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Jawhar N, Nakanishi H, Marrero K, Tomey D, Alamy NH, Danaf J, Ghanem OM. Risk reduction of non-hormonal cancers following bariatric surgery. Minerva Surg 2023; 78:657-670. [PMID: 38059440 DOI: 10.23736/s2724-5691.23.10104-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/08/2023]
Abstract
Metabolic and bariatric surgery (MBS) is the most effective intervention for weight loss leading to significant resolution of obesity-related medical conditions. Recent literature has demonstrated risk reduction of certain cancer types after MBS. Studies have shown an overall reduction in the risk of hormonal cancer, such as breast and endometrial cancer. However, the association between bariatric surgery and the incidence of various types of non-hormonal cancer such as esophageal, gastric, liver, gallbladder, colorectal, pancreatic and kidney cancer remains contested. The aim of this study was to highlight obesity and its relationship to cancer development as well as bariatric surgery and its role in cancer reduction with focus on non-hormonal cancers.
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Affiliation(s)
- Noura Jawhar
- Department of Surgery, Mayo Clinic, Rochester, MN, USA
- Division of Pediatric Surgery, UPMC Children's Hospital of Pittsburgh, Pittsburgh, PA, USA
| | - Hayato Nakanishi
- St. George's University of London, London, UK
- University of Nicosia Medical School, Nicosia, Cyprus
| | - Katie Marrero
- Department of Surgery, Carle Foundation Hospital General Surgery Residency, Champaign, IL, USA
| | - Daniel Tomey
- Department of General Surgery, Houston Methodist Hospital, Houston, TX, USA
| | - Nadine H Alamy
- Alix School of Medicine, Mayo Clinic, Rochester, MN, USA
| | - Jamil Danaf
- Kansas City University, Kansas City, MO, USA
| | - Omar M Ghanem
- Department of Surgery, Mayo Clinic, Rochester, MN, USA -
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2
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Chiang CH, Chang YJ, He SR, Chao JN, Yang CH, Liu YT. Association of 25(OH)-Vitamin D and metabolic factors with colorectal polyps. PLoS One 2023; 18:e0286654. [PMID: 37289677 PMCID: PMC10249833 DOI: 10.1371/journal.pone.0286654] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2022] [Accepted: 05/21/2023] [Indexed: 06/10/2023] Open
Abstract
BACKGROUND Studies have revealed the association of vitamin D with specific types of cancer development, however, its correlation with colorectal polyps (CRPs) remains unverified. Our study aimed to investigate the relationship between vitamin D levels, metabolic factors, and CRPs. METHODS A cross-sectional study from 2017 to 2019 involving 1306 participants was conducted to investigate the association among vitamin D levels, metabolic factors, uric acid and CRPs in Taiwan. CRPs diagnoses were determined via colonoscopies conducted by experienced gastrointestinal physicians, and biopsied polyps were inspected under a microscope by experienced pathologists. We employed both simple and multiple logistic regression analyses to identify significant factors associated with CRPs and adenomatous polyps, respectively. RESULTS Our result showed that the prevalence of 25(OH)-vitamin D deficiency (≦ 20 ng/mL) and CRPs was 21.21% and 40.89%, respectively. Multiple logistic regression revealed that the risk of CRPs increased with old age, male sex, hyperglycemia, high triglyceride levels, and low 25(OH)D levels after adjustment for other factors. Besides, low 25(OH)D levels were significantly associated with CRPs risk in women, whereas elevated blood pressure was associated with CRPs risk in men. 25(OH)D Deficiency was revealed to be significantly associated with risk of CRPs in adults over 50 years old. Compared to nonadenomatous polyps, older age, higher 25(OH) vitamin D and higher uric acid levels were at increased risk for adenomatous polyps. CONCLUSIONS Our study revealed that vitamin D deficiency was significantly associated with the risk of CRPs, especially in adults over 50 years old and women. We should therefore be concerned about the CRP risk of vitamin D deficiency and metabolic syndrome (especially hyperglycemia, elevated blood pressure in men, and high triglyceride levels) in this population.
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Affiliation(s)
- Chih-Hsiang Chiang
- Department of Family Medicine, Changhua Christian Hospital, Changhua, Taiwan
| | - Yu-Jun Chang
- Big Data Center, Changhua Christian Hospital, Changhua, Taiwan
| | - Sin-Ru He
- Department of Family Medicine, Changhua Christian Hospital, Changhua, Taiwan
| | - Jih-Ning Chao
- Institute of Statistics, National Chung Hsing University, Taichung City, Taiwan
| | - Chih-Huai Yang
- Department of Family Medicine, Changhua Christian Hospital, Changhua, Taiwan
| | - Yen-Tze Liu
- Department of Family Medicine, Changhua Christian Hospital, Changhua, Taiwan
- Big Data Center, Changhua Christian Hospital, Changhua, Taiwan
- Department of Post-Baccalaureate Medicine, College of Medicine, National Chung Hsing University, Taichung, Taiwan
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3
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Wang X, Zou Y, Zhang R, Teng C, Ren X, Zhang H, Zhou L. The relationship between serum lipid levels and colorectal serrated lesions: A systematic review and meta-analysis. Front Physiol 2022; 13:984586. [PMID: 36304580 PMCID: PMC9592854 DOI: 10.3389/fphys.2022.984586] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2022] [Accepted: 09/20/2022] [Indexed: 11/13/2022] Open
Abstract
Objective: To clarify the relationship between colorectal serrated lesions and serum lipid levels, and provide a scientific basis for the identification and early clinical prevention and treatment of populations that are at risk for colorectal serrated lesions. Methods: Studies comparing serum lipid levels in patients with colorectal serrated lesions and controls were searched in PubMed, Embase, Web of Science, the Cochrane Library, China Biomedical Literature Database, CNKI, Wanfang Database, and VIP Database. Relevant literature was screened according to the inclusion and exclusion criteria. The mean and standard deviation of the serum lipid levels in patients and controls were extracted from the included literature. The combined weighted mean difference (WMD) and 95% confidence intervals (CIs) were calculated using Review Manager 5.0 software to evaluate the relationship between serum lipid levels and colorectal serrated lesions. Publication bias of the included studies was evaluated by the Egger test. Results: Twenty-three studies were included, comprising 2,063 patients and 63,909 controls. The serum high-density lipoprotein cholesterol (HDL-C) levels in the case group was significantly lower than in the control group (WMD = −0.122 mmol/L, 95% CI: 0.170–0.073). Total cholesterol (TC), low-density lipoprotein cholesterol (LDL-C), and serum triglyceride levels in the case group were significantly higher than in the control group, and the WMDs were 0.180 mmol/L (95% CI: 0.061–0.299), 0.155 mmol/L (95% CI: 0.038–0.273), and 0.241 mmol/L (95% CI: 0.181–0.302), respectively. Conclusion: Colorectal serrated lesions may be related to blood lipid levels. Hyperlipidemia might be a risk factor for colorectal serrated lesions.
