The Frequency and Risk Factors of Colorectal Adenoma in Health-Check-up Subjects in South Korea: Relationship to Abdominal Obesity and Age
1
조회
0
다운로드
5
인용
0
참고문헌
키워드
초록
Background/Aims: Obesity is associated with the risk of colorectal cancer. However, there is a lack of information about the relationship between obesity and colorectal adenoma. We investigated whether general and abdominal obesity are risk factors for colorectal adenoma. Methods: Subjects who received health check-ups, including colonoscopy, from April 2006 to September 2007 in Chung-Ang University Hospital were included (n=1,316). The frequency and characteristics of colorectal adenomas were analyzed according to demographic features, past history, blood tests, body mass index, and components of metabolic syndrome. Abdominal obesity was defined as a waist circumference of ≥80 cm in women and ≥90 cm in men. Results: The sex ratio of the subjects was 1.9:1(male:female) and their age was 47.7±10.0 years (mean±SD). In univariate analysis, abdominal obesity was significantly associated with the frequency of colorectal adenoma (26.5% “yes” vs 16.9% “no”; p<0.001). The frequency of colorectal adenoma was significantly higher among males, older patients, current smokers, and subjects with fasting hyperglycemia (≥100 mg/dL) or fatty liver (p<0.05). Multivariate analysis identified that male sex (odds ratio [OR], 1.5; 95%confidence interval [CI], 1.0-2.2), old age (age ≥60years; OR, 6.7; 95% CI, 3.5-12.5), and abdominal obesity (OR, 1.5; 95% CI, 1.0-2.2) were independent risk factors for colorectal adenoma (p<0.05). The frequency of multiple adenomas (more than two sites)was also significantly higher in subjects with abdominal obesity. However, the effect of abdominal obesity on the development of colorectal adenoma decreased in elderly people. Conclusions: Abdominal obesity is an independent risk factor for colorectal adenoma and its multiplicity, especially in younger people in South Korea.
Abstract
Background/Aims: Obesity is associated with the risk of colorectal cancer. However, there is a lack of information about the relationship between obesity and colorectal adenoma. We investigated whether general and abdominal obesity are risk factors for colorectal adenoma. Methods: Subjects who received health check-ups, including colonoscopy, from April 2006 to September 2007 in Chung-Ang University Hospital were included (n=1,316). The frequency and characteristics of colorectal adenomas were analyzed according to demographic features, past history, blood tests, body mass index, and components of metabolic syndrome. Abdominal obesity was defined as a waist circumference of ≥80 cm in women and ≥90 cm in men. Results: The sex ratio of the subjects was 1.9:1(male:female) and their age was 47.7±10.0 years (mean±SD). In univariate analysis, abdominal obesity was significantly associated with the frequency of colorectal adenoma (26.5% “yes” vs 16.9% “no”; p<0.001). The frequency of colorectal adenoma was significantly higher among males, older patients, current smokers, and subjects with fasting hyperglycemia (≥100 mg/dL) or fatty liver (p<0.05). Multivariate analysis identified that male sex (odds ratio [OR], 1.5; 95%confidence interval [CI], 1.0-2.2), old age (age ≥60years; OR, 6.7; 95% CI, 3.5-12.5), and abdominal obesity (OR, 1.5; 95% CI, 1.0-2.2) were independent risk factors for colorectal adenoma (p<0.05). The frequency of multiple adenomas (more than two sites)was also significantly higher in subjects with abdominal obesity. However, the effect of abdominal obesity on the development of colorectal adenoma decreased in elderly people. Conclusions: Abdominal obesity is an independent risk factor for colorectal adenoma and its multiplicity, especially in younger people in South Korea.
