일개 대학병원 건강검진 남성 수진자에서 대사증후군과 음주, 흡연 등 생활습관이 하부대장선종 발생에 미치는 영향
The Association between Distal Colon Adenoma and the Metabolic Syndrome and Lifestyle Factors in Male Examinees in a University Hospital
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연구배경: 대사증후군이나 생활습관은 독립적으로 대장용종의 발생과 관련이 있는 것으로 알려져 있다. 본 연구는 대사증후군 환자가 생활습관에 따라 대장선종의 발생에 어떠한 관련이 있는지 알아보기 위해서 시행되었다. 방법: 울산대학교병원 건강증진센터에서 2002년 1월부터 2003년 12월까지 무증상 환자를 대상으로 S상 결장경 검사를 시행한 검진자 중에서 과거 대장용종으로 진단 받은 적이 있거나, 치료를 받았거나 암 및 비특이성 용종으로 진단된 경우를 제외한 1,565명의 검진자 중에서 선종군과 정상군으로 나누어 분석하였다. 다중 로지스틱 회귀분석을 이용하여 연령, 성별, 음주, 흡연, 식이영양 등의 교란변수를 통제한 상태에서 교차비와 95% 신뢰구간을 추정하였다. 결과: 연령과 신체활동 등의 영향을 보정한 상태에서 대사증후군이 있으면서 흡연을 동시에 하는 군에서는 대장선종 발생에 대한 교차비가 3.63 (95% 신뢰구간 1.49∼8.89)이었고, 신체활동은 하부대장 선종발생의 위험을 감소시켰다. 결론: 대사증후군이 있으면서 흡연을 하는 군에서 대장선종발생위험이 대사증후군만 있는 군에 비해 더 증가되었다.
Abstract
The Association between Distal Colon Adenoma and the Metabolic Syndrome and Lifestyle Factors in Male Examinees in a University HospitalMoon Chan Kim, M.D., Ph.D., Chang Sup Kim, M.D., Deuk Kee Lee, M.D., Tae Heum Jeong, M.D., Ph.D. Background: According to previous epidemiologic studies, the metabolic syndrome, dietary and lifestyle factors were associated with colon polyps. The aim of this cross-sectional study was to assess the relationship between the risk of the colorectal adenoma incidence and the individual components of the metabolic syndrome with lifestyle factors such as drinking, cigarette smoking and physical activity. Methods: Sigmoidoscopic examination for colon cancer screening was performed from January 2002 to December 2003 at the Health Promotion Center of Ulsan University Hospital in Ulsan, Korea. A total of 1,565 subjects underwent satisfactory sigmoidoscopy. The subjects with a history of colon cancer or polyps or inflammatory bowel disease were excluded from the study. Alcohol consumption, cigarette smoking and other confounding factors were included as covariates in the models. Results: After adjusting for age, physical activity, smoking and alcohol intake, the subjects of metabolic syndrome (≥3 vs. 0 components) combined with cigarette smoking had a positive association with colorectal adenoma incidence (OR 3.63, 95% CI 1.49∼8.89). Physical activity was negatively associated the risk of the colorectal adenoma incidence (OR 0.60 95% CI 0.44∼0.81). Conclusion: These results suggest that clustering of components of the metabolic syndrome combined with cigarette smoking significantly increased the colorectal adenoma risk, but physical activity reduced the risk of colorectal adenoma incidence in Korean adult males after multivariate adjustment. (J Korean Acad Fam Med 2008; 29:195-200)
참고문헌 (29)
- Expert Panel on Detection, Evaluation, and Treatment of High Blood Cholesterol in Adults, "Executive summary of the third report of the national cholesterol education program (NCEP) expert panel on detection, evaluation, and treatment of high blood cholesterol in adults (adult treatment panel III)", JAMA, 285(19), pp.2486~2497 (2001)
- Park HS, "Prevalence and trends of metabolic syndrome in Korea: Korean National Health and Nutrition Survey 1998-2001", Diabetes Obes Metab, 9, pp.50~58 (2007)
- Wang YY, "Association between adenomas of rectosigmoid colon and metabolic syndrome features in a Chinese population", Gastroenterol Hepatol, 20(9), pp.1410~1415 (2005)
- Morita T, "The metabolic syndrome is associated with increased risk of colorectal adenoma development: the Self-Defense Forces Health Study", Asian Pac J Cancer Prev, 6(4), pp.485~489 (2005)