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Affiliation(s)
- Xuerui Wang
- Department of Gastrointestinal Colorectal and Anal Surgery, China-Japan Union Hospital of Jilin University, Changchun, China
- Department of Clinical Laboratory, The Second Hospital of Jilin University, Changchun, China
| | - Yangbin Zou
- Department of Occupational and Environmental Health, School of Public Health, Jilin University, Changchun, China
| | - Ruxuan Zhang
- Department of Occupational and Environmental Health, School of Public Health, Jilin University, Changchun, China
| | - Chunyan Teng
- Department of Clinical Laboratory, The Second Hospital of Jilin University, Changchun, China
| | - Xuejiao Ren
- Department of Clinical Laboratory, The Second Hospital of Jilin University, Changchun, China
| | - Haishan Zhang
- Department of Gastrointestinal Colorectal and Anal Surgery, China-Japan Union Hospital of Jilin University, Changchun, China
- *Correspondence: Haishan Zhang, ; Liting Zhou,
| | - Liting Zhou
- Department of Occupational and Environmental Health, School of Public Health, Jilin University, Changchun, China
- *Correspondence: Haishan Zhang, ; Liting Zhou,
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4
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Zhang R, Yin J, Huo C, Li X, Ye J, Zhao W, Zhou L, Ye L. The Relationship Between Colorectal Polyps and Serum Lipid Levels: A Systematic Review and Meta-analysis. J Clin Gastroenterol 2022; 56:654-667. [PMID: 35152239 DOI: 10.1097/mcg.0000000000001678] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/30/2023]
Abstract
Colorectal polyp has been considered as the precancerous lesion of colorectal cancer, to which serum lipid levels are closely related. At present, there is no consensus on the relationship between colorectal polyps and serum lipid levels. We performed a meta-analysis to explore the effects of lipid levels on colorectal polyps. Relevant articles published from 2000 to 2020 were searched in PubMed, Web of Science, EMBASE, and Cochrane Library databases. The mean value and SD of serum lipid indexes and body mass index in colorectal polyps groups and control groups were extracted from the included articles. Combined weighted mean differences (WMDs) and 95% confidence intervals (CIs) were calculated to assess the effect size of serum lipid levels on colorectal polyps. The publication bias of the included studies were assessed based on the Egger test. Thirty-seven articles containing 19,464 cases and 63,979 controls were included. There were no significant publication bias. The levels of high-density lipoprotein cholesterol in the cases were lower than those in the controls (WMD: -2.589 mg/dL, 95% CI: -3.273, -1.906). While the levels of triglyceride (WMD: 16.933 mg/dL, 95% CI: 13.131, 20.736), total cholesterol (WMD: 5.561 mg/dL, 95% CI: 3.477, 7.645), low-density lipoprotein cholesterol (WMD: 3.109 mg/dL, 95% CI: 0.859, 5.359) and body mass index (WMD: 0.747 mg/dL, 95% CI: 0.588, 0.906) were higher in the cases. Colorectal polyps were associated with serum lipid levels and obesity. Hyperlipidemia and obesity may be the risk factors for colorectal polyps.
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Affiliation(s)
- Ruxuan Zhang
- Department of Occupational and Environmental Health, School of Public Health, Jilin University, Changchun, Jilin Province, China
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Boughanem H, Canudas S, Hernandez-Alonso P, Becerra-Tomás N, Babio N, Salas-Salvadó J, Macias-Gonzalez M. Vitamin D Intake and the Risk of Colorectal Cancer: An Updated Meta-Analysis and Systematic Review of Case-Control and Prospective Cohort Studies. Cancers (Basel) 2021; 13:cancers13112814. [PMID: 34200111 PMCID: PMC8201292 DOI: 10.3390/cancers13112814] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2021] [Accepted: 05/31/2021] [Indexed: 12/15/2022] Open
Abstract
Simple Summary Colorectal cancer (CRC) is the third most diagnosed cancer in men and the second in women worldwide, being the second most deadly cancer worldwide. The evidence coming from experimental studies suggest a protective effect of vitamin D intake on the risk of CRC. Different studies have shown that vitamin D may play a chemopreventive role in colorectal adenoma incidence, malignant transformation and progression. Our objective was to conduct an updated systematic review and meta-analysis of both case-control and prospective cohort studies on vitamin D intake and CRC. This manuscript provides a complete and updated state-of-the-art about vitamin D intake and CRC risk. Abstract Obesity, a sedentary lifestyle, high red meat consumption and alcohol, and tobacco are considered the driving factors behind colorectal cancer (CRC) worldwide. Both diet and lifestyle are recognized to play an important role in the prevention of CRC. Forty years later, the vitamin D–cancer hypothesis is considered consistent. However, the relationship between low vitamin D intake and CRC is still controversial. The aim of this meta-analysis is to determine the associations between Vitamin D intake and CRC. MEDLINE-PubMed and Cochrane databases were searched up to May 2020 for studies evaluating the association between vitamin D intake (from foods and supplements) and CRC. Two reviewers, working independently, screened all titles and abstracts to identify the studies that met the inclusion criteria (case-control or prospective cohort (PC) studies published in English). Data were pooled by the generic inverse variance method using a random or fixed effect model. Heterogeneity was identified using the Cochran Q-test and quantified by the I2 statistic. A total of 31 original studies were included for the quantitative meta-analysis, comprising a total 47.540 cases and 70.567 controls in case-control studies, and a total of 14.676 CRC-incident cases (out of 808.130 subjects in PC studies) from 17 countries. A significant 25% lower risk was reported comparing the highest vs. the lowest dietary vitamin D consumption and CRC risk (odds ratio (95% confidence interval): 0.75 (0.67; 0.85)) in case-control studies, whereas a non-significant association was reported in case of prospective studies (hazard ratio (95% confidence interval): 0.94 (0.79; 1.11). The present meta-analysis demonstrates that high dietary vitamin D is associated to CRC prevention. However, larger and high-quality prospective studies and clinical trials are warranted to confirm this association.
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Affiliation(s)
- Hatim Boughanem
- Instituto de Investigación Biomédica de Málaga (IBIMA), Unidad de Gestión Clínica de Endocrinología y Nutrición del Hospital Virgen de la Victoria, 29010 Málaga, Spain; (H.B.); (M.M.-G.)
| | - Silvia Canudas
- Universitat Rovira i Virgili, Departament de Bioquímica i Biotecnologia, Unitat de Nutrició Humana, Hospital Universitari San Joan de Reus, 43201 Reus, Spain; (S.C.); (N.B.); (J.S.-S.)
- Institut d’Investigació Sanitària Pere Virgili (IISPV), 43204 Reus, Spain
- Instituto de Salud Carlos III (ISCIII), Consorcio CIBER, M.P. Fisiopatología de la Obesidad y Nutrición (CIBERObn), 28220 Madrid, Spain
- Department of Nutrition, Food Sciences and Gastronomy, Food Torribera Campus, School of Pharmacy and Food Sciences, University of Barcelona, Santa Coloma de Gramenet, 08921 Barcelona, Spain
| | - Pablo Hernandez-Alonso
- Instituto de Investigación Biomédica de Málaga (IBIMA), Unidad de Gestión Clínica de Endocrinología y Nutrición del Hospital Virgen de la Victoria, 29010 Málaga, Spain; (H.B.); (M.M.-G.)
