Change in body size and the risk of colorectal adenomas
Change in body size and the risk of colorectal adenomas
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DOI：
10.1158/1055-9965.epi-06-0229
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发表时间：
2007-03-01
影响因子：
3.8
通讯作者：
D'Agostino, Ralph B., Jr.
中科院分区：
文献类型：
--
作者：
Sedjo, Rebecca L.;Byers, Tim;D'Agostino, Ralph B., Jr.
肥胖已被认为是结直肠腺瘤的一个危险因素，但体重增加，脂肪组织分布的影响，以及种族/种族和性别群体之间的可能差异仍然没有答案。这项前瞻性研究的目的是检查肥胖和体重变化与结直肠腺瘤风险之间的关系。在相似的10年时间里，在多中心多种族胰岛素抵抗动脉粥样硬化研究队列的三个时间点测量人体测量指标和其他危险因素。然后对600名队列参与者进行结肠镜检查，无论症状如何，其结肠镜检查时的平均年龄为64岁。多变量逻辑回归分析被用来评估结肠直肠腺瘤与结肠镜检查前10年内肥胖和体重变化之间的关系。肥胖与结肠镜检查时结直肠腺瘤的风险呈正相关[校正比值比（ORadj），2.16; 95%置信区间（95% CI），1.13-4.14]，女性（ORadj，4.42; 95% CI，1.53-12.78）比男性（ORadj，1.26; 95% CI，0.52-3.07）更强。与保持体重5年（ORadj，2.30; 95%CI，1.25-4.22）和10年（ORadj，2.12; 95%CI，1.25-3.62）相似的参与者相比，体重增加的参与者发生腺瘤的风险增加。这些关联在晚期和非晚期腺瘤中是相似的。这些结果表明肥胖、体重增加和结直肠腺瘤风险之间存在正相关。当在结肠镜检查时测量肥胖时，观察到更强的相关性，表明肥胖可能是结直肠腺瘤生长的促进因素。
Adiposity has been recognized as a risk factor for colorectal adenoma, but the influence of weight gain, adipose tissue distribution, and possible differences between ethnic/racial and gender groups remains unanswered. The aim of this prospective study was to examine the association between adiposity and weight change and colorectal adenoma risk. Over similar to 10-year period, anthropometric measures and other risk factors were measured at three time points in the multicenter multiethnic Insulin Resistance Atherosclerosis Study cohort. Colonoscopies were then conducted on 600 cohort participants regardless of symptoms whose mean age at colonoscopy was 64 years. Multivariate logistic regression analyses were used to assess the association between colorectal adenomas and measures of adiposity and weight change over the similar to 10-year period before colonoscopy. Obesity was positively associated with risk of colorectal adenomas at the time of colonoscopy [adjusted odds ratio (ORadj), 2.16; 95% confidence interval (95% CI), 1.13-4.14] and was stronger in women (ORadj, 4.42; 95% CI, 1.53-12.78) than in men (ORadj, 1.26; 95% CI, 0.52-3.07). The risk of adenomas increased among participants who gained weight compared with those who maintained weight over the similar to 5 years (ORadj, 2.30; 95% CI, 1.25-4.22) and similar to 10 years (ORadj, 2.12; 95% CI, 1.25-3.62). These associations were similar for both advanced and nonadvanced adenomas. These results suggest a positive association between obesity, weight gain, and colorectal adenoma risk. Stronger associations were observed when obesity was measured at the time of colonoscopy, suggesting that obesity may be a promoting factor in the growth of colorectal adenomas.