title: Factors that determine prolonged cecal intubation time during colonoscopy: impact of visceral adipose tissue.
abstract: OBJECTIVE
  Various factors including age, sex, body mass index (BMI) and history of operation have been linked to the colonoscopic intubation time. The aims of this study were to identify the factors predicting cecal intubation time (CIT) and to evaluate the effect of the visceral adipose tissue (VAT) area on CIT.
  
  
  METHODS
  A total of 1386 consecutive subjects who underwent colonoscopy and abdominal CT on the same day for a health checkup at a single health care center in Korea from August to December 2011 were studied prospectively. Age, sex, BMI, height, waist circumference, history of operation, symptoms of irritable bowel syndrome, bowel preparation status, experience of colonoscopists, VAT amount on abdominal CT and time required to reach the cecum were analyzed.
  
  
  RESULTS
  The mean age of the subjects was 53.0 ± 9.6 years, and 63.5% were male. The median CIT was 271 s. Univariate analyses showed that female gender, old age, shorter height, lower BMI, prior history of surgery and lower VAT were associated with longer CIT. To adjust for confounding effects of the gender, we investigated the genders separately in multivariate analysis. Older age and lower VAT were associated with prolonged CIT. However, the significance of association of VAT on prolonged CIT disappeared in women.
  
  
  CONCLUSIONS
  This study demonstrates that CIT is prolonged by lower VAT area in men. This is the first study to demonstrate a direct association between VAT area and CIT.
authors.affiliation: Department of Internal Medicine, Healthcare Research Institute, Healthcare System Gangnam Center, Seoul National University Hospital , Seoul , Korea.
authors.forename: Goh Eun
authors.initials: GE
authors.lastname: Chung
authors.forename: Seon Hee
authors.initials: SH
authors.lastname: Lim
authors.forename: Sun Young
authors.initials: SY
authors.lastname: Yang
authors.forename: Ji Hyun
authors.initials: JH
authors.lastname: Song
authors.forename: Hae Yeon
authors.initials: HY
authors.lastname: Kang
authors.forename: Seung Joo
authors.initials: SJ
authors.lastname: Kang
authors.forename: Young Sun
authors.initials: YS
authors.lastname: Kim
authors.forename: Jeong Yoon
authors.initials: JY
authors.lastname: Yim
authors.forename: Min Jung
authors.initials: MJ
authors.lastname: Park
mesh_terms: D000328:Adult; D000367:Age Factors; D001827:Body Height; D015992:Body Mass Index; D002432:Cecum; D003113:Colonoscopy; D005260:Female; D006801:Humans; D050152:Intra-Abdominal Fat; D007440:Intubation; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D012737:Sex Factors; D013997:Time Factors
keywords: cecal intubation; colonoscopy; visceral adipose tissue area