- Universitat Rovira i Virgili, Departament de Bioquímica i Biotecnologia, Unitat de Nutrició Humana, Hospital Universitari San Joan de Reus, 43201 Reus, Spain; (S.C.); (N.B.); (J.S.-S.)
- Institut d’Investigació Sanitària Pere Virgili (IISPV), 43204 Reus, Spain
- Instituto de Salud Carlos III (ISCIII), Consorcio CIBER, M.P. Fisiopatología de la Obesidad y Nutrición (CIBERObn), 28220 Madrid, Spain
- Biochemical and Biotechnology Department, Faculty of Medicine and Health Sciences Human Nutrition Unit, Rovira and Virgili University, C/Sant Llorenç, 21, 43201 Reus, Spain
- Open Evidence Research Group, Universitat Oberta de Catalunya, 08018 Barcelona, Spain
- Correspondence: (P.H.-A.); (N.B.-T.); Tel.: +34-977-759-312 (P.H.-A. & N.B.-T.)
| | - Nerea Becerra-Tomás
- Universitat Rovira i Virgili, Departament de Bioquímica i Biotecnologia, Unitat de Nutrició Humana, Hospital Universitari San Joan de Reus, 43201 Reus, Spain; (S.C.); (N.B.); (J.S.-S.)
- Institut d’Investigació Sanitària Pere Virgili (IISPV), 43204 Reus, Spain
- Instituto de Salud Carlos III (ISCIII), Consorcio CIBER, M.P. Fisiopatología de la Obesidad y Nutrición (CIBERObn), 28220 Madrid, Spain
- Biochemical and Biotechnology Department, Faculty of Medicine and Health Sciences Human Nutrition Unit, Rovira and Virgili University, C/Sant Llorenç, 21, 43201 Reus, Spain
- Department of Preventive Medicine and Public Health, School of Medicine, University of Valencia, 46010 Valencia, Spain
- MRC Centre for Environment and Health, Department of Epidemiology & Biostatistics, School of Public Health, Faculty of Medicine, Imperial College London, St Mary’s Campus, Norfolk Place, London W2 1PG, UK
- Correspondence: (P.H.-A.); (N.B.-T.); Tel.: +34-977-759-312 (P.H.-A. & N.B.-T.)
| | - Nancy Babio
- Universitat Rovira i Virgili, Departament de Bioquímica i Biotecnologia, Unitat de Nutrició Humana, Hospital Universitari San Joan de Reus, 43201 Reus, Spain; (S.C.); (N.B.); (J.S.-S.)
- Institut d’Investigació Sanitària Pere Virgili (IISPV), 43204 Reus, Spain
- Instituto de Salud Carlos III (ISCIII), Consorcio CIBER, M.P. Fisiopatología de la Obesidad y Nutrición (CIBERObn), 28220 Madrid, Spain
| | - Jordi Salas-Salvadó
- Universitat Rovira i Virgili, Departament de Bioquímica i Biotecnologia, Unitat de Nutrició Humana, Hospital Universitari San Joan de Reus, 43201 Reus, Spain; (S.C.); (N.B.); (J.S.-S.)
- Institut d’Investigació Sanitària Pere Virgili (IISPV), 43204 Reus, Spain
- Instituto de Salud Carlos III (ISCIII), Consorcio CIBER, M.P. Fisiopatología de la Obesidad y Nutrición (CIBERObn), 28220 Madrid, Spain
| | - Manuel Macias-Gonzalez
- Instituto de Investigación Biomédica de Málaga (IBIMA), Unidad de Gestión Clínica de Endocrinología y Nutrición del Hospital Virgen de la Victoria, 29010 Málaga, Spain; (H.B.); (M.M.-G.)
- Instituto de Salud Carlos III (ISCIII), Consorcio CIBER, M.P. Fisiopatología de la Obesidad y Nutrición (CIBERObn), 28220 Madrid, Spain
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Nakai K, Watari J, Tozawa K, Tamura A, Hara K, Yamasaki T, Kondo T, Kono T, Tomita T, Ohda Y, Oshima T, Fukui H, Sakurai J, Kim Y, Hayakawa Y, Fujisawa T, Morimoto T, Miwa H. Sex differences in associations among metabolic syndrome, obesity, related biomarkers, and colorectal adenomatous polyp risk in a Japanese population. J Clin Biochem Nutr 2018. [PMID: 30279628 DOI: 10.3164/jcbn.18.11] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
To investigate sex differences in the associations among metabolic syndrome, obesity, adipose tissue-related biomarkers, and colorectal adenomatous polyps, a cross-sectional, multicenter study was conducted on 489 consecutive individuals who underwent their first colonoscopy at 3 hospitals. Plasma concentrations of adiponectin and leptin, as well as homeostatic model assessment of insulin resistance were also evaluated. The presence and number of adenomatous polyps, including advanced adenoma, were higher in men than in women. Metabolic syndrome was a risk factor for adenomatous polyps in both sexes. Large waist circumference was an independent risk factor for adenomatous polyps in men, and high BMI and large waist circumference were risk factors for adenomatous polyps in women. Interestingly, low BMI was associated with large adenomatous polyps (≥10 mm) and advanced adenoma, and waist-hip ratio was involved in proximal adenomatous polyp development only in women. In contrast, the highest quartile of leptin concentration had a 3.67-fold increased adenomatous polyp risk compared with the lowest quartile only in men. These results indicate that regarding colorectal pathogenesis, sex differences were identified in obesity but not in metabolic syndrome. Visceral obesity and a high serum leptin level may be risk factors for colorectal adenomatous polyp development in Japanese men.
