Association of Visceral Fat Accumulation and Plasma Adiponectin with Colorectal Adenoma: Evidence for Participation of Insulin Resistance

Abstract

Purpose: Colorectal carcinogenesis is thought to be related to abdominal obesity and insulin resistance. To investigate whether visceral fat accumulation contributes to colorectal carcinogenesis, we examined its accumulation and the levels of the adipose tissue^derived hormone adiponectin in Japanese patients with colorectal adenoma. Experimental Design: Fifty-one consecutive Japanese patients ages z40 years and with colorectal adenoma were subjected to measurement of visceral fat area by computed tomography scanning and plasma adiponectin concentration. The patients also underwent the 75-g oral glucose tolerance test. Insulin resistance was calculated by the homeostasis metabolic assessment (HOMA-IR) method. The controls were 52 Japanese subjects ages z40 years and without colorectal polyp. Cigarette smokers and subjects who consumed alcohol (z30 g ethanol/d) were excluded. Results: The patients with colorectal adenoma showed significantly more visceral fat area and significantly less plasma adiponectin concentration in comparison with the controls [odds ratio (OR), 2.19; 95% confidence interval (95% CI), 1.47-3.28; P < 0.001 and OR, 0.24; 95% CI, 0.14-0.41; P < 0.001, respectively] by logistic regression analysis. HOMA-IR index was also associated with colorectal adenoma (OR 2.60; 95% CI, 1.20-5.64; P = 0.040). Visceral fat area and adiponectin were associated with adenoma number (1, 2, z 3), the size of the largest adenoma (<10 and z10 mm), and adenoma histology (tubular and tubulovillous/villous). Conclusions: These results suggest an association of visceral fat accumulation and decreased plasma adiponectin concentration with colorectal adenoma in Japanese patients. This study may offer a new insight to understanding the relationship of colorectal carcinogenesis with abdominal obesity and insulin resistance.

Association of Adiponectin Receptor (Adipo-R1/-R2) Expression and Colorectal Cancer

“…A positive correlation was shown between body-mass index and colorectal cancer in several studies (Murphy et al, 2000;Moore et al, 2004). Some authors have reported an inverse relationship between serum ApN and colorectal carcinoma and also between serum ApN and accumulation of fat in visceral tissues and adenoma development (Otake et al, 2005;Wei et al, 2005).…”

Translational approaches to addressing complex genetic pathways in colorectal cancer

“…In particular, there is a clear association between abdominal obesity, as reflected by a higher waist circumference, and colon cancer and advanced adenoma risk in both men and women (28), findings confirmed in studies where visceral fat-measured by CT scanning-was strongly associated with colorectal adenoma detection and inversely associated with circulating adiponectin levels (29). Accumulating evidence in experimental animals support these data and indicate that normal colonic epithelial cells as well as CRC cells proliferate more rapidly in obese animals and in mice fed a hypercaloric diet (30,31).…”

Associations between Adiponectin and Two Different Cancers: Breast and Colon

“…There are few data in literature and all of them were obtained in the last five years. In 2005, Otake S et al suggested that decreased plasma adiponectin concentration is associated with the development of colon adenoma in Japanese patients (Otake et al,2005). Later in his prospective case control study, Wei EK et al suggested that the risk of colorectal cancer is higher in patients with low adiponectin plasma levels (Wei et al,2005).…”