Visceral obesity and insulin resistance as risk factors for colorectal adenoma: a cross-sectional, case-control study.
OBJECTIVE
Colorectal adenoma is known to be associated with obesity, but the association between colorectal adenoma and visceral adipose tissue (VAT) area measured by abdominal computed tomography (CT) has not been documented clearly. In addition, the relationship between insulin resistance and colorectal adenomas, which underlies the mechanism that links obesity and colorectal adenoma, has not been studied extensively. The aim of this study was to examine VAT area and insulin resistance as risk factors of colorectal adenoma.


METHODS
A cross-sectional, case-control study was conducted in Koreans that presented for health check-ups. Subjects underwent various laboratory tests, abdominal CT, and colonoscopy. VAT, subcutaneous adipose tissue (SAT), and homeostatic metabolic assessment (HOMA) index were evaluated as potential risk factors of colorectal adenoma in 2,244 age- and sex-matched subjects.


RESULTS
According to univariate analysis, the prevalences of smoking, hypertension, metabolic syndrome, and family history of colorectal cancer were higher in the adenoma group than in the normal control group. In addition, body mass index, waist circumference, triglyceride, high-density lipoprotein cholesterol, and VAT and SAT areas were significantly different in the two groups. According to the multivariate analysis adjusted for multiple confounders, VAT area was independently associated with the risk of colorectal adenoma (odds ratio (OR)=3.09, 95% confidence interval (CI): 2.19-4.36, highest quintile vs. lowest quintile). Mean HOMA index was higher in the adenoma group than in the control group (OR=1.99, 95% CI: 1.35-2.92, highest vs. lowest quintile).


CONCLUSIONS
Visceral obesity was found to be an independent risk factor of colorectal adenoma, and insulin resistance was associated with the presence of colorectal adenoma.
Kang
Hyoun Woo
HW
Department of Internal Medicine, Liver Research Institute, Seoul National University College of Medicine, Korea.
Kim
Donghee
D
Kim
Hwa Jung
HJ
Kim
Chung Hyeon
CH
Kim
Young Sun
YS
Park
Min Jung
MJ
Kim
Joo Sung
JS
Cho
Sang-Heon
SH
Sung
Myung-Whun
MW
Jung
Hyun Chae
HC
Lee
Hyo-Suk
HS
Song
In Sung
IS
D000236:Adenoma / Q000453:epidemiology / Q000209:etiology* / Q000473:pathology; D015992:Body Mass Index; D016022:Case-Control Studies; D016009:Chi-Square Distribution; D003113:Colonoscopy; D015179:Colorectal Neoplasms / Q000453:epidemiology / Q000209:etiology* / Q000473:pathology; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D006973:Hypertension / Q000453:epidemiology; D007333:Insulin Resistance; D050152:Intra-Abdominal Fat / Q000000981:diagnostic imaging / Q000473:pathology*; D007723:Korea / Q000453:epidemiology; D008055:Lipids / Q000097:blood; D016015:Logistic Models; D008297:Male; D024821:Metabolic Syndrome / Q000150:complications / Q000453:epidemiology; D009765:Obesity / Q000150:complications* / Q000453:epidemiology / Q000473:pathology; D015995:Prevalence; D012307:Risk Factors; D014057:Tomography, X-Ray Computed
D008055:Lipids