title: Association of metabolic syndrome with proximal and synchronous colorectal neoplasm.
abstract: OBJECTIVE
  Metabolic syndrome and its associated morbidities have become a major public health problem in both developed and developing countries. Insulin resistance, the core mechanism of metabolic syndrome, has been associated with the development of colorectal neoplasm, but the interrelation between metabolic syndrome and colon cancer is rarely addressed. Our study aimed to determine whether metabolic syndrome is associated with the risk and clinical presentation of colorectal neoplasia.
  
  
  METHODS
  Consecutive 4277 ethnic Chinese who received complete total colonoscopy and thorough health checkups were enrolled. Both National Cholesterol Education Program's Adult Treatment Panel III and modified Asian criteria were used for defining metabolic syndrome. Logistic regression modeling was used to elucidate the association between colorectal neoplasia and metabolic syndrome. The impact of metabolic syndrome on distribution and number of colorectal neoplasia was also assessed.
  
  
  RESULTS
  Of all those enrolled, 27.1% of men and 18.9% of women met the criteria of metabolic syndrome, and 9.8% had colorectal neoplasia. Metabolic syndrome was associated with odds ratio (OR) of 1.35 (95% confidence interval [CI], 1.05-1.73) for colorectal neoplasia. OR was 0.96 (95% CI, 0.67-1.38) for distal lesions, 1.62 (95% CI, 1.14-2.30) for proximal lesions, 2.15 (95% CI, 1.40-3.31) for synchronous lesions, and 2.30 (95% CI, 1.42-3.72) for synchronous lesions located at both sides of colon.
  
  
  CONCLUSIONS
  Subjects with metabolic syndrome have a higher risk of colon neoplasia at the proximal colon and synchronous lesions at both sides of the colon. These findings will help future colon cancer screening and prevention in patients with metabolic syndrome.
authors.affiliation: Department of Internal Medicine, National Taiwan University Hospital, National Taiwan University College of Medicine, Taipei, Taiwan.
authors.forename: Han-Mo
authors.initials: HM
authors.lastname: Chiu
authors.forename: Jaw-Town
authors.initials: JT
authors.lastname: Lin
authors.forename: Chia-Tung
authors.initials: CT
authors.lastname: Shun
authors.forename: Jin-Tung
authors.initials: JT
authors.lastname: Liang
authors.forename: Yi-Chia
authors.initials: YC
authors.lastname: Lee
authors.forename: Shih-Pei
authors.initials: SP
authors.lastname: Huang
authors.forename: Ming-Shiang
authors.initials: MS
authors.lastname: Wu
mesh_terms: D000328:Adult; D000368:Aged; D003113:Colonoscopy; D015179:Colorectal Neoplasms / Q000150:complications* / Q000175:diagnosis / Q000453:epidemiology; D005260:Female; D006801:Humans; D008297:Male; D024821:Metabolic Syndrome / Q000150:complications* / Q000453:epidemiology; D008875:Middle Aged; D012306:Risk