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Visceral obesity linked to higher colorectal adenoma risk
Patients with increased visceral adipose tissue are more likely to develop precancerous colorectal adenomas, according to research published in Gastrointestinal Endoscopy.
“These findings provide novel evidence that visceral obesity may be the most important target for future colorectal adenoma prevention,” Donghee Kim, MD, PhD, of the division of gastroenterology and hepatology at Stanford University School of Medicine, and colleagues wrote.
Kim and colleagues noted that BMI has long been associated with the development of adenomas, but no large, prospective studies have examined the role of body fat distribution in the development and recurrence of colorectal adenoma. Therefore, they performed a large prospective cohort study using a registry database to investigate the relationship between body fat distribution and the incidence and recurrence of colorectal adenoma.
The investigators evaluated patients aged between 40 and 75 years who underwent a screening colonoscopy and an abdominal fat CT scan between 2006 and 2007 (n = 2,244). They assigned patients who underwent at least one follow-up colonoscopy (n=1,163) into groups based on whether they had an adenoma at baseline (n = 654) or not (n= 509).
Colorectal adenomas occurred in 592 patients (50.9%) during a median period of 43 months. Data showed that incident adenoma prevalence was 39.1% and recurrent adenoma prevalence was 60.1%.
Kim and colleagues found that visceral adipose tissue (VAT) was significantly higher in patients who developed incident colorectal adenomas (127.7 ± 49 cm²) than in patients who did not develop adenomas (112.2 ± 48.3 cm²).
Additionally, the researchers found that an increase in VAT area correlated with a higher incidence of adenoma (highest quintile vs. lowest quintile of VAT, HR = 2.16; 95% CI, 1.26–3.71; HR = 1.32 [per 1 standard deviation]; 95% CI, 1.1–1.6).
Kim and colleagues also found that increases in BMI (HR = 1.33 [per 1 kg/m²]; 95% CI, 1.18–1.46) and waist circumference (HR = 1.04 [per 1 cm]; 95% CI, 1.01–1.07) correlated with recurrent adenoma in a multivariate analysis.
“This prospective longitudinal study demonstrated that VAT area at baseline independently predicted incident colorectal adenoma in an apparently healthy general population,” they concluded. “Additionally, increases in BMI were associated with the incidence and recurrence of colorectal adenoma, whereas WC, ie, a surrogate marker of abdominal obesity, was associated with a higher risk of recurrent adenoma."
However, further interventional prospective studies are needed to clarify the relationship between VAT area and colorectal adenoma,” they noted. – by Alex Young
Disclosures: The authors report no relevant financial disclosures.