Increased Risk of Advanced Colorectal Neoplasia Among Korean Men With Metabolic Abnormality and Obesity.
Obesity and metabolic abnormality are risk factors for colorectal cancer and adenoma. We evaluated the risk of advanced colorectal neoplasm (AN) according to metabolic status and obesity in Koreans.



We performed a retrospective cross-sectional study of 70,428 individuals in Korea who underwent colonoscopy and whose metabolic state and body mass index were examined, from 2003 through 2012, at Kangbuk Samsung Hospital in Korea. We calculated odds ratios (ORs) for AN in people who were metabolically healthy but obese, people with metabolic abnormality who were not obese, and people with metabolic abnormality who were obese. The reference group was metabolically healthy nonobese peoples. AN was defined as adenoma ≥10 mm in diameter, adenoma with any component of villous histology, high-grade dysplasia, or invasive cancer.



No increased risk of AN was observed in the metabolically healthy but obese (OR, 0.99; 95% confidence interval [CI], 0.67-1.46; P = .825) and metabolic abnormality who were not obese groups (OR, 1.01; 95% CI, 0.85-1.21; P = .765). In contrast, risk of AN was increased in the metabolic abnormality who were obese group (OR, 1.33; 95% CI, 1.12-1.58; P = .006). In men, risk of AN showed a greater increase in the metabolic abnormality who were obese group (OR, 1.48; 95% CI, 1.20-1.83; P = .001). This association was not observed in women (OR, 1.21; 95% CI, 0.84-1.75; P = .476).



Men with 1 or more metabolic abnormality and obesity are at increased risk for AN.
Department of Internal Medicine, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Korea.
Ji Yeon
JY
Kim
Department of Internal Medicine, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Korea. Electronic address: diksmc.park@samsung.com.
Dong Il
DI
Park
Department of Internal Medicine, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Korea.
Junghee
J
Yu
Department of Internal Medicine, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Korea.
Yoon Suk
YS
Jung
Department of Internal Medicine, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Korea.
Jung Ho
JH
Park
Department of Internal Medicine, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Korea.
Hong Joo
HJ
Kim
Department of Internal Medicine, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Korea.
Yong Kyun
YK
Cho
Department of Internal Medicine, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Korea.
Chong Il
CI
Sohn
Department of Internal Medicine, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Korea.
Woo Kyu
WK
Jeon
Department of Internal Medicine, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Korea.
Byung Ik
BI
Kim
Department of Internal Medicine, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Korea.
Kyu Yong
KY
Choi
D000328:Adult; D015179:Colorectal Neoplasms / Q000453:epidemiology*; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D008297:Male; D008659:Metabolic Diseases / Q000150:complications*; D008875:Middle Aged; D009765:Obesity / Q000150:complications*; D056910:Republic of Korea / Q000453:epidemiology; D012189:Retrospective Studies; D018570:Risk Assessment
Advanced Colorectal Neoplasm Risk Factors; BMI; Diabetes; Metabolic Abnormality