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Affiliation(s)
- Keisuke Nakai
- Division of Gastroenterology, Department of Internal Medicine, Hyogo College of Medicine, 1-1 Mukogawa-cho, Nishinomiya, Hyogo 663-8501, Japan
| | - Jiro Watari
- Division of Gastroenterology, Department of Internal Medicine, Hyogo College of Medicine, 1-1 Mukogawa-cho, Nishinomiya, Hyogo 663-8501, Japan
| | - Katsuyuki Tozawa
- Division of Gastroenterology, Department of Internal Medicine, Hyogo College of Medicine, 1-1 Mukogawa-cho, Nishinomiya, Hyogo 663-8501, Japan
| | - Akio Tamura
- Division of Gastroenterology, Department of Internal Medicine, Hyogo College of Medicine, 1-1 Mukogawa-cho, Nishinomiya, Hyogo 663-8501, Japan
| | - Ken Hara
- Division of Gastroenterology, Department of Internal Medicine, Hyogo College of Medicine, 1-1 Mukogawa-cho, Nishinomiya, Hyogo 663-8501, Japan
| | - Takahisa Yamasaki
- Division of Gastroenterology, Department of Internal Medicine, Hyogo College of Medicine, 1-1 Mukogawa-cho, Nishinomiya, Hyogo 663-8501, Japan
| | - Takashi Kondo
- Division of Gastroenterology, Department of Internal Medicine, Hyogo College of Medicine, 1-1 Mukogawa-cho, Nishinomiya, Hyogo 663-8501, Japan
| | - Tomoaki Kono
- Division of Gastroenterology, Department of Internal Medicine, Hyogo College of Medicine, 1-1 Mukogawa-cho, Nishinomiya, Hyogo 663-8501, Japan
| | - Toshihiko Tomita
- Division of Gastroenterology, Department of Internal Medicine, Hyogo College of Medicine, 1-1 Mukogawa-cho, Nishinomiya, Hyogo 663-8501, Japan
| | - Yoshio Ohda
- Division of Gastroenterology, Department of Internal Medicine, Hyogo College of Medicine, 1-1 Mukogawa-cho, Nishinomiya, Hyogo 663-8501, Japan
| | - Tadayuki Oshima
- Division of Gastroenterology, Department of Internal Medicine, Hyogo College of Medicine, 1-1 Mukogawa-cho, Nishinomiya, Hyogo 663-8501, Japan
| | - Hirokazu Fukui
- Division of Gastroenterology, Department of Internal Medicine, Hyogo College of Medicine, 1-1 Mukogawa-cho, Nishinomiya, Hyogo 663-8501, Japan
| | - Jun Sakurai
- Department of Gastroenterology, Meiwa Hospital, 3-39 Kaminaruo-cho, Nishinomiya, Hyogo 663-8186, Japan
| | - Yongmin Kim
- Department of Gastroenterology, Meiwa Hospital, 3-39 Kaminaruo-cho, Nishinomiya, Hyogo 663-8186, Japan
| | - Yuji Hayakawa
- Department of Gastroenterology, Meiwa Hospital, 3-39 Kaminaruo-cho, Nishinomiya, Hyogo 663-8186, Japan
| | - Takashi Fujisawa
- Department of Gastroenterology, Steel Memorial Hirohata Hospital, 3-1 Yumesaki-cho, Hirohata-ku, Himeji, Hyogo 671-1122, Japan
| | - Takeshi Morimoto
- Department of Clinical Epidemiology, Hyogo College of Medicine, 1-1 Mukogawa-cho, Nishinomiya, Hyogo 663-8501, Japan
| | - Hiroto Miwa
- Division of Gastroenterology, Department of Internal Medicine, Hyogo College of Medicine, 1-1 Mukogawa-cho, Nishinomiya, Hyogo 663-8501, Japan
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7
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Nakai K, Watari J, Tozawa K, Tamura A, Hara K, Yamasaki T, Kondo T, Kono T, Tomita T, Ohda Y, Oshima T, Fukui H, Sakurai J, Kim Y, Hayakawa Y, Fujisawa T, Morimoto T, Miwa H. Sex differences in associations among metabolic syndrome, obesity, related biomarkers, and colorectal adenomatous polyp risk in a Japanese population. J Clin Biochem Nutr 2018; 63:154-163. [PMID: 30279628 PMCID: PMC6160732 DOI: 10.3164/jcbn.18-11] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2018] [Accepted: 01/24/2018] [Indexed: 12/14/2022] Open
Abstract
To investigate sex differences in the associations among metabolic syndrome, obesity, adipose tissue-related biomarkers, and colorectal adenomatous polyps, a cross-sectional, multicenter study was conducted on 489 consecutive individuals who underwent their first colonoscopy at 3 hospitals. Plasma concentrations of adiponectin and leptin, as well as homeostatic model assessment of insulin resistance were also evaluated. The presence and number of adenomatous polyps, including advanced adenoma, were higher in men than in women. Metabolic syndrome was a risk factor for adenomatous polyps in both sexes. Large waist circumference was an independent risk factor for adenomatous polyps in men, and high BMI and large waist circumference were risk factors for adenomatous polyps in women. Interestingly, low BMI was associated with large adenomatous polyps (≥10 mm) and advanced adenoma, and waist-hip ratio was involved in proximal adenomatous polyp development only in women. In contrast, the highest quartile of leptin concentration had a 3.67-fold increased adenomatous polyp risk compared with the lowest quartile only in men. These results indicate that regarding colorectal pathogenesis, sex differences were identified in obesity but not in metabolic syndrome. Visceral obesity and a high serum leptin level may be risk factors for colorectal adenomatous polyp development in Japanese men.
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Affiliation(s)
- Keisuke Nakai
- Division of Gastroenterology, Department of Internal Medicine, Hyogo College of Medicine, 1-1 Mukogawa-cho, Nishinomiya, Hyogo 663-8501, Japan
| | - Jiro Watari
- Division of Gastroenterology, Department of Internal Medicine, Hyogo College of Medicine, 1-1 Mukogawa-cho, Nishinomiya, Hyogo 663-8501, Japan
| | - Katsuyuki Tozawa
- Division of Gastroenterology, Department of Internal Medicine, Hyogo College of Medicine, 1-1 Mukogawa-cho, Nishinomiya, Hyogo 663-8501, Japan
| | - Akio Tamura
- Division of Gastroenterology, Department of Internal Medicine, Hyogo College of Medicine, 1-1 Mukogawa-cho, Nishinomiya, Hyogo 663-8501, Japan
| | - Ken Hara
- Division of Gastroenterology, Department of Internal Medicine, Hyogo College of Medicine, 1-1 Mukogawa-cho, Nishinomiya, Hyogo 663-8501, Japan
| | - Takahisa Yamasaki
- Division of Gastroenterology, Department of Internal Medicine, Hyogo College of Medicine, 1-1 Mukogawa-cho, Nishinomiya, Hyogo 663-8501, Japan
| | - Takashi Kondo
- Division of Gastroenterology, Department of Internal Medicine, Hyogo College of Medicine, 1-1 Mukogawa-cho, Nishinomiya, Hyogo 663-8501, Japan
| | - Tomoaki Kono
- Division of Gastroenterology, Department of Internal Medicine, Hyogo College of Medicine, 1-1 Mukogawa-cho, Nishinomiya, Hyogo 663-8501, Japan
| | - Toshihiko Tomita
- Division of Gastroenterology, Department of Internal Medicine, Hyogo College of Medicine, 1-1 Mukogawa-cho, Nishinomiya, Hyogo 663-8501, Japan
| | - Yoshio Ohda
- Division of Gastroenterology, Department of Internal Medicine, Hyogo College of Medicine, 1-1 Mukogawa-cho, Nishinomiya, Hyogo 663-8501, Japan
| | - Tadayuki Oshima
- Division of Gastroenterology, Department of Internal Medicine, Hyogo College of Medicine, 1-1 Mukogawa-cho, Nishinomiya, Hyogo 663-8501, Japan
| | - Hirokazu Fukui
- Division of Gastroenterology, Department of Internal Medicine, Hyogo College of Medicine, 1-1 Mukogawa-cho, Nishinomiya, Hyogo 663-8501, Japan
| | - Jun Sakurai
- Department of Gastroenterology, Meiwa Hospital, 3-39 Kaminaruo-cho, Nishinomiya, Hyogo 663-8186, Japan
| | - Yongmin Kim
- Department of Gastroenterology, Meiwa Hospital, 3-39 Kaminaruo-cho, Nishinomiya, Hyogo 663-8186, Japan
| | - Yuji Hayakawa
- Department of Gastroenterology, Meiwa Hospital, 3-39 Kaminaruo-cho, Nishinomiya, Hyogo 663-8186, Japan
| | - Takashi Fujisawa
- Department of Gastroenterology, Steel Memorial Hirohata Hospital, 3-1 Yumesaki-cho, Hirohata-ku, Himeji, Hyogo 671-1122, Japan
| | - Takeshi Morimoto
