目的:内脏脂肪被认为在周围脂肪的结肠癌发生中起不同的作用。我们的目的是评估通过生物电阻抗分析(BIA)测量的体脂分布与结直肠腺瘤(CRA)发生率的关系。
方法:从2017年7月至2019年12月在我们中心进行结肠镜检查的410名无症状参与者被招募。包括230例腺瘤和180例未检出腺瘤。参与者的身体脂肪是通过BIA测量的,包括他们的身体脂肪量(BFM),体脂百分比(BFP),和腰臀比.代谢综合征(MetS)参数,包括腰围,血压,空腹血糖(FBG),血甘油三酯水平,胆固醇,还测量了高密度脂蛋白。
结果:根据单因素分析,年龄,男性,身体质量指数,腰围,BFM,腰臀比,血压,腺瘤组FBG高于无腺瘤组(P<0.05)。在多变量后勤分析(根据年龄调整,性别,吸烟,饮酒,和CRC家族史),高腰臀比与高CRA发生率相关(比值比[OR]1.84,95%置信区间[CI]1.09~3.09,P=0.02).在多变量分析中,仅MetS成分中的大腰围与CRA的发生率独立相关(OR1.90,95%CI1.17-3.08,P=0.01)。
结论:身体脂肪分布与CRA相关,中心性肥胖是MetS中CRA的核心危险因素。中国临床试验登记号:ChiCTR-RRC-17010862。
OBJECTIVE: Visceral fat is thought to play different roles in the carcinogenesis of the colon with peripheral fat. Our aim was to evaluate the association of body fat distribution measured by bioelectrical impedance analysis (BIA) with the incidence of colorectal adenoma (CRA).
METHODS: A total of 410 asymptomatic participants who underwent a screening colonoscopy from July 2017 to December 2019 in our center were recruited, including 230 with adenomas and 180 without detected adenomas. The participants\' body fat was measured by BIA, including their body fat mass (BFM), body fat percentage (BFP), and waist-to-hip ratio. Parameters of metabolic syndrome (MetS), including waist circumference, blood pressure, fasting blood glucose (FBG), blood level of triglyceride, cholesterol, and high-density lipoprotein were measured as well.
RESULTS: According to univariate analysis, age, male sex, body mass index, waist circumference, BFM, waist-to-hip ratio, blood pressure, and FBG were higher in the adenoma group than in the adenoma-free group (P < 0.05). On multivariate logistical analysis (adjusted for age, sex, smoking, drinking, and family history of CRC), a high waist-to-hip ratio was associated with a high incidence of CRA (odds ratio [OR] 1.84, 95% confidence interval [CI] 1.09-3.09, P = 0.02). Only a large waist circumference in components of MetS was independently associated with the incidence of CRA (OR 1.90, 95% CI 1.17-3.08, P = 0.01) in the multivariate analysis.
CONCLUSIONS: Body fat distribution is associated with CRA, central obesity is a core risk factor for CRA in MetS. Chinese Clinical Trial Registration number: ChiCTR-RRC-17010862.