Body Mass Index Increases Risk for Colorectal Adenomas Based on Meta-analysis
Body Mass Index Increases Risk for Colorectal Adenomas Based on Meta-analysis
复制标题
根据荟萃分析，体重指数会增加结直肠腺瘤的风险
DOI：
10.1053/j.gastro.2011.12.050
复制
发表时间：
2012-04-01
期刊：
影响因子：
29.4
通讯作者：
Li, Zhaoshen
中科院分区：
文献类型：
--
作者：
Ben, Qiwen;An, Wei;Li, Zhaoshen
背景与目的：关于超重（表示为体重指数（BMI）增加）与结直肠腺瘤（CRA）风险之间的关系，发表的结果不一致。我们进行了一项荟萃分析来探索这种关系。我们关注的是这种关系是否会因研究对象的性别、研究设计、息肉的特征或潜在的混杂因素（包括饮酒、使用非甾体抗炎药、吸烟和运动）而变化。我们通过对Medline、EMBASE和ISI Web of Science进行文献检索，确定了截至2011年7月31日的研究，并通过搜索相关文章的参考文献列表。我们分析了36项独立研究，其中包括29，860例CRA事件病例。采用随机效应模型计算相对风险及其95%置信区间（CI）。结果：总体而言，BMI（以kg/m2计算）增加5个单位会增加CRA的风险（相对危险度= 1.19; 95%CI：1.13-1.26），尽管研究间存在高水平的异质性（P-异质性<0.001; I-2 = 76.8%）。亚组分析显示，肥胖个体CRA风险增加与种族、地理位置、研究设计、性别、腺瘤进展和混杂因素无关。BMI增加与CRA风险之间的关联性在结肠腺瘤比直肠腺瘤更强。结论：基于荟萃分析，BMI增加会增加结肠腺瘤的风险，但不会增加直肠腺瘤的风险。与结直肠癌不同，BMI增加与CRA风险之间的关系没有性别差异。
BACKGROUND & AIMS: There have been inconsistent results published about the relationship between excess body weight, expressed as increased body mass index (BMI), and risk of colorectal adenoma (CRA). We conducted a meta-analysis to explore this relationship. We focused on whether the relationship varied based on the sex of the study subjects, study design, features of the polyps, or potential confounders, including alcohol use, nonsteroidal anti-inflammatory drug use, smoking, and exercise.METHODS: We identified studies by performing a literature search of Medline, EMBASE, and ISI Web of Science through July 31, 2011, and by searching the reference lists of pertinent articles. We analyzed 36 independent studies, which included 29,860 incident cases of CRA. Summary relative risks with their 95% confidence intervals (CIs) were calculated with a random-effects model. Between-study heterogeneity was assessed using Cochran's Q statistic and I-2 analyses.RESULTS: Overall, a 5-unit increase in BMI (calculated as kg/m(2)) increased the risk for CRA (summary relative risk = 1.19; 95% CI: 1.13-1.26), although there was a high level of heterogeneity among studies (P-heterogeneity < .001; I-2 = 76.8%). Subgroup analyses revealed that the increased risk of CRA in obese individuals was independent of race, geographic location, study design, sex, adenoma progression, and confounders. The association between increased BMI and risk for CRA was stronger for colon than rectal adenoma.CONCLUSIONS: Based on a meta-analysis, increased BMI increases the risk for colon but not rectal adenoma. Unlike colorectal cancer, there is no sex difference in the relationship between increased BMI and risk of CRA.