참고문헌 (31)
- Jackman RJ, "The adenoma-carcinoma sequence in cancer of the colon", Surg Gynecol Obstet, 93, pp.327~330 (1951)
- Rider JA, "Polyps of the colon and rectum; their incidence and relationship tocarcinoma", Am J Med, 16, pp.555~564 (1954)
- Ramsey SD, "Population-based study of the prevalence of family history of cancer: implications for cancer screening and prevention", Genet Med, 8, pp.571~575 (2006)
- Frezza EE, "Influence of obesity on the risk of developing colon cancer", Gut, 55, pp.285~291 (2006)
- Hu FB, "Prospective study of adult onset diabetes mellitus (type 2) and risk of colorectal cancer in women", J Natl Cancer Inst, 91, pp.542~547 (1999)
- Yamada K, "Relation of serum total cholesterol, serum triglycerides and fasting plasma glucose to colorectal carcinoma in situ", Int J Epidemiol, 28, pp.794~798 (1998)
- Lin J, "Body mass index and risk of colorectal cancer in women (United States)", Cancer Causes Control, 15, pp.581~589 (2004)
- Todoroki I, "Relationship of cigarette smoking, alcohol use, and dietary habits with sigmoid colon adenomas", Ann Epidemiol, 5, pp.478~483 (1995)
- Lupton JR, "Potential protective mechanisms of wheat bran fiber", Am J Med, 106, pp.24S~27S (1999)
- Yoshida I, "Serum insulin levels and the prevalence of adenomatous and hyperplastic polyps in the proximal colon", Clin Gastroenterol Hepatol, 4, pp.1225~1231 (2006)
- Alberti KG, "The metabolic syndrome: a new worldwide definition", Lancet, 366, pp.1059~1062 (2005)
- Waye JD, "Colon polyps: problems, promises, prospects", Am J Gastroenterol, 81, pp.101~103 (1986)
- Hill MJ, "Aetiology of adenoma: carcinoma sequence in large bowel", Lancet, 1, pp.245~247 (1978)
- Nilsen TI, "Prospective study of colorectal cancer risk and physical activity, diabetes, blood glucose and BMI: exploring the hyperinsulinaemia hypothesis", Br J Cancer, 84, pp.417~422 (2001)
- Cho E, "Alcohol intake and colorectal cancer: a pooled analysis of 8 cohort studies", Ann Intern Med, 140, pp.603~613 (2004)
- Botteri E, "Smoking and colorectal cancer: a metaanalysis", JAMA, 300, pp.2765~2778 (2008)
- Giovannucci E, "Physical activity, obesity, and risk for colon cancer and adenoma in men", Ann Intern Med, 122, pp.327~334 (1995)
- Kim JH, "Is metabolic syndrome a risk factor for colorectal adenoma?", Cancer Epidemiol Biomarkers Prev, 16, pp.1543~1546 (2007)
- Clendenen TV, "Postmenopausal levels of endogenous sex hormones and risk of colorectal cancer", Cancer Epidemiol Biomarkers Prev, 28, pp.275~281 (2009)
- Gunter MJ, "Insulin, insulin-like growth factor-I, endogenous estradiol, and risk of colorectal cancer in postmenopausal women", Cancer Res, 68, pp.329~337 (2008)
- Kono S, "Obesity, weight gain and risk of colon adenomas in Japanese men", Jpn J Cancer Res, 90, pp.805~811 (1999)
- Morimoto LM, "Risk factors for hyperplastic and adenomatous polyps: evidence for malignant potential?", Cancer EpidemiolBiomarkers Prev, 11, pp.1012~1018 (2002)
- Park SY, "Proximal shift in the distribution of adenomatous polyps in Korea over the past ten years", Hepatogastroenterology, 56, pp.677~681 (2009)
- Watkins LF, "Characterization of the synergistic effect of insulin and transferrin and the regulation of their receptors on a human colon carcinoma cell line", Int J Cancer, 45, pp.372~375 (1990)
- Koenuma M, "Insulin and insulin-likegrowth factor 1 stimulate proliferation of metastatic variants of colon carcinoma 26", Jpn J Cancer Res, 80, pp.51~58 (1989)
- Kaaks R, "Serum C-peptide, insulin-like growth factor (IGF)-I, IGF-binding proteins, and colorectal cancer risk in women", J Natl Cancer Inst, 92, pp.1592~1600 (2000)
- Schoen RE, "Insulin-like growth factor-I and insulin are associated with the presence and advancement of adenomatous polyps", Gastroenterology, 129, pp.464~475 (2005)
- Eckel RH, "The metabolic syndrome", Lancet, 365, pp.1415~1428 (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, pp.485~489 (2005)
- Marugame T, "Relation of impaired glucose tolerance and diabetes mellitus to colorectal adenomas in Japan", Cancer Causes Control, 13, pp.917~921 (2002)
- Nishii T, "Glucose intolerance, plasma insulin levels, and colon adenomas in Japanese men", Jpn J Cancer Res, 92, pp.836~840 (2001)
