Association Between Body Mass Index and Colorectal Neoplasia at Follow-Up Colonoscopy: A Pooling Study
Association Between Body Mass Index and Colorectal Neoplasia at Follow-Up Colonoscopy: A Pooling Study
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DOI：
10.1093/aje/kwn401
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发表时间：
2009-03-15
影响因子：
5
通讯作者：
Martinez, Maria Elena
中科院分区：
文献类型：
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作者：
Jacobs, Elizabeth T.;Ahnen, Dennis J.;Martinez, Maria Elena
据报道，体重指数（BMI）与结直肠腺瘤和癌症风险之间存在直接关系，但很少有研究具有足够的样本量，可以根据性别、家族史、结直肠亚部位或异时性病变的特征进行分层分析。来自7项异时性结直肠腺瘤前瞻性研究的8213名参与者的数据被汇总，以评估BMI与异时性瘤变之间的关系是否因这些因素而变化。BMI与非晚期腺瘤的直接相关（P-trend < 0.001）有统计学意义，而晚期腺瘤的相关无统计学意义（P-trend < 0.07）。在性别分层分析中，肥胖在男性中与任何异时性病变的几率有统计学显著相关（优势比= 1.36,95%可信区间：1.17,1.58），但在女性中没有（优势比= 1.10,95%可信区间：0.89,1.37）。与BMI的关联似乎仅限于近端瘤变，BMI和近端瘤变有统计学意义（P-trend < 0.001），但远端瘤变没有统计学意义（P-trend < 0.85）。探索性分析表明，BMI与男性异时性腺瘤的大多数组织学特征显著相关，而与女性无关。我们的研究结果进一步支持BMI与异时性结直肠腺瘤之间的关联，特别是在男性中，从而表明体型可能在相对较早的阶段影响结直肠癌的发生。
A direct relation between body mass index (BMI) and risk of colorectal adenomas and cancer has been reported, but few studies have had adequate sample size for conducting stratified analyses by sex, family history, colorectal subsite, or features of metachronous lesions. Data from 8,213 participants in 7 prospective studies of metachronous colorectal adenomas were pooled to assess whether the association between BMI and metachronous neoplasia varied by these factors. A statistically significant direct association between BMI and the odds of nonadvanced adenomas (P-trend < 0.001) was observed, while the relation for advanced adenomas was of marginal significance (P-trend < 0.07). In sex-stratified analyses, obesity was statistically significantly associated with the odds of any metachronous lesion among men (odds ratio = 1.36, 95% confidence interval: 1.17, 1.58) but not among women (odds ratio = 1.10, 95% confidence interval: 0.89, 1.37). The associations with BMI appeared to be limited to proximal neoplasia, with statistically significant results for BMI and proximal (P-trend < 0.001), but not distal (P-trend < 0.85), neoplasia. Exploratory analyses indicated that BMI was significantly related to most histologic characteristics of metachronous adenomas among men but not among women. Our results provide further support for the association between BMI and metachronous colorectal adenomas, particularly among men, thereby indicating that body size may affect colorectal carcinogenesis at comparatively early stages.