- Department of Clinical Epidemiology, Hyogo College of Medicine, 1-1 Mukogawa-cho, Nishinomiya, Hyogo 663-8501, Japan
| | - Hiroto Miwa
- Division of Gastroenterology, Department of Internal Medicine, Hyogo College of Medicine, 1-1 Mukogawa-cho, Nishinomiya, Hyogo 663-8501, Japan
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8
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Kim JH, Cho KI, Kim YA, Park SJ. Elevated Neutrophil-to-Lymphocyte Ratio in Metabolic Syndrome Is Associated with Increased Risk of Colorectal Adenoma. Metab Syndr Relat Disord 2017; 15:393-399. [PMID: 28910195 DOI: 10.1089/met.2017.0041] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022] Open
Abstract
BACKGROUND Metabolic syndrome (MetS) is an important cardiovascular risk factor for insulin resistance and has been linked to colorectal adenoma via inflammation. The neutrophil-to-lymphocyte ratio (NLR) has been suggested as an important inflammatory marker. We initiated this investigation to determine the relationship between colorectal adenoma and NLR in patients with MetS. METHODS We examined participants who visited the Health Promotion Center at Kosin University Gospel Hospital, Busan, Korea. Subjects who underwent both colonoscopy and liver ultrasonography were included. Colorectal adenoma was defined as the presence of a colon polyp with a histologically adenomatous component. MetS was defined according to the modified National Cholesterol Education Program Adult Treatment Panel III definition for South Asians. Anthropometric measurements and biochemical tests of liver and metabolic function were assessed. RESULTS A total of 1007 subjects were included in the study sample. Their mean age was 48.3 ± 9.7 years and 262 (26.0%) subjects had MetS, while 439 (43.6%) subjects had pathologically proven colorectal adenoma. Subjects with MetS were older, more likely to be male, and had significantly higher prevalences of colorectal adenoma (49.2% vs. 41.6%, P = 0.032), nonalcoholic fatty liver disease (62.8% vs. 19.5%, P < 0.001), and higher NLR (2.0 ± 0.9 vs. 1.7 ± 0.7, P < 0.001) compared to those without MetS. High NLR (≥2.0) was an independent factor affecting the prevalence of colorectal adenoma [odds ratio (OR) 1.38, confidence interval (95% CI) 1.02-1.88, P = 0.040], especially in subjects with MetS (OR 1.91, 95% CI 1.12-3.28, P = 0.018). CONCLUSION High NLR was associated with increased colorectal adenomatous polyps, particularly in subjects with MetS. Screening colonoscopies for the prevention of colorectal adenoma may be warranted for patients with high NLR and MetS.
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Affiliation(s)
- Jae Hyun Kim
- 1 Department of Internal Medicine, Kosin University College of Medicine , Busan, Korea
| | - Kyoung Im Cho
- 1 Department of Internal Medicine, Kosin University College of Medicine , Busan, Korea
| | - Young A Kim
- 2 Health Promotion Center, Kosin University College of Medicine , Busan, Korea
| | - Seun Ja Park
- 1 Department of Internal Medicine, Kosin University College of Medicine , Busan, Korea
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Lim HS, Shin EJ, Yeom JW, Park YH, Kim SK. Association between Nutrient Intake and Metabolic Syndrome in Patients with Colorectal Cancer. Clin Nutr Res 2017; 6:38-46. [PMID: 28168180 PMCID: PMC5288551 DOI: 10.7762/cnr.2017.6.1.38] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2017] [Revised: 01/20/2017] [Accepted: 01/26/2017] [Indexed: 01/05/2023] Open
Abstract
The purpose of this study was to investigate the difference of nutritional status according to metabolic syndrome in colorectal cancer patients. The subjects were divided into 2 groups (metabolic syndrome group and normal group) according to the presence or absence of metabolic syndrome in 143 patients diagnosed with colorectal cancer, and their lifestyle and nutritional status were analyzed. Recall method was used for the dietary survey, and metabolic syndrome was defined as the presence of 3 or more of waist circumference, fasting blood glucose, triglyceride, high-density lipoprotein (HDL)-cholesterol, and blood pressure. This study showed that the metabolic syndrome group had a low age, a high body mass index (BMI), and a high drinking rate. The intake of energy, protein, fat, calcium, and phosphorus was significantly higher in the metabolic syndrome group than in the normal group, and the intake of β-carotene, vitamin C, and folic acid was significantly low. The intake of cholesterol, fatty acid, saturated fatty acid, and polyunsaturated fatty acid was also higher in the metabolic syndrome group. Higher BMI, alcohol consumption, intake of fat, total fatty acid or saturated fatty acid increased the risk of metabolic syndrome, but fiber, vitamin C, or folic acid intake lowered the risk.Weight management and balanced nutritional intake should be emphasized to prevent metabolic syndrome and to improve the condition in patients with colorectal cancer.
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Affiliation(s)
- Hee-Sook Lim
- Department of Clinical Nutrition, Soonchunhyang University Bucheon Hospital, Bucheon 14584, Korea.; Department of Preventive Medicine, Soonchunhyang University College of Medicine, Cheonan 31151, Korea
| | - Eung-Jin Shin
- Department of Surgery, Soonchunhyang University Bucheon Hospital, Bucheon 14584, Korea
| | - Jeong-Won Yeom
- Department of Surgery, Soonchunhyang University Bucheon Hospital, Bucheon 14584, Korea
| | - Yoon-Hyung Park
- Department of Preventive Medicine, Soonchunhyang University College of Medicine, Cheonan 31151, Korea
| | - Soon-Kyung Kim
- Department of Food Sciences & Nutrition, Soonchunhyang University, Asan 31538, Korea
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Advanced Hepatic Fibrosis in Fatty Liver Disease Linked to Hyperplastic Colonic Polyp. Can J Gastroenterol Hepatol 2017; 2017:2054871. [PMID: 28127545 PMCID: PMC5239862 DOI: 10.1155/2017/2054871] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/20/2016] [Accepted: 11/29/2016] [Indexed: 12/31/2022] Open
Abstract
Aim. Our study aims to determine possible association between biopsy-proven nonalcoholic steatohepatitis (NASH) and hyperplastic polyps (HP) of the colon. Methods. A retrospective cohort observational study. All subjects underwent screening colonoscopy within two years. Data were extracted from the patient charts including demographic, anthropometric measurement, vital signs, underlying diseases, medical therapy, laboratory data, results of the liver biopsy with degree of fibrosis and necroinflammatory activity, the colonoscopy report, and the pathological report of the extracted polyp. Results. A total of 223 patients were included in our study, 123 patients with biopsy-proven NASH and 100 patients without NASH who served as the control group matched for age. 14 colonic adenomas (11% of patients) were found in the NASH group compared with 16 adenomas (16% of patients) found in the control group (P = 0.9). 28 HPs were found in the NASH group (22.7%) compared with only 8 HPs in the control group (8%) (P < 0.05). 21 from the 28 (75%) HPs diagnosed in the NASH group were observed in the high degree fibrosis patients (Fibrosis Stages 3 and 4), 6 HPs (21%) were associated with Fibrosis Stages 1 and 2, and single HP (4%) was associated with Fibrosis Stage 0. Conclusions. Our study showed an association between biopsy-proven steatohepatitis and the burden of hyperplastic polyp. The severity of hepatic fibrosis may play important role in the increased occurrence of HPs.
