Davidow A L, Neugut A I, Jacobson J S, Ahsan H, Garbowski G C, Forde K A, Treat M R, Waye J D
Department of Medicine, College of Physicians and Surgeons, Columbia University, New York, New York 10032, USA.
Cancer Epidemiol Biomarkers Prev. 1996 Apr;5(4):313-5.
Interest in risk factors for the recurrence of adenomatous polyps derives from the use of recurrent adenomas as surrogate end points in longitudinal studies of invasive colorectal cancer. In this case-control study, the effect of increased body mass index (BMI) on the risk of recurrent adenomas was investigated. Subjects consisted of patients seen at three colonoscopy practices in New York City, all of whom had a previous history of adenomas. On index colonoscopy, recurrent cases had an adenoma, whereas controls were normal. Men and women were analyzed separately, with different logistic models developed using backward elimination from a full model containing the covariates age at diagnosis, age-at-highest-weight, pack-years of smoking, activity level, energy intake, and fat and fiber intake. Men in the upper quartiles of BMI were found to be at greater risk of recurrent adenomas. In a model which controlled for age at diagnosis, age-at-highest-weight, activity level, pack-years of smoking and kilocalories, the estimated odds ratios were 2.2, 1.9 and 1.9 respectively for the second, third and fourth quartiles compared to the first quartile. Only the estimate for the second quartile was found to be statistically significant. No effect was observed for women, even in a model which controlled for age at diagnosis, age-at-highest-weight, pack-years and total fat. Obesity may play a role in adenoma recurrence. Confirmation of this finding would have important implications for possible prevention strategies in the future.
对腺瘤性息肉复发风险因素的关注源于在侵袭性结直肠癌纵向研究中使用复发性腺瘤作为替代终点。在这项病例对照研究中，研究了体重指数（BMI）升高对复发性腺瘤风险的影响。研究对象包括在纽约市三家结肠镜检查机构就诊的患者，他们都有腺瘤病史。在首次结肠镜检查时，复发病例有腺瘤，而对照组正常。对男性和女性分别进行分析，使用包含协变量诊断年龄、最高体重时年龄、吸烟包年数、活动水平、能量摄入以及脂肪和纤维摄入的全模型通过向后排除法建立不同的逻辑模型。发现BMI处于上四分位数的男性复发性腺瘤风险更高.在一个控制了诊断年龄、最高体重时年龄、活动水平、吸烟包年数和千卡的模型中，与第一四分位数相比第二、第三和第四四分位数的估计比值比分别为2.2、1.9和1.9。仅发现第二四分位数估计值具有统计学意义.未观察到女性有此影响，即使在一个控制了诊断年龄、最高体重时年龄、吸烟包年数和总脂肪的模型中也是如此。肥胖可能在腺瘤复发中起作用。这一发现的证实将对未来可能的预防策略产生重要影响。
