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Abstract：
BACKGROUND: We aimed to evaluate the interaction between colorectal adenoma risks among asymptomatic individuals in terms of metabolic health status and obesity, and examine the normal waist-to-hip ratio (WHR) in adults with colorectal adenoma risk.
METHODS: A cross-sectional, retrospective study was conducted at MacKay Memorial Hospital involving 16,996 participants who underwent bidirectional gastrointestinal endoscopy between 2013 and 2023. The study recorded important clinicopathological characteristics, including age, body mass index and WHR, Framingham Risk Score (FRS), blood glucose level, and Helicobacter pylori (H. pylori) infection status.
RESULTS: Multivariate logistic regression analysis demonstrated that elevated hemoglobin A1C (HbA1c), increased FRS, positive H. pylori infection, and WHR ≥ 0.9 are independent risk factors for colorectal adenoma. In examining the interaction between FRS and WHR using multivariate logistic regression to evaluate adenoma risk, the OR for the interaction term was 0.95, indicating a decline in adenoma risk when considering the interaction between these two factors. Incorporating HbA1c into the analysis, evaluating the interaction between FRS and WHR still demonstrated a statistically significant impact on adenoma risk (OR 0.96, p < 0.001). Participants with WHR < 0.9, elevated FRS, positive H. pylori infection, and increased HbA1c levels were associated with a higher risk of colorectal adenoma formation. Remarkably, the increased risk of adenoma due to rising HbA1c levels was statistically significant only for those with a WHR < 0.9.
CONCLUSIONS: An increase in FRS and HbA1c or a positive H. pylori infection still warrants vigilance for colorectal adenoma risk when WHR is 0.9. These factors interacted with each other and were found to have a minimal decline in adenoma risk when considering the interaction between WHR and FRS.
METHODS: A cross-sectional, retrospective study was conducted at MacKay Memorial Hospital involving 16,996 participants who underwent bidirectional gastrointestinal endoscopy between 2013 and 2023. The study recorded important clinicopathological characteristics, including age, body mass index and WHR, Framingham Risk Score (FRS), blood glucose level, and Helicobacter pylori (H. pylori) infection status.
RESULTS: Multivariate logistic regression analysis demonstrated that elevated hemoglobin A1C (HbA1c), increased FRS, positive H. pylori infection, and WHR ≥ 0.9 are independent risk factors for colorectal adenoma. In examining the interaction between FRS and WHR using multivariate logistic regression to evaluate adenoma risk, the OR for the interaction term was 0.95, indicating a decline in adenoma risk when considering the interaction between these two factors. Incorporating HbA1c into the analysis, evaluating the interaction between FRS and WHR still demonstrated a statistically significant impact on adenoma risk (OR 0.96, p < 0.001). Participants with WHR < 0.9, elevated FRS, positive H. pylori infection, and increased HbA1c levels were associated with a higher risk of colorectal adenoma formation. Remarkably, the increased risk of adenoma due to rising HbA1c levels was statistically significant only for those with a WHR < 0.9.
CONCLUSIONS: An increase in FRS and HbA1c or a positive H. pylori infection still warrants vigilance for colorectal adenoma risk when WHR is 0.9. These factors interacted with each other and were found to have a minimal decline in adenoma risk when considering the interaction between WHR and FRS.
摘要：
背景：我们旨在根据代谢健康状况和肥胖评估无症状个体之间结直肠腺瘤风险之间的相互作用，并检查患有结直肠腺瘤风险的成年人的正常腰臀比（WHR）。
方法：横截面，我们在麦凯纪念医院进行了回顾性研究,纳入了2013年至2023年间接受双向胃肠内镜检查的16,996名参与者.该研究记录了重要的临床病理特征，包括年龄,体重指数和WHR，弗雷明汉风险评分（FRS），血糖水平，和幽门螺杆菌(H.幽门螺杆菌)感染状态。
结果：多因素logistic回归分析显示血红蛋白A1C（HbA1c）升高，FRS增加，幽门螺杆菌感染阳性，WHR≥0.9是结直肠腺瘤的独立危险因素。在检查FRS和WHR之间的相互作用时，使用多变量逻辑回归评估腺瘤风险，交互作用项的OR为0.95,这表明当考虑到这两个因素之间的交互作用时,腺瘤风险下降.将HbA1c纳入分析，评估FRS和WHR之间的相互作用仍显示对腺瘤风险有统计学意义(OR0.96,p<0.001).WHR<0.9，FRS升高，幽门螺杆菌感染阳性，HbA1c水平升高与结直肠腺瘤形成的高风险相关。值得注意的是,仅在WHR<0.9的人群中,由于HbA1c水平升高而导致的腺瘤风险增加具有统计学意义.
结论：当WHR为0.9时，FRS和HbA1c升高或幽门螺杆菌感染阳性仍需警惕结直肠腺瘤风险。这些因素相互作用，当考虑WHR和FRS之间的相互作用时，发现腺瘤风险下降最小。
方法：横截面，我们在麦凯纪念医院进行了回顾性研究,纳入了2013年至2023年间接受双向胃肠内镜检查的16,996名参与者.该研究记录了重要的临床病理特征，包括年龄,体重指数和WHR，弗雷明汉风险评分（FRS），血糖水平，和幽门螺杆菌(H.幽门螺杆菌)感染状态。
结果：多因素logistic回归分析显示血红蛋白A1C（HbA1c）升高，FRS增加，幽门螺杆菌感染阳性，WHR≥0.9是结直肠腺瘤的独立危险因素。在检查FRS和WHR之间的相互作用时，使用多变量逻辑回归评估腺瘤风险，交互作用项的OR为0.95,这表明当考虑到这两个因素之间的交互作用时,腺瘤风险下降.将HbA1c纳入分析，评估FRS和WHR之间的相互作用仍显示对腺瘤风险有统计学意义(OR0.96,p<0.001).WHR<0.9，FRS升高，幽门螺杆菌感染阳性，HbA1c水平升高与结直肠腺瘤形成的高风险相关。值得注意的是,仅在WHR<0.9的人群中,由于HbA1c水平升高而导致的腺瘤风险增加具有统计学意义.
结论：当WHR为0.9时，FRS和HbA1c升高或幽门螺杆菌感染阳性仍需警惕结直肠腺瘤风险。这些因素相互作用，当考虑WHR和FRS之间的相互作用时，发现腺瘤风险下降最小。