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Unler GK, Gokturk HS, Toprak E, Erinanc OH, Korkmaz H. Does the Presence of Endometrial Polyp Predict Colorectal Polyp? Am J Med Sci 2016; 351:129-32. [PMID: 26897266 DOI: 10.1016/j.amjms.2015.11.006] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2015] [Accepted: 08/22/2015] [Indexed: 10/22/2022]
Abstract
INTRODUCTION Endometrial polyps (EPs) and colorectal polyps (CPs) are common disorders and the incidence of both increase rapidly with aging. CPs are focal lesions and incidence increases with age. AIM In this study, we aimed to analyze retrospectively the relationship between the EPs and CPs sharing similar clinical and genetic factors in their etiopathogenesis. MATERIALS AND METHODS This study was retrospectively performed between 2010 and 2013 and it included patients diagnosed to have eEPs. The study group and the control group consisted of patients who were diagnosed with or without EPs and who underwent colonoscopy at the same period. RESULTS The study group was formed by 57 patients with diagnosis of EP who underwent colonoscopy during the same period. The control group consisted of 71 patients without EP examined with colonoscopy. Among 128 patients assessed in this study, 24 were diagnosed with CPs, all of which were adenomatous polyps smaller than 1cm. No hyperplastic or inflammatory polyps were diagnosed. While 18 of 57 patients with EPs had CPs, 6 of 71 control subjects had CPs. Hence, the risk of having CP was 5 times greater in patients with EP compared to those without (P < 0.05). CONCLUSION The present study demonstrated that the prevalence of CPs increased significantly in postmenopausal patients with EPs. Recommending colonoscopy to these patients irrespective of age may be beneficial for detecting more CPs and preventing colorectal cancer.
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Affiliation(s)
- Gulhan Kanat Unler
- Department of Gastroenterology, Baskent University Faculty of Medicine, Konya, Turkey
| | - Huseyin Savas Gokturk
- Department of Gastroenterology, Baskent University Faculty of Medicine, Konya, Turkey.
| | - Erzat Toprak
- Department of Obstetrics and Gynecology, Baskent University Faculty of Medicine, Konya, Turkey
| | - Ozgur Hilal Erinanc
- Department of Pathology, Baskent University Faculty of Medicine, Konya, Turkey
| | - Huseyin Korkmaz
- Department of Gastroenterology, Selcuk University Faculty of Medicine, Konya, Turkey
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12
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Ko S, Yoon SJ, Kim D, Kim AR, Kim EJ, Seo HY. Metabolic Risk Profile and Cancer in Korean Men and Women. J Prev Med Public Health 2016; 49:143-52. [PMID: 27255073 PMCID: PMC4898898 DOI: 10.3961/jpmph.16.021] [Citation(s) in RCA: 32] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2016] [Accepted: 04/05/2016] [Indexed: 01/10/2023] Open
Abstract
OBJECTIVES Metabolic syndrome is a cluster of risk factors for type 2 diabetes mellitus and cardiovascular disease. Associations between metabolic syndrome and several types of cancer have recently been documented. METHODS We analyzed the sample cohort data from the Korean National Health Insurance Service from 2002, with a follow-up period extending to 2013. The cohort data included 99 565 individuals who participated in the health examination program and whose data were therefore present in the cohort database. The metabolic risk profile of each participant was assessed based on obesity, high serum glucose and total cholesterol levels, and high blood pressure. The occurrence of cancer was identified using Korean National Health Insurance claims data. Hazard ratios (HRs) and 95% confidence intervals (CIs) were estimated using Cox proportional hazards models, adjusting for age group, smoking status, alcohol intake, and regular exercise. RESULTS A total of 5937 cases of cancer occurred during a mean follow-up period of 10.4 years. In men with a high-risk metabolic profile, the risk of colon cancer was elevated (HR, 1.40; 95% CI, 1.14 to 1.71). In women, a high-risk metabolic profile was associated with a significantly increased risk of gallbladder and biliary tract cancer (HR, 2.05; 95% CI, 1.24 to 3.42). Non-significantly increased risks were observed in men for pharynx, larynx, rectum, and kidney cancer, and in women for colon, liver, breast, and ovarian cancer. CONCLUSIONS The findings of this study support the previously suggested association between metabolic syndrome and the risk of several cancers. A high-risk metabolic profile may be an important risk factor for colon cancer in Korean men and gallbladder and biliary tract cancer in Korean women.
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Affiliation(s)
- Seulki Ko
- Department of Preventive Medicine, Korea University College of Medicine, Seoul, Korea
| | - Seok-Jun Yoon
- Department of Preventive Medicine, Korea University College of Medicine, Seoul, Korea
| | - Dongwoo Kim
- Department of Preventive Medicine, Korea University College of Medicine, Seoul, Korea
| | - A-Rim Kim
- Department of Public Health, Graduate School of Korea University, Seoul, Korea
| | - Eun-Jung Kim
- Department of Economics, Economic Research Institute, Korea University, Seoul, Korea
| | - Hye-Young Seo
- Department of Public Health, Graduate School of Korea University, Seoul, Korea
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Kim HJ, Kim JE, Jung JH, Kim ER, Hong SN, Chang DK, Son HJ, Rhee PL, Kim JJ, Kim YH. Uric Acid Is a Risk Indicator for Metabolic Syndrome-related Colorectal Adenoma: Results in a Korean Population Receiving Screening Colonoscopy. THE KOREAN JOURNAL OF GASTROENTEROLOGY 2016; 66:202-8. [PMID: 26493505 DOI: 10.4166/kjg.2015.66.4.202] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
BACKGROUND/AIMS An association between serum uric acid and cancer risk has been noted over the past few decades. There is ongoing debate about whether hyperuricemia represents an independent risk factor for colorectal neoplasm. We investigated the association between serum uric acid and prevalence of colorectal adenoma considering numerous confounding factors. METHODS A cross-sectional study was performed with individuals who underwent a routine health check-up examination, including a screening colonoscopy and blood chemistry. The association between serum uric acid and prevalence of colorectal adenoma was estimated from the results of a logistic regression analysis. RESULTS Of the 1,066 participants, 402 had colorectal adenoma (37.7%). In univariate models, the prevalence of colorectal adenoma was higher in participants in the fourth quartile uric acid level, compared to those in the first quartile uric acid level (OR, 1.67; 95% CI, 1.17-2.42; p=0.004). However, no significant association was detected between serum uric acid and prevalence of colorectal adenoma in multiple logistic regression analysis. A number of metabolic syndrome components exhibited a strong association with the prevalence of colorectal adenoma in the multivariate model (OR, 3.46 for highest vs. lowest; 95% CI, 1.30-9.20; p=0.021). Moreover, serum uric acid was strongly associated with metabolic syndrome-associated variables, including waist circumference, fasting blood glucose, systolic blood pressure, diastolic blood pressure, triglyceride, and high-density lipoprotein. CONCLUSIONS Uric acid is not an independent risk factor for colorectal adenoma but is a risk indicator for metabolic syndrome-related colorectal adenoma.
