肪分布与代谢综合征与结直肠腺瘤发生的相关性:病例对照研究。

Association of body fat distribution and metabolic syndrome with the occurrence of colorectal adenoma: A case-control study.

机构信息

Department of Surgery, University of Hong Kong-Shenzhen Hospital, Shenzhen, Guangdong Province, China.

Department of Surgery, Li Ka Shing Faculty of Medicine, University of Hong Kong, Hong Kong SAR, China.

出版信息

J Dig Dis. 2021 Apr;22(4):222-229. doi: 10.1111/1751-2980.12979. Epub 2021 Mar 29.

Abstract

OBJECTIVE

Visceral fat is thought to play different roles in the carcinogenesis of the colon with peripheral fat. Our aim was to evaluate the association of body fat distribution measured by bioelectrical impedance analysis (BIA) with the incidence of colorectal adenoma (CRA).

METHODS

A total of 410 asymptomatic participants who underwent a screening colonoscopy from July 2017 to December 2019 in our center were recruited, including 230 with adenomas and 180 without detected adenomas. The participants' body fat was measured by BIA, including their body fat mass (BFM), body fat percentage (BFP), and waist-to-hip ratio. Parameters of metabolic syndrome (MetS), including waist circumference, blood pressure, fasting blood glucose (FBG), blood level of triglyceride, cholesterol, and high-density lipoprotein were measured as well.

RESULTS

According to univariate analysis, age, male sex, body mass index, waist circumference, BFM, waist-to-hip ratio, blood pressure, and FBG were higher in the adenoma group than in the adenoma-free group (P < 0.05). On multivariate logistical analysis (adjusted for age, sex, smoking, drinking, and family history of CRC), a high waist-to-hip ratio was associated with a high incidence of CRA (odds ratio [OR] 1.84, 95% confidence interval [CI] 1.09-3.09, P = 0.02). Only a large waist circumference in components of MetS was independently associated with the incidence of CRA (OR 1.90, 95% CI 1.17-3.08, P = 0.01) in the multivariate analysis.

CONCLUSION

Body fat distribution is associated with CRA, central obesity is a core risk factor for CRA in MetS. Chinese Clinical Trial Registration number: ChiCTR-RRC-17010862.

摘要

目的

内脏脂肪被认为在结肠癌的发生发展中发挥着不同于外周脂肪的作用。我们旨在评估通过生物电阻抗分析(BIA)测量的体脂分布与结直肠腺瘤(CRA)发生率之间的关系。

方法

我们招募了 2017 年 7 月至 2019 年 12 月在我们中心接受筛查性结肠镜检查的 410 名无症状参与者,其中 230 名患有腺瘤,180 名未发现腺瘤。参与者的体脂通过 BIA 进行测量,包括体脂量(BFM)、体脂百分比(BFP)和腰臀比。还测量了代谢综合征(MetS)的参数,包括腰围、血压、空腹血糖(FBG)、甘油三酯、胆固醇和高密度脂蛋白的血液水平。

结果

根据单因素分析,腺瘤组的年龄、男性、体重指数、腰围、BFM、腰臀比、血压和 FBG 均高于无腺瘤组(P<0.05)。在多变量逻辑分析(调整年龄、性别、吸烟、饮酒和结直肠癌家族史)中,高腰臀比与 CRA 发生率较高相关(比值比[OR]1.84,95%置信区间[CI]1.09-3.09,P=0.02)。仅在 MetS 成分中较大的腰围与 CRA 的发生独立相关(OR 1.90,95% CI 1.17-3.08,P=0.01)。

结论

体脂分布与 CRA 相关,中心性肥胖是 MetS 中 CRA 的核心危险因素。中国临床试验注册号:ChiCTR-RRC-17010862。

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