title: Metabolic syndrome is associated with increased risk of recurrent colorectal adenomas in Korean men.
abstract: OBJECTIVE
  Because of the high incidence of recurrent colorectal adenomas, regular surveillance by colonoscopy is recommended. However, there is still a shortage of information on the factors that influence the incidence of recurrent colorectal adenomas in patients with a history of these lesions. The aim of this study was to determine the association between the development of recurrent colorectal adenomas, metabolic syndrome and obesity.
  
  
  METHODS
  The hospital-based cohort was composed of 193 patients who had recurrent colorectal adenomas removed between January 2002 and December 2003. The Cox proportional hazard model was used to determine hazard ratio (HR) and 95% confidence interval (CI) between obesity, metabolic syndrome and other factors, and the incidence of recurrent adenomatous polyps.
  
  
  RESULTS
  The mean follow-up period was 4.8 person-years. In all, 78 of the patients (40.4%) had recurrent colorectal adenomas. In the overall recurrent adenoma group, significant associations between metabolic syndrome (HR, 1.33; 95% CI, 1.02-1.73), waist circumference (WC) ≥ 90 cm (HR, 1.42; 95% CI, 1.06-1.90) and waist-hip ratio (WHR) ≥ 0.9 (HR, 2.03; 95% CI, 1.55-2.68) were found. Moreover, advanced adenomas were significantly associated with metabolic syndrome (HR, 2.81; 95% CI, 1.86-4.25), body mass index ≥ 25 kg m(-2) (HR, 2.69; 95% CI, 1.64-4.42), WC (HR, 2.16; 95% CI, 1.31-3.54) and WHR (HR, 1.99; 95% CI, 1.28-3.11). In addition, current smoking (HR, 2.60; 95% CI, 1.09-6.25) and alcohol consumption (HR, 2.20; 95% CI, 1.10-4.39) were also significantly associated with recurrent advanced adenoma.
  
  
  CONCLUSIONS
  Metabolic syndrome and obesity were significantly associated with the development of recurrent colorectal adenomas in Korean adult males. Furthermore, these associations were more strongly associated with advanced adenomas.
authors: Department of Family Medicine, University of Ulsan College of Medicine, Ulsan University Hospital, Ulsan, South Korea.
authors: M-C
authors: MC
authors: Kim
authors: S W
authors: SW
authors: Jung
authors: C-S
authors: CS
authors: Kim
authors: T-H
authors: TH
authors: Chung
authors: C-I
authors: CI
authors: Yoo
authors: N H
authors: NH
authors: Park
mesh_terms: D044466:Asian People; D015992:Body Mass Index; D015331:Cohort Studies; D003111:Colonic Polyps / Q000453:epidemiology* / Q000473:pathology; D003113:Colonoscopy; D015179:Colorectal Neoplasms / Q000453:epidemiology* / Q000209:etiology / Q000473:pathology; D005500:Follow-Up Studies; D006801:Humans; D015994:Incidence; D008297:Male; D024821:Metabolic Syndrome / Q000150:complications / Q000453:epidemiology* / Q000473:pathology; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000453:epidemiology* / Q000209:etiology / Q000473:pathology; D009765:Obesity / Q000150:complications / Q000453:epidemiology*; D010808:Physical Examination; D016016:Proportional Hazards Models; D056910:Republic of Korea / Q000453:epidemiology; D012307:Risk Factors; D011795:Surveys and Questionnaires