Association of colorectal adenoma with components of metabolic syndrome

Kim, Jae Hak; Shin, Aesun; Hong, Chang Won; Sohn, Dae Kyung; Han, Kyung Su; Ryu, Kum Hei; Park, Bum-Joon; Nam, Ji Hyung; Park, Ji Won; Chang, Hee Jin; Choi, Hyo Seong; Kim, Jeongseon; Oh, Jae Hwan

doi:10.1007/s10552-012-9942-9

Cited by 84 publications

(91 citation statements)

References 33 publications

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“…A more recent case–control study comparing 1771 patients with diagnosed adenomas and 4667 polyp-free controls confirmed that a greater waist circumference was significantly associated with increased CRA risk (OR=1.32, 1.17 to 1.49) 37. In addition, MS was significantly associated with finding adenomas (OR=1.44, 1.23 to 1.70), regardless of histological type, CRA number or location other than rectum 37…”

Section: Resultsmentioning

confidence: 96%

Obesity and colorectal cancer

Bardou

Barkun

Martel

2013

Gut

665

479

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Excess body weight, as defined by the body mass index (BMI), has been associated with several diseases and includes subjects who are overweight (BMI ≥ 25-29.9 kg/m(2)) or obese (BMI ≥ 30 kg/m(2)). Overweight and obesity constitute the fifth leading risk for overall mortality, accounting for at least 2.8 million adult deaths each year. In addition around 11% of colorectal cancer (CRC) cases have been attributed to overweight and obesity in Europe. Epidemiological data suggest that obesity is associated with a 30-70% increased risk of colon cancer in men, whereas the association is less consistent in women. Similar trends exist for colorectal adenoma, although the risk appears lower. Visceral fat, or abdominal obesity, seems to be of greater concern than subcutaneous fat obesity, and any 1 kg/m(2) increase in BMI confers additional risk (HR 1.03). Obesity might be associated with worse cancer outcomes, such as recurrence of the primary cancer or mortality. Several factors, including reduced sensitivity to antiangiogenic-therapeutic regimens, might explain these differences. Except for wound infection, obesity has no significant impact on surgical procedures. The underlying mechanisms linking obesity to CRC are still a matter of debate, but metabolic syndrome, insulin resistance and modifications in levels of adipocytokines seem to be of great importance. Other biological factors such as the gut microbiota or bile acids are emerging. Many questions still remain unanswered: should preventive strategies specifically target obese patients? Is the risk of cancer great enough to propose prophylactic bariatric surgery in certain patients with obesity?

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Section: Resultsmentioning

confidence: 96%

Obesity and colorectal cancer

Bardou

Barkun

Martel

2013

Gut

665

479

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“…However, the standard protocol recommends that screening is initiated after the age of 50 years. Previous studies have suggested that there is a certain degree of correlation between metabolic syndrome and colorectal adenoma, a precancerous lesion of CRC (12)(13)(14), our study aimed to develop a risk determinant for younger patients who may benefit from screening on the basis of their metabolic profiles and associated clinical history. The general adenoma detection rate of 20% for both sexes, 23% in males and 17% in females, is in line with standard quality indicators in colonoscopic practice (15).…”

Section: Discussionmentioning

confidence: 99%

Predicting the occurrence of cancer-associated colorectal polyp using a metabolic risk score

Orannapalai

Attawettayanon

Kanngern

et al. 2013

Molecular and Clinical Oncology

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Abstract. This study was conducted with the aim of developing a metabolic risk score to help identify patients who are likely to have a cancer-associated polyp (CAP) on colonoscopy, based on a metabolic syndrome-related clinical profile. The clinical history and anthropometric and metabolic profiles of patients who came for a screening colonoscopy at our institute between June, 2010 and December, 2012 were prospectively collected. The data were analyzed for their association with the occurrence of CAP. Subsequently, six parameters were selected in order to construct a metabolic risk score that correlated with the presence of CAP. A total of 286 subjects (132 males and 154 females), with an age range of 19-85 years, were included in this study. The colonoscopy detected polyps in 56 cases (19.6%). Anthropometric parameters that were significantly associated with CAP included a body mass index (BMI) of >23.4 kg/m 2 and a waist circumference of >32 inches in females. Laboratory profiles that were significantly associated with CAP were fasting blood sugar (FBS) >110 mg%, hemoglobin A1C (HbA1C) >7%, aspartate transaminase (SGOT) >40 IU̸l, alanine transaminase (SGPT) >50 IU̸l and uric acid >7 mg%. When a metabolic risk score was constructed, it was observed that moderate (2-3) and high risk (4-6) was significantly associated with CAP [odds ratio (OR)=4.9, 95% confidence interval (CI): 2.0-12.0 and OR=13.7, 95% CI: 4.4-43.0, respectively]. The association between the risk score and CAP was stronger in the subgroup of patients aged <65 years, in whom the moderate and high metabolic risk groups exhibited ORs of 5.6 (95% CI: 1.8-17.9) and 39.0 (95% CI: 8.2-186.6), respectively. In conclusion, this study demonstrated that it is possible to use a metabolic profile to construct a reliable scoring method to identify patients at higher risk of having CAP who should be fast-tracked for a colonoscopy.

