VISCERAL ADIPOSE TISSUE AND COLORECTAL NEOPLASIA

结直肠癌（CRC）是一个重大的公共卫生问题。 由于晚期CRC的治疗有限， 控制必须侧重于早期发现和预防。 强 间接证据表明，CRC是由一种 腺瘤性息肉。 因为个体的数量 患息肉的人数远远超过患癌症的人数， CRC控制必须注重提高我们对风险的认识 发展腺瘤和转化的因素 腺瘤转化为结直肠癌。 肥胖，估计身体质量指数，一直是 与男性CRC风险相关，但与女性无关。 近期流行病学 数据表明，脂肪组织分布，特别是内脏 脂肪组织（VAT），而不是整体肥胖，可能是一个 CRC的重要危险因素。膳食脂肪、肉类和蛋白质摄入量 也被假定为CRC的风险因素，但研究 有不同的。 例如，多不饱和脂肪酸作为 与饱和脂肪摄入量相反，并没有在所有研究中观察到。 以前的调查可能会受到阻碍， 测量肥胖或估计膳食脂肪的不精确方法 摄入 生物措施是可取的，因为它们的更大 精度 我建议研究内脏与 脂肪组织和饮食脂肪摄入腺瘤性息肉， CRC的前驱病变。 两种明确的生物标志物， 将采用极好的再现性和成功的中试。 这些研究的结果将迅速转化为临床应用 并可能对今后的预防工作产生重大影响。

Colorectal cancer (CRC) is a significant public health problem. Because treatment of advanced CRC is limited, prospects for CRC control must focus on early detection and prevention. Strong circumstantial evidence suggests that CRC develops from a precursor lesion, the adenomatous polyp. Because the number of individuals with polyps far exceeds the number who develop cancer, advances in CRC control must focus on improving our understanding of the risk factors for developing adenomas and for the transformation of adenomas into colorectal cancers. Obesity, estimated by body mass index, has been consistently linked to CRC risk in men but not in women. Recent epidemiologic data suggest that adipose tissue distribution, and in particular visceral adipose tissue (VAT) rather than overall adiposity, may be an important risk factor for CRC. Dietary fat, meat, and protein intake have also been postulated as risk factors for the CRC but studies have varied. For example, the benefits of polyunsaturated as opposed to saturated fat intake have not been observed in all studies. Previous investigations may have been hampered by using imprecise methodologies to measure obesity or estimate dietary fat intake. Biologic measures are preferable because of their greater precision. I propose to investigate the relationship of visceral adipose tissue and dietary fat intake to adenomatous polyps, the precursor lesion of CRC. Two well established biomarkers with superb reproducibility and successful pilot testing will be employed. Results from these studies will translate rapidly to clinical application and may impact significantly on future prevention efforts.