title: Increase in body size is associated with an increased incidence of advanced adenomatous colon polyps in male veteran patients.
abstract: OBJECTIVE
  Our aim was to determine how weight change influences the development of advanced adenomas.
  
  
  METHODS
  We performed a retrospective study of patients with adenomatous polyps (APs) on an index colonoscopy, and who also had a follow-up colonoscopy 3-5 years later. APs were evaluated for advanced features (i.e. size ≥1 cm in diameter and/or villous component and/or high-grade dysplasia). Patients were divided into 2 groups: those with no change or a reduction in their body mass index (BMI) during the interval between colonoscopies and those with an increase in BMI during the interval between colonoscopies.
  
  
  RESULTS
  925 patients with a history of APs were identified. Univariate analysis showed that patients with an increase in BMI had more advanced APs (28 vs. 23%, p = 0.04), and a larger mean AP size (8.0 vs. 6.8 mm, p = 0.03) than those with a no change or decreased BMI. Multiple logistic regression analysis revealed that a decrease in BMI between colonoscopies was associated with a significantly reduced risk of developing advanced APs (OR: 0.4, 95% CI: 0.37-0.5, p < 0.05).
  
  
  CONCLUSIONS
  An increase in weight in male veterans appears to be strongly associated with the development of clinically advanced AP lesions, even after adjustment for other known polyp risk factors.
authors.affiliation: Departments of Internal Medicine, Dallas Veterans Affairs Medical Center, Dallas, Texas, USA. Ali.Siddiqui@jefferson.edu
authors.forename: Ali
authors.initials: A
authors.lastname: Siddiqui
authors.forename: Mimi
authors.initials: M
authors.lastname: Chang
authors.forename: Amar
authors.initials: A
authors.lastname: Mahgoub
authors.forename: Helene N Pena
authors.initials: HN
authors.lastname: Sahdala
mesh_terms: D018256:Adenomatous Polyps / Q000175:diagnosis / Q000453:epidemiology*; D000368:Aged; D015992:Body Mass Index; D049628:Body Size; D015331:Cohort Studies; D003110:Colonic Neoplasms / Q000175:diagnosis / Q000453:epidemiology*; D003113:Colonoscopy; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D012307:Risk Factors; D014481:United States / Q000453:epidemiology; D058014:Veterans Health