- Zahm SH, "Tobacco smoking as a risk factor for colon polyps", Am J Public Health, 81(7), pp.846~849 (1991)
- Lee WC, "Cigarettes, alcohol, coffee, and caffeine as risk factors for colorectal adenomatous polyps", Ann Epidemiol, 3(3), pp.239~244 (1993)
- Todoroki I, "Relationship of cigarette smoking, alcohol use, and dietary habits with sigmoid colon adenomas", Ann Epidemiol, 5(6), pp.478~483 (1995)
- Grabrant DH, "Job activity and colon cancer risk", Am J Epidemiol, 119(6), pp.1005~1014 (1984)
- Gerhardsson M, "Physical activity and colon cancer risk", Int J Epidemiol, 17(4), pp.743~746 (1988)
- Cope GF, "Healtley RV, Kelleher J. Alcohol consumption in patients with colorectal adenomatous polyps", Gut, 32(1), pp.70~72 (1991)
- Martinez ME, "Cigarette smoking and alcohol consumption as risk factors for colorectal adenomatous polyps", Natl Cancer Inst, 87(4), pp.274~279 (1995)
- Giovannucci E, "Relationship of diet to risk of colorectal adenoma in men", J Natl Cancer Inst, 84(2), pp.91~98 (1992)
- Borg GA, "Perceived exertion: a note on "history" and methods", Med Sci Sports, 5(2), pp.90~93 (1973)
- "DietPlus version 2.0 for windows. AhOne computer and telecom corporation", ~ (1995)
- McKeigue PM, "Relation of central obesity and insulin resistance with high diabetes prevalence and cardiovascular risk in South Asians", Lancet, 337(8738), pp.382~386 (1991)
- Giovannucci E, "Insulin, insulin-like growth factors and colon cancer: a review of the evidence", J Nutr, 131(11), pp.3109~3120 (2001)
- Nilsen TI, "Prospective study of colorectal cancer risk and physical activity, diabetes, blood glucose and BMI: exploring the hyperinsulinemia hypothesis", Br J Cancer, 84(3), pp.417~422 (2001)
- Keku TO, "Woosley JT, Sandler RS. Insulin resistance, aptosis, and colorectal adenoma risk", Cancer Epidemiol Biomarkers Prev, 14(9), pp.2076~2081 (2005)
- Silha JV, "Angiogenic factors are elevated in overweight and obese individuals", Int J Obese (Lond), 29(11), pp.1308~1314 (2005)
- Kadowaki T, "Adiponectin and adiponectin recptors", Endocr Rev, 26(3), pp.439~451 (2005)
- Pan WH, "Body mass index and obesity-related metabolic disorders in Taiwanese and US whites and blacks: implications for definitions of overweight and obesity for Asians", Am J Clin Nutr, 79(1), pp.31~39 (2004)
- Giovannucci E, "Physical activity, obesity, and risk for colon cancer and adenoma in men", Ann Intern Med, 122(5), pp.327~334 (1995)
- Kune GA, "Body weight and physical activity as predictors of colorectal cancer risk", Nutr Cancer, 13(1), pp.9~17 (1990)
- Dietz AT, "The association of body size and large bowel cancer risk in Wisconsin (United States) women", Cancer Cause Control, 6(1), pp.30~36 (1995)
- Le Marchand L, "Obesity in youth and middle age and risk of colorectal cancer men", Cancer Causes Control, 3(4), pp.349~354 (1992)
- Henriksen EJ, "Invited review: effect of acute exercise and exercise training on insulin resistance", J Appl Physiol, 93(2), pp.788~796 (2002)
- Wu AH, "Alcohol, physical activity and other risk factors for colorectal cancer: a prospective study", Br J Cancer, 55, pp.687~694 (1987)
- Fredriksson M, "Colon cancer, physical activity, and occupational exposures. A case- control study", Cancer, 63(9), pp.1838~1842 (1989)
- Tsushima M, "Stemmermann GN. Prospective study of the association of serum triglyceride and glucose with colorectal cancer", Dig Dis Sci, 50(3), pp.499~505 (2005)