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“…Nine studies were conducted in the USA (16,18,20,32,35,(37)(38)(39)(40) , one in Sweden (42) , five in Korea (6,9,10,22,27) , two in China (23,30) , eight in Japan (8,24,26,28,29,31,36,43) , one in Austria (41) and three in European countries (4,17,34) (Tables 1 and 2). Pooled analysis showed a significant association between serum TAG and CRN (n 29 studies; summary RR = 1·08; 95 % CI 1·05, 1·12, P < 0·00001; Fig.…”

Section: Study Characteristicsmentioning

confidence: 99%

“…There were fourteen studies on HDL-C (four cohort studies, four cross-sectional and six case-control studies) and risk of CRA published between 1990 and 2013 and involved a total of 14 098 CRA cases (Table 2) (6,9,10,(18)(19)(20)23,(26)(27)(28)(29)(30)(31)39) . Fig.…”

Section: Study Characteristicsmentioning

confidence: 99%

The association between serum lipids and colorectal neoplasm: a systemic review and meta-analysis

Tian

Wang

et al. 2015

Public Health Nutr.

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Objective: There have been inconsistent results published regarding the relationship between dyslipidaemia and an increased risk of colorectal neoplasia (CRN), including colorectal adenoma (CRA) and colorectal cancer (CRC). We conducted a meta-analysis to explore the relationship between dyslipidaemia and CRN. Design: We identified studies by performing a literature search using PubMed, EMBASE and the Science Citation Index through October 2013. Setting: We analysed thirty-three independent studies reporting the association between CRN and at least one of the selected lipid components, including total cholesterol (TC), TAG, HDL-cholesterol (HDL-C) and LDL-cholesterol (LDL-C). Subjects: CRN cases (n 21 809) were identified. Results: Overall, people with high levels of serum TAG (risk ratio (RR) = 1·08; 95 % CI 1·05, 1·12, P < 0·00001) and LDL-C (RR = 1·07; 95 % CI 1·00, 1·14, P = 0·04) presented an increased prevalence of CRN. Subgroup analyses revealed that high levels of serum TC (RR = 1·04; 95 % CI 1·01, 1·09, P = 0·02), TAG (RR = 1·06; 95 % CI 1·03, 1·10, P = 0·0009) and LDL-C (RR = 1·11; 95 % CI 1·04, 1·19, P = 0·003) increased the risk of CRA but not of CRC. No association between serum HDL-C and risk for CRN (including CRA and CRC) was observed. Conclusions: Both TAG and LDL-C were significantly associated with an increasing prevalence of CRN. High levels of serum TC, TAG and LDL-C were positively associated with CRA but not with CRC. No significant association was observed between levels of serum HDL-C and CRN. Keywords Serum lipids Colorectal adenomaColorectal cancer TAG Meta-analysis Colorectal cancer (CRC) is reported to be the fourth most commonly diagnosed cancer and is the second most common cause of cancer deaths in North America (1) . CRC is believed to arise from colorectal adenoma (CRA) through a sequence from adenoma to adenocarcinoma as a consequence of a limited set of molecular events that largely originate with a relatively benign adenoma that progresses to cancer (2) . Accumulated data indicate that metachronous lesions occur at a rate of 20 to 30 % per year in post-polypectomy patients. The propensity to develop CRA identifies a sizeable subgroup of the population at an enhanced risk for subsequent adenoma formation and colorectal carcinoma. This indicates that identifying risk factors associated with CRN is essential for the reduction of colorectal carcinoma.The positive association between obesity and CRA prevalence demonstrates an underlying dose-response relationship according to BMI (3) . Timely screening of obese patients for CRA is thus recommended. Dyslipidaemia is an important component of metabolic syndrome and is demonstrated to contribute to colorectal tumorigenesis through insulin resistance, oxidative stress and inflammatory † The first three authors contributed equally to this work.

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Association of colorectal adenoma with components of metabolic syndrome

Abstract: Central obesity, triglyceride level, and MS are risk factors for colorectal adenoma including advanced adenoma and multiplicity.

Cited by 84 publications

References 33 publications

Obesity and colorectal cancer

Obesity and colorectal cancer

Predicting the occurrence of cancer-associated colorectal polyp using a metabolic risk score

The association between serum lipids and colorectal neoplasm: a systemic review and meta-analysis

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