Association between body size and colorectal adenoma recurrence
Association between body size and colorectal adenoma recurrence
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DOI：
10.1016/j.cgh.2007.03.022
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发表时间：
2007-08-01
影响因子：
12.6
通讯作者：
Thompson, Patricia A.
中科院分区：
文献类型：
--
作者：
Jacobs, Elizabeth T.;Martinez, Maria Elena;Thompson, Patricia A.
背景与目的：肥胖与结直肠腺瘤的风险增加有关，尽管肥胖症作为息肉切除术后复发的危险因素的作用尚不清楚。因此，我们试图评估肥胖症的人体测量对息肉切除术后腺瘤的影响。方法：有腺瘤基线的受试者(n=2465)和随访的结肠镜检查数据来自两项旨在预防腺瘤复发的随机试验。结果：在3.1年的平均随访期内，体重指数(BMI)=30 kg/m(2)与所有受试者中任何腺瘤复发的几率无显著增加17%(优势比[OR]，1.17；95%可信区间[CI]，0.92-1.48)。这一结果仅限于男性(OR，1.36；95%CI，1.01-1.83)，而女性没有观察到(OR，0.90；95%CI，0.60-1.33)。腰围的结果没有达到统计学意义，尽管趋势与BMI相似。对肥胖对更具临床意义的病变的影响的分析表明，与非晚期病变(OR，1.26；95%CI，0.91-1.75)相比，高BMI是男性晚期腺瘤复发的略强的危险因素(OR，1.62；95%CI，1.04-2.53)。此外，我们观察到，在有结直肠癌家族史的参与者中，肥胖与腺瘤复发的几率存在关联(OR，2.25；95%CI，1.32-3.84)，但没有家族史的参与者(OR，1.00；95%CI，0.77至1.31；P-INT=P=.008)与肥胖和腺瘤复发之间存在关联。结论：我们的结果支持肥胖是结直肠腺瘤后续短间隔(平均随访时间3.1年)发展的危险因素，特别是在男性和有结直肠癌家族史的人中。此外，男性肥胖似乎与临床晚期病变的发展密切相关。
Background & Aims: Obesity has been associated with increased risk for colorectal adenoma, although its role as a risk factor after polypectomy for recurrence is unclear. Therefore, we sought to evaluate the effect of anthropometric measures of obesity on adenoma after polypectomy. Methods: Subjects with baseline adenomas (n = 2465) and follow-up colonoscopy data were drawn from 2 randomized trials designed to prevent adenoma recurrence. Results: Over a mean follow-up period of 3.1 years presence of a body mass index (BMI) >= 30 kg/m(2) was associated with a nonsignificant 17% increase in the odds for any adenoma recurrence among all subjects (odds ratio [OR], 1.17; 95% confidence interval [CI], 0.92-1.48). This result was confined to men (OR, 1.36; 95% CI, 1.01-1.83) and not observed for women (OR, 0.90; 95% CI, 0.60-1.33). Results for waist circumference did not reach statistical significance, although trends were similar to those for BMI. Analyses of the effects of obesity on more clinically significant lesions demonstrated that high BMI was a slightly stronger risk factor for advanced adenoma recurrences in men (OR, 1.62; 95% CI, 1.04-2.53) when compared with non-advanced lesions (OR, 1.26; 95% CI, 0.91-1.75). In addition, we observed an association for obesity and odds of adenoma recurrence among participants reporting a family history of colorectal cancer (OR, 2.25; 95% CI, 1.32-3.84) but not for those without (OR, 1.00; 95% CI, 0.77 to 1.31; P-int = P = .008). Conclusions: Our results support obesity as a risk factor for subsequent short-interval (mean follow-up time 3.1 years) development of colorectal adenomas, particularly among men and persons with a family history of colorectal cancer. Furthermore, obesity in men appears to be strongly associated with the development of clinically advanced lesions.