Correlation between obesity and colorectal adenoma

Xiao-cong Zhang, Jinhua Yang, Qi-long Li, Zenghao Xu, Shu-juan Lin, Jiayu Li, S. Qian, L. You, M. Jin, Kun Chen
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Abstract

Objective To explore the correlation between obesity and the risk of colorectal adenoma, so as to provide theoretic evidence for the intervention of the high-risk population for colorectal cancer. Methods Based on the Screen Project of Early Diagnosis and Treatment of Colorectal Cancer in Jiashan County, from August 2012 to March 2018, the results of colonoscopy and body measurement information of the high-risk population for colorectal cancer were collected. According to the results of colonoscopy, 3 895 patients with colorectal adenoma and 11 232 healthy controls were enrolled. Multivariate logistic regression was used to analyze the correlation between overweight (body mass index (BMI) 24.0 to 27.9 kg/m2), obesity (BMI≥28.0 kg/m2) and the risk of colorectal adenoma. Results After adjusting for gender and age, compared with that of individuals with normal weight (BMI 18.5 to 23.9 kg/m2), the risk of colorectal adenoma of obese patients increased by 36% (odds ratio (OR)=1.36, 95% confidence interval (CI) 1.18 to 1.56). After stratifing by gender, compared with that of individuals with normal weight, the risk of colorectal adenoma of obese males increased by 30% (OR=1.30, 95%CI 1.07 to 1.59), the risk of colorectal adenoma of overweight females and obese females increased by 15% (OR=1.15, 95%CI 1.01 to 1.31) and 40% (OR=1.40, 95%CI 1.14 to 1.71), respectively. After stratifing by age, compared with that of individuals with normal weight, the risk of colorectal adenoma of obese patients aged between 40 and 59 years increased by 31% (OR=1.31, 95%CI 1.07 to 1.61), and the risk of colorectal adenoma of overweight and obese patients aged between 60 and 74 years increased by 13% (OR=1.13, 95%CI 1.01 to 1.27) and 39% (OR=1.39, 95%CI 1.15 to 1.70), respectively. The results of subgroup analysis according to pathological types indicated that the risk of non-advanced adenoma and advanced adenoma of obese patients increased by 35% (OR=1.35, 95%CI 1.16 to 1.57) and 39% (OR=1.39, 95%CI 1.06 to 1.83), respectively. Conclusions Obesity is correlated with colorectal adenoma, which is more significant in women, individuals aged between 60 and 74 years and advanced adenoma. The intervention of high-risk population for colorectal cancer should include body mass control. Key words: Colorectal adenoma; Body mass index; Obesity; Correlation
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肥胖与结直肠腺瘤的关系
目的探讨肥胖与结直肠腺瘤发病风险的相关性,为结直肠癌高危人群的干预提供理论依据。方法基于嘉善县结直肠癌早期诊疗筛查项目,收集2012年8月至2018年3月结直肠癌高危人群结肠镜检查结果及体测信息。根据结肠镜检查结果,纳入3 895例结直肠腺瘤患者和11 232例健康对照。采用多因素logistic回归分析超重(体质指数(BMI) 24.0 ~ 27.9 kg/m2)、肥胖(BMI≥28.0 kg/m2)与结直肠腺瘤发病风险的相关性。结果在调整性别和年龄后,与体重正常人群(BMI 18.5 ~ 23.9 kg/m2)相比,肥胖患者发生结直肠腺瘤的风险增加36%(优势比(OR)=1.36, 95%可信区间(CI) 1.18 ~ 1.56)。按性别分层后,与体重正常人群相比,肥胖男性发生结直肠腺瘤的风险增加30% (OR=1.30, 95%CI 1.07 ~ 1.59),超重女性和肥胖女性发生结直肠腺瘤的风险分别增加15% (OR=1.15, 95%CI 1.01 ~ 1.31)和40% (OR=1.40, 95%CI 1.14 ~ 1.71)。按年龄分层后,与体重正常人群相比,40 ~ 59岁肥胖患者的结直肠腺瘤风险增加31% (OR=1.31, 95%CI 1.07 ~ 1.61), 60 ~ 74岁超重和肥胖患者的结直肠腺瘤风险分别增加13% (OR=1.13, 95%CI 1.01 ~ 1.27)和39% (OR=1.39, 95%CI 1.15 ~ 1.70)。按病理分型进行亚组分析结果显示,肥胖患者发生非晚期腺瘤和晚期腺瘤的风险分别增加35% (OR=1.35, 95%CI 1.16 ~ 1.57)和39% (OR=1.39, 95%CI 1.06 ~ 1.83)。结论肥胖与结直肠腺瘤相关,且在女性、60 ~ 74岁及晚期腺瘤患者中更为显著。结直肠癌高危人群的干预应包括控制体重。关键词:结直肠腺瘤;身体质量指数;肥胖;相关
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