Central obesity and atherogenic dyslipidemia in metabolic syndrome are associated with increased risk for colorectal adenoma in a Chinese population.
BACKGROUND
Metabolic syndrome (MetS) is composed of cardiovascular risk factors including insulin resistance, obesity, dyslipidemia, and hypertension. Most of the components of MetS have been linked to the development of neoplasm. The purpose of this study was to evaluate the relationship between individual components of MetS and colorectal adenoma.


METHODS
The study subjects were recruited from a pool of 4872 individuals who underwent a health check-up examination during the period January 2006 to May 2008. Each participant fulfilled a structured questionnaire. MetS was defined based on the America Heart Association and National Heart Lung Blood Institute criteria. Subjects with history of colon cancer, colon polyps, colitis, or prior colonic surgery were excluded.


RESULTS
A total of 4122 subjects were included for final analysis (2367 men and 1755 women; mean age, 49.6 +/- 11.7 years). Of them, MetS was diagnosed in 708 men (29.9%) and in 367 women (20.9%). Among the patients with MetS, 34.6% had adenoma, 31.7% had hyperplastic polyps and 23.3% were polyp-free (p < 0.0001, Chi-square test). The adjusted OR for colorectal adenoma was significantly higher in the subjects with MetS (OR, 1.31, CI: 1.09-1.57). A stronger association between MetS and colorectal adenoma was found in men (OR:1.44, CI:1.16-1.80) than in women (OR:1.04, CI:0.74-1.46). The adjusted OR for adenoma increased as the number of MetS components increased (p for trend = 0.0001 ). When the individual components of MetS were analyzed separately, only central obesity (OR:1.36, CI:1.14-1.63), low HDL cholesterol levels (OR:1.30, CI:1.10-1.54) and high triglyceride levels (OR:1.26, CI:1.04-1.53) were independently associated with colorectal adenoma.


CONCLUSIONS
Of the components of MetS analyzed in this study, central obesity and dyslipidemia are independent risk factors for colorectal adenoma. With regard to the prevention of colorectal neoplasm, life-style modification such as weight reduction is worthwhile.
Liu
Chiu-Shong
CS
Department of Family Medicine, China Medical University and Hospital, Taichung, Taiwan.
Hsu
Hua-Shui
HS
Li
Chia-Ing
CI
Jan
Chia-Ing
CI
Li
Tsai-Chung
TC
Lin
Wen-Yuan
WY
Lin
Tsann
T
Chen
Ya-Chien
YC
Lee
Cheng-Chun
CC
Lin
Cheng-Chieh
CC
D000236:Adenoma / Q000453:epidemiology* / Q000208:ethnology* / Q000517:prevention & control; D000328:Adult; D002681:China; D003113:Colonoscopy; D015179:Colorectal Neoplasms / Q000453:epidemiology* / Q000208:ethnology* / Q000517:prevention & control; D050171:Dyslipidemias / Q000150:complications*; D005260:Female; D006801:Humans; D008019:Life Style; D008297:Male; D024821:Metabolic Syndrome / Q000150:complications*; D008875:Middle Aged; D056128:Obesity, Abdominal / Q000150:complications*; D015995:Prevalence; D012189:Retrospective Studies; D012307:Risk Factors; D015431:Weight Loss