title: Visceral abdominal fat measured by computed tomography is associated with an increased risk of colorectal adenoma.
abstract: We investigated whether visceral adipose tissue (VAT) measured by computed tomography (CT) is a risk factor for colorectal adenoma. For a total of 1,328 patients (857 without adenoma, 471 with colorectal adenoma) undergoing colonoscopy and CT, associations between colorectal adenoma and body mass index (BMI), VAT area and subcutaneous adipose tissue (SAT) were assessed using odds ratios (ORs) with 95% confidence intervals (CIs) adjusted for age, sex, family history, smoking, alcohol intake, diabetes mellitus, aspirin use and nonsteroidal anti-inflammatory drug use. Multivariate analysis showed that colorectal adenoma was marginally associated (p=0.06) with BMI, but not with SAT, while it was significantly associated with VAT and the VAT to SAT ratio (VAT/SAT) for both categorical data and trend (p<0.05). When the obesity indices were considered simultaneously, colorectal adenoma remained significantly associated with VAT and VAT/SAT (p<0.05), but not BMI and SAT. In patients with colorectal adenoma, the adjusted OR for the highest quartiles of VAT and VAT/SAT was 1.90 (95% CI 1.16-3.13) and 2.25 (95% CI 1.49-3.41), respectively, compared to the lowest quartiles. Only VAT area was significantly associated with colorectal adenoma in both men and women (p<0.05). Proximal, multiple and advanced adenomas had significantly higher VAT areas (p<0.05) than distal, solitary and nonadvanced adenomas. Our findings implicate abdominal VAT in the development and progression of colorectal adenoma, and it was better obesity index for colorectal adenoma than BMI in both sexes.
authors.affiliation: Department of Gastroenterology and Hepatology, National Center for Global Health and Medicine, 1-21-1 Toyama, Shinjuku-ku, Tokyo, 162-8655, Japan.
authors.forename: Naoyoshi
authors.initials: N
authors.lastname: Nagata
authors.forename: Kayo
authors.initials: K
authors.lastname: Sakamoto
authors.forename: Tomohiro
authors.initials: T
authors.lastname: Arai
authors.forename: Ryota
authors.initials: R
authors.lastname: Niikura
authors.forename: Takuro
authors.initials: T
authors.lastname: Shimbo
authors.forename: Masafumi
authors.initials: M
authors.lastname: Shinozaki
authors.forename: Tomonori
authors.initials: T
authors.lastname: Aoki
authors.forename: Yoshihiro
authors.initials: Y
authors.lastname: Kishida
authors.forename: Katsunori
authors.initials: K
authors.lastname: Sekine
authors.forename: Shohei
authors.initials: S
authors.lastname: Tanaka
authors.forename: Hidetaka
authors.initials: H
authors.lastname: Okubo
authors.forename: Kazuhiro
authors.initials: K
authors.lastname: Watanabe
authors.forename: Toshiyuki
authors.initials: T
authors.lastname: Sakurai
authors.forename: Chizu
authors.initials: C
authors.lastname: Yokoi
authors.forename: Junichi
authors.initials: J
authors.lastname: Akiyama
authors.forename: Mikio
authors.initials: M
authors.lastname: Yanase
authors.forename: Mitsuhiko
authors.initials: M
authors.lastname: Noda
authors.forename: Toshiyuki
authors.initials: T
authors.lastname: Itoh
authors.forename: Masashi
authors.initials: M
authors.lastname: Mizokami
authors.forename: Naomi
authors.initials: N
authors.lastname: Uemura
mesh_terms: D000236:Adenoma / Q000209:etiology* / Q000473:pathology; D050154:Adiposity; D000368:Aged; D015992:Body Mass Index; D003113:Colonoscopy; D015179:Colorectal Neoplasms / Q000209:etiology* / Q000473:pathology; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D050152:Intra-Abdominal Fat / Q000503:physiopathology*; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D056128:Obesity, Abdominal / Q000150:complications*; D011379:Prognosis; D011446:Prospective Studies; D012307:Risk Factors; D014057:Tomography, X-Ray Computed / Q000379:methods*
keywords: Asian country; abdominal visceral obesity; colorectal cancer; diabetes mellitus; premalignant lesion