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Affiliation(s)
- Hyo Jin Kim
- Department of Internal Medicine, Samsung Medical Center, Sungkyunkwan University College of Medicine, Seoul, Korea
| | - Jee Eun Kim
- Center for Health Promotion, Samsung Medical Center, Sungkyunkwan University College of Medicine, Seoul, Korea
| | - Ji Hye Jung
- Department of Internal Medicine, Samsung Medical Center, Sungkyunkwan University College of Medicine, Seoul, Korea
| | - Eun Ran Kim
- Department of Internal Medicine, Samsung Medical Center, Sungkyunkwan University College of Medicine, Seoul, Korea
| | - Sung Noh Hong
- Department of Internal Medicine, Samsung Medical Center, Sungkyunkwan University College of Medicine, Seoul, Korea
| | - Dong Kyung Chang
- Department of Internal Medicine, Samsung Medical Center, Sungkyunkwan University College of Medicine, Seoul, Korea
| | - Hee Jung Son
- Department of Internal Medicine, Samsung Medical Center, Sungkyunkwan University College of Medicine, Seoul, Korea.,Center for Health Promotion, Samsung Medical Center, Sungkyunkwan University College of Medicine, Seoul, Korea
| | - Poong Lyul Rhee
- Department of Internal Medicine, Samsung Medical Center, Sungkyunkwan University College of Medicine, Seoul, Korea
| | - Jae J Kim
- Department of Internal Medicine, Samsung Medical Center, Sungkyunkwan University College of Medicine, Seoul, Korea
| | - Young Ho Kim
- Department of Internal Medicine, Samsung Medical Center, Sungkyunkwan University College of Medicine, Seoul, Korea
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14
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Lee BI. [Role of Gastroenterologists in Management of Obesity]. THE KOREAN JOURNAL OF GASTROENTEROLOGY 2015; 66:186-9. [PMID: 26493502 DOI: 10.4166/kjg.2015.66.4.183] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
Obesity is a serious disorder that increases morbidity and mortality. Primary intervention with life style modification and medication is not always effective for obese patients. Endoscopic management of obesity may be a less invasive, more cost-effective, and relatively safer option than bariatric surgery. Moreover, therapeutic endoscopy is considered to be the primary modality for managing complications that occur after bariatric surgery. In the near future, role of gastroenterologists will be more important in the management of obesity and its related problems.
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Affiliation(s)
- Bo-In Lee
- Department of Internal Medicine, Catholic-Harvard Wellman Photomedicine Center, College of Medicine, The Catholic University of Korea, Seoul, Korea
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15
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Associations Between Parameters of Glucose and Lipid Metabolism and Risk of Colorectal Neoplasm. Dig Dis Sci 2015; 60:2996-3004. [PMID: 25986527 DOI: 10.1007/s10620-015-3713-x] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/30/2015] [Accepted: 05/07/2015] [Indexed: 01/24/2023]
Abstract
BACKGROUND Diabetes and dyslipidemia have been linked to an increased risk of colorectal neoplasm (CRN). However, previous studies evaluating these associations have shown inconsistent results, and large-scale studies are few in number. AIM To investigate the associations between the parameters of glucose and lipid metabolism and the presence of CRN. METHODS A cross-sectional study was performed on 38,490 Korean adults aged ≥30 years undergoing their first colonoscopy as part of routine preventive health care between 2010 and 2011. RESULTS The prevalence of overall CRN increased with increasing levels of glucose, hemoglobin A1c (HbA1c), insulin, homeostasis model assessment of insulin resistance (HOMA-IR), triglycerides, total cholesterol, low-density lipoprotein cholesterol (LDL-C), and apolipoprotein B (ApoB) and with decreasing level of apolipoprotein A1 (ApoA1). The adjusted prevalence ratios for overall CRN comparing the fourth with the first quartiles of fasting glucose, HbA1c, insulin, HOMA-IR, triglycerides, total cholesterol, LDL-C, ApoB, and ApoA-1 were 1.83 (95% CI 1.62-2.06), 1.17 (95% CI 1.03-1.33), 1.09 (95% CI 0.97-1.23), 1.22 (95% CI 1.08-1.37), 1.31 (95% CI 1.16-1.48), 1.19 (95 % CI 1.07-1.33), 1.38 (95% CI 1.23-1.54), 1.30 (95% CI 1.14-1.47), and 0.85 (95% CI 0.76-0.95), respectively. There was also a significant association between higher levels of glucose, LDL-C, and ApoB with a higher prevalence of advanced CRN. Moreover, the risk of CRN increased further in cases in which the parameters of glucose metabolism and lipid metabolism worsened simultaneously. CONCLUSIONS The levels of parameters of glucose and lipid metabolism are significantly associated with the prevalence of CRN. Altered glucose and lipid metabolism may contribute to the development of CRN.
