Visceral obesity as a risk factor for colorectal neoplasm.
OBJECTIVE
Obesity as a risk factor for colorectal neoplasm (CRN) is controversial. In the present study, we evaluated visceral obesity as a risk factor for CRN.


METHODS
We prospectively enrolled 200 consecutive, asymptomatic adults (male : female = 133:67, mean age, 50.9 +/- 8.5 years) undergoing both colonoscopy and abdominopelvic computed tomography (CT) scan for routine health evaluations. The presence or absence and the characteristics of CRN were determined during colonoscopy. The amount of visceral adipose tissue (VAT) and subcutaneous adipose tissue was measured by an abdominopelvic CT scan. Body mass index, waist circumference, and percentage of body fat were measured. Blood pressure and other blood markers for assessing the metabolic syndrome were also investigated.


RESULTS
Of the 200 patients, 53 (26.5%) had CRN. Old age, smoking, metabolic syndrome, and a high fasting plasma glucose level were associated with an increased risk of CRN. VAT (P < 0.01) and waist circumference (P = 0.01) were significantly higher in those with CRN. A multivariate analysis of the risks of CRN showed an odds ratio of 4.07 (95% confidence interval: 1.01-16.43, P = 0.03) for those with VAT over 136.61 cm(2) relative to those with VAT under 67.23 cm(2). Waist circumference, metabolic syndrome, and fasting plasma glucose levels were not independent risk factors for CRN in the multivariate analysis.


CONCLUSIONS
Increased VAT is an independent risk factor for CRN. Further large scale studies are needed to clarify the causal relationship between VAT and CRN.
Oh
Tae-Hoon
TH
Department of Internal Medicine, Inje University College of Medicine, Sanggye Paik Hospital, Seoul, Korea.
Byeon
Jeong-Sik
JS
Myung
Seung-Jae
SJ
Yang
Suk-Kyun
SK
Choi
Kwi-Sook
KS
Chung
Jun-Won
JW
Kim
Benjamin
B
Lee
Don
D
Byun
Jae Ho
JH
Jang
Se Jin
SJ
Kim
Jin-Ho
JH
D000328:Adult; D000367:Age Factors; D049628:Body Size; D003113:Colonoscopy; D015179:Colorectal Neoplasms / Q000175:diagnosis / Q000209:etiology* / Q000473:pathology / Q000503:physiopathology; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D050152:Intra-Abdominal Fat / Q000000981:diagnostic imaging*; D008297:Male; D008403:Mass Screening / Q000379:methods*; D024821:Metabolic Syndrome / Q000150:complications; D008875:Middle Aged; D009765:Obesity / Q000150:complications* / Q000000981:diagnostic imaging / Q000503:physiopathology; D016017:Odds Ratio; D011446:Prospective Studies; D018570:Risk Assessment; D012307:Risk Factors; D012907:Smoking / Q000009:adverse effects; D014057:Tomography, X-Ray Computed