Bayerdörffer E, Mannes G A, Ochsenkühn T, Köpcke W, Wiebecke B, Paumgartner G
Medical Department II, Klinikum Grosshadern, University of Munich, Germany.
Gastroenterology. 1993 Jan;104(1):137-44. doi: 10.1016/0016-5085(93)90845-4.
Epidemiologic studies have suggested that the incidence of colorectal carcinoma may be related to overnutrition, but retrospective analysis of its relation to the body mass index (BMI: kg/m2) has produced conflicting data.
To avoid as many sources of statistical bias as possible, the relation between BMI and the presence of colorectal adenomas was investigated in a cross-sectional study.
Two thousand twelve consecutive colonoscoped patients were investigated (532 patients with malignancies or other conditions associated with weight loss were excluded). The relation between BMI and observed colorectal adenomas was evaluated by a logistic model controlling for other prognostic factors such as age, sex, and serum cholesterol level. The subgroup of "high-risk" adenomas with an increased risk of malignant transformation was positively associated with the BMI in men of the age group 50.5-68.1 years (quintiles III and IV: odds ratio for the top quintile vs. the lowest quintile, 3.21; 95% confidence interval, 1.15-8.98).
It was concluded that the risk of developing high-risk adenomas tends to be increased in men who are overweight and that this association is independent of the positive association with the serum cholesterol level recently described.
流行病学研究表明，结直肠癌的发病率可能与营养过剩有关，但对其与体重指数（BMI：千克/平方米）关系的回顾性分析得出了相互矛盾的数据。
为尽可能避免多种统计偏差来源，在一项横断面研究中调查了BMI与结直肠腺瘤存在之间的关系。
对连续212例接受结肠镜检查的患者进行了调查（排除了532例患有恶性肿瘤或其他与体重减轻相关疾病的患者）。通过一个逻辑模型评估BMI与观察到的结直肠腺瘤之间的关系，该模型控制了其他预后因素，如年龄、性别和血清胆固醇水平。在年龄为50.5 - 68.1岁的男性中，具有恶性转化风险增加的“高危”腺瘤亚组与BMI呈正相关（五分位数III和IV：最高五分位数与最低五分位数的比值比为3.21；95%置信区间为1.15 - 8.98）。
得出的结论是，超重男性发生高危腺瘤的风险往往会增加，并且这种关联独立于最近描述的与血清胆固醇水平的正相关。
