Obesity and Metabolic Unhealthiness Have Different Effects on Colorectal Neoplasms
Obesity and Metabolic Unhealthiness Have Different Effects on Colorectal Neoplasms
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DOI：
10.1210/jc.2017-00152
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发表时间：
2017-08-01
影响因子：
5.8
通讯作者：
Choi, Myung-Gyu
中科院分区：
文献类型：
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作者：
Ko, Sun-Hye;Baeg, Myong Ki;Choi, Myung-Gyu
内容：肥胖和胰岛素抵抗是结直肠肿瘤（CRN）的危险因素，但是关于代谢状态、肥胖和CRN的数据缺乏。目的：调查接受结肠镜检查的韩国人的代谢状态、肥胖和CRN之间的关系。设计：回顾性，横断面。参与者：受试者根据代谢和肥胖标准分为以下几类：代谢健康的非肥胖（MHNO）、代谢健康的肥胖（MHO）、代谢不健康的非肥胖（MUNO）和代谢不健康的肥胖（MUO）。主要结果测量：以MHNO组为参照，采用多元回归分析确定CRN和晚期CRN的危险因素。共纳入10，235例受试者，具体如下：5096例MHNO、1538例MHO、1746例MUNO和1855例MUO。其中，3297例（32.2%）为CRN，434例（4.2%）为晚期CRN。各组CRN受试者例数分别为：MHNO 25.8%、MHO 33.9%、MUNO 38.9%和MUO 42.0%（趋势P < 0.001）。CRN的风险在MHO中增加[比值比（OR）1.239，95%置信区间（CI）1.082至1.418，P = 0.002]，MUNO（OR 1.233，95% CI 1.086至1.400，P = 0.001），MUO组（OR 1.510，95%CI 1.338 ~ 1.706，P < 0.001），而MUNO组晚期CRN的风险增加结论：肥胖可增加CRN的危险性，代谢不良可增加CRN的危险性。对于晚期CRN，代谢不健康的状态增加了风险，但肥胖没有。
Context: Obesity and insulin resistance are risk factors for colorectal neoplasms (CRN), but data regarding metabolic status, obesity, and CRN are lacking.Objective: To investigate the relationship between metabolic status, obesity, and CRN in Koreans who underwent colonoscopy.Design: Retrospective, cross-sectional.Participants: Subjects were divided based on metabolic and obesity criteria, as follows: metabolically healthy nonobese (MHNO), metabolically healthy obese (MHO), metabolically unhealthy nonobese (MUNO), and metabolically unhealthy obese (MUO).Main Outcome Measures: Multiple regression was used to identify CRN and advanced CRN risk factors, with the MHNO group as reference.Results: A total of 10,235 subjects was included, as follows: 5096 MHNO, 1538 MHO, 1746 MUNO, and 1855 MUO. Of these, 3297 had CRN (32.2%), and 434 (4.2%) had advanced CRN. Number of subjects with CRN in each group were: MHNO 25.8%, MHO 33.9%, MUNO 38.9%, and MUO 42.0% (P for trend < 0.001). Risk of CRN was increased in the MHO [odds ratio (OR) 1.239, 95% confidence interval (CI) 1.082 to 1.418, P = 0.002], the MUNO(OR 1.233, 95% CI 1.086 to 1.400, P = 0.001), and the MUO groups (OR 1.510, 95% CI 1.338 to 1.706, P < 0.001), whereas risk of advanced CRN was increased in the MUNO (OR 1.587, 95% CI 1.222 to 2.062, P = 0.001) and the MUO groups (OR 1.456, 95% CI 1.116 to 1.900, P = 0.006).Conclusions: Obesity increased CRN risk with metabolically unhealthy status adding risk. For advanced CRN, metabolically unhealthy status increased the risk but obesity did not.