Association of visceral fat accumulation and plasma adiponectin with colorectal adenoma: Evidence for participation of insulin resistance
Association of visceral fat accumulation and plasma adiponectin with colorectal adenoma: Evidence for participation of insulin resistance
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DOI：
10.1158/1078-0432.ccr-04-1868
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发表时间：
2005-05-15
影响因子：
11.5
通讯作者：
Kawata, S
中科院分区：
文献类型：
--
作者：
Otake, S;Takeda, H;Kawata, S
目的：大肠癌的发生与腹型肥胖和胰岛素抵抗有关。为了探讨内脏脂肪堆积是否有助于结直肠癌的发生，我们研究了它的积累和水平的脂肪组织来源的激素脂联素在日本患者colorectal adenomato.Experimental Design：51个连续的日本患者年龄>= 40岁和结直肠腺瘤进行了测量内脏脂肪面积的计算机断层扫描和血浆脂联素浓度。患者还接受了75克口服葡萄糖耐量试验。采用稳态代谢评估（HOMA-IR）法计算胰岛素抵抗。对照组为52名年龄≥ 40岁且无结直肠息肉的日本受试者。吸烟者和饮酒受试者结果：结直肠腺瘤患者内脏脂肪面积显著大于对照组，血浆脂联素浓度显著低于对照组[比值比（OR）为2.19，95%可信区间（95% CI）为1.47-3.28，P < 0.001和OR为0.24; 95%CI，0.14-0.41; P < 0.001]进行Logistic回归分析。HOMA-IR指数也与结直肠腺瘤相关（OR 2.60; 95%CI，1.20-5.64; P = 0.040）。内脏脂肪面积和脂联素与腺瘤数量（1，2，>= 3），最大腺瘤的大小（00和10 mm），腺瘤组织学（管状和tubulovilous/villous）相关。结论：这些结果表明内脏脂肪积累和血浆脂联素浓度降低与日本患者结直肠腺瘤相关。本研究为进一步认识腹型肥胖和胰岛素抵抗与结直肠癌发生的关系提供了新的思路。
Purpose: Colorectal carcinogenesis is thought to be related to abdominal obesity and insulin resistance. To investigate whether visceral fat accumulation contributes to colorectal carcinogenesis, we examined its accumulation and the levels of the adipose tissue-derived hormone adiponectin in Japanese patients with colorectal adenoma.Experimental Design: Fifty-one consecutive Japanese patients ages >= 40 years and with colorectal adenoma were subjected to measurement of visceral fat area by computed tomography scanning and plasma adiponectin concentration. The patients also underwent the 75-g oral glucose tolerance test. Insulin resistance was calculated by the homeostasis metabolic assessment (HOMA-IR) method. The controls were 52 Japanese subjects ages >= 40 years and without colorectal polyp. Cigarette smokers and subjects who consumed alcohol (>= 30 g ethanol/d) were excluded.Results: The patients with colorectal adenoma showed significantly more visceral fat area and significantly less plasma adiponectin concentration in comparison with the controls [odds ratio (OR), 2.19; 95% confidence interval (95% CI), 1.47-3.28; P < 0.001 and OR, 0.24; 95% CI, 0.14-0.41; P < 0.001, respectively] by logistic regression analysis. HOMA-IR index was also associated with colorectal adenoma (OR 2.60; 95% CI, 1.20-5.64; P = 0.040). Visceral fat area and adiponectin were associated with adenoma number (1, 2, >= 3), the size of the largest adenoma (00 and 10 mm), and adenoma histology (tubular and tubulovillous/villous).Conclusions: These results suggest an association of visceral fat accumulation and decreased plasma adiponectin concentration with colorectal adenoma in Japanese patients. This study may offer a new insight to understanding the relationship of colorectal carcinogenesis with abdominal obesity and insulin resistance.