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Trabulo D, Ribeiro S, Martins C, Teixeira C, Cardoso C, Mangualde J, Freire R, Gamito &E, Alves AL, Augusto F, Oliveira AP, Cremers I. Metabolic syndrome and colorectal neoplasms: An ominous association. World J Gastroenterol 2015; 21:5320-7. [PMID: 25954106 PMCID: PMC4419073 DOI: 10.3748/wjg.v21.i17.5320] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/22/2014] [Revised: 01/07/2015] [Accepted: 02/11/2015] [Indexed: 02/06/2023] Open
Abstract
AIM To evaluate the association of metabolic syndrome (MS) and colorectal cancer and adenomas in a Western country, where the incidence of MS is over 27%. METHODS This was a prospective study between March 2013 and March 2014. MS was diagnosed according to the National Cholesterol Education Program-ATP III. Demographic characteristics, anthropometric measurements, metabolic risk factors, and colonoscopic pathologic findings were assessed in patients with MS (group 1) who underwent routine colonoscopy at our department. This data was compared with consecutive patients without metabolic syndrome (group 2), with no differences regarding sex and age. Patients with incomplete colonoscopy, family history, or past history of colorectal neoplasm were excluded. Informed consent was obtained and the ethics committee approved this study. Statistical analysis was performed using Student's t-test and χ(2) test, with a P value ≤ 0.05 being considered statistically significant. RESULTS Of 258 patients, 129 had MS; 51% males; mean-age 67.1 years (50-87). Among the MS group, 94% had high blood pressure, 91% had increased waist circumference, 60% had diabetes, 55% had low high-density lipoprotein cholesterol level, 50% had increased triglyceride level, and 54% were obese [body mass index (BMI) 30 kg/m(2)]. 51% presented 4 criteria of MS. MS was associated with increased prevalence of adenomas (43% vs 25%, P = 0.004) and colorectal cancer (13% vs 5%, P = 0.027), compared with patients without MS. MS was also positively associated with multiple (≥ 3) adenomas (35% vs 9%, P = 0.024) and sessile adenomas (69% vs 53%, P = 0.05). No difference existed between location (P = 0.086), grade of dysplasia (P = 0.196), or size (P = 0.841) of adenomas. In addition, no difference was found between BMI (P = 0.078), smoking (P = 0.146), alcohol consumption (P = 0.231), and the presence of adenomas. CONCLUSION MS is positively associated with adenomas and colorectal cancer. However, there is not enough information in western European countries to justify screening in patients with MS. To our knowledge, no previous study has evaluated this association in Portuguese patients.
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Subclinical hypothyroidism as an independent risk factor for colorectal neoplasm. Clin Res Hepatol Gastroenterol 2015; 39:261-6. [PMID: 25242140 DOI: 10.1016/j.clinre.2014.08.002] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/07/2014] [Revised: 06/30/2014] [Accepted: 08/06/2014] [Indexed: 02/04/2023]
Abstract
BACKGROUND AND OBJECTIVE Recently, the prevalence of colorectal neoplasm is increasing sharply. It has been reported that both colorectal neoplasm and cardiovascular disease share similar common risk factors. Subclinical hypothyroidism (SCH) occurs in 4-20% of the adult population and is an independent risk factor for cardiovascular disease. However, no study has yet explored the relationship between SCH and colorectal neoplasm. Our objectives were to clarify the association between the two conditions. METHODS This is a case-control study. A total of 273 cases of colorectal neoplasm were first identified, and a 1:3 matched random sample of 819 controls was then collected using strata according to age, and gender. The medical records of all these patients were retrieved. Blood pressure, body mass index, and thyroid function were determined. Colonoscopies were performed by experienced gastroenterologists. A logistic regression analysis was carried out to explore the relationship between SCH and colorectal neoplasm. RESULTS Remarkably, the prevalence rate of SCH was significantly higher in colorectal neoplasm (+) group, compared with colorectal neoplasm (-) group (P<0.01). Colorectal neoplasm was found in 67 (34.9%) subjects in SCH group, which was more than that in euthyroid group (P=0.002). Moreover, patients with SCH were more likely to have advanced colonic lesion and colorectal cancer compared with euthyroid subjects (P=0.028 and 0.036, respectively). After adjusting for the factors of blood pressure, body mass index, history of hypertension and smoking, an association still existed between colorectal neoplasm and SCH (OR=1.689, 95% CI: 1.207-2.362, P=0.002). CONCLUSION A strong association between SCH and colorectal neoplasm was firstly identified. SCH was found to be an independent risk factor for colorectal neoplasm.
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Pulse-wave velocity, the ankle-brachial index, and the visceral fat area are highly associated with colorectal adenoma. Dig Liver Dis 2014; 46:943-9. [PMID: 24953207 DOI: 10.1016/j.dld.2014.05.012] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/26/2013] [Revised: 05/06/2014] [Accepted: 05/17/2014] [Indexed: 02/07/2023]
Abstract
BACKGROUND Although both colorectal neoplasms and atherosclerosis may be induced by visceral fat accumulation, no association between these factors has yet been elucidated. METHODS Among Japanese participants in our colonoscopic screening and annual surveillance programs, asymptomatic subjects were investigated. Visceral fat area was measured by computed tomography, and the ankle-brachial index and pulse-wave velocity (markers of systemic atherosclerosis) were also estimated. Colorectal findings during screening were investigated in association with these parameters. RESULTS Nine hundred and seven subjects (males: 71.9%; mean age: 57.3±8.7 years) were enrolled. Colorectal adenomas were identified during colorectal screening of 407 subjects (44.9%). The prevalence of all colorectal adenoma and advanced neoplasia increased with an elevated pulse-wave velocity from 32.2% (advanced neoplasia, 2.6) to 62.1% (8.4%) in higher quartiles (p<0.001 and p=0.003). The risk of advanced neoplasia was higher in subjects with an abnormal ankle-brachial index (33% vs. 4.6%, p<0.001). Upon multivariate analysis, visceral fat area and pulse-wave velocity were associated with all adenoma, and the ankle-brachial index with advanced neoplasia. CONCLUSIONS The risk of colorectal adenoma was strongly associated with visceral fat area and markers of atherosclerosis. Colorectal adenoma and atherosclerosis may share a common pathogenesis and the same populations are at high-risk.
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Goh LY, Leow AHR, Goh KL. Observations on the epidemiology of gastrointestinal and liver cancers in the Asia-Pacific region. J Dig Dis 2014; 15:463-8. [PMID: 24894597 DOI: 10.1111/1751-2980.12164] [Citation(s) in RCA: 34] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
Gastric cancer (GC) has long been thought to be an Asian type of cancer that is broadly associated with poverty, whereas colorectal cancer (CRC) has been thought to be a Western type of cancer associated with affluence. The incidence of GC has declined dramatically in the West but has a very high incidence in East Asia. The age-standardized incidence rates (ASR) have also declined. The decrease in the incidence of GC is associated with the decrease in the prevalence of Helicobacter pylori (H. pylori) infection worldwide. The discrepancy between a high H. pylori infection rate and a low GC incidence is seen chiefly among southern Asians of Indian origin and has been aptly termed the "Indian enigma". CRC is a new emerging cancer in this region. Some of the highest CRC ASR have been reported from Asian countries, in many of which it has now surpassed that of GC. Liver cancer is also an important cancer in the Asia-Pacific region. The highest ASR worldwide is reported from the Asian countries of Mongolia, Korea and Japan. The predominant underlying etiology across the region has been hepatitis B virus infection, except in Japan, where hepatitis C is an important cause of hepatocellular carcinoma (HCC). With mass vaccination of hepatitis B at birth and improved public health measures in many countries, hepatitis B and C are set to decline with time. However, the exponential increase in obesity and consequent non-alcoholic fatty liver disease portends a future epidemic of fatty liver-related HCC.
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Affiliation(s)
- Li-Yen Goh
- Faculty of Medicine, University of Nottingham, Nottingham, United Kingdom
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The relationship between different glycemic statuses and colon polyps in a Taiwanese population. J Gastroenterol 2014; 49:1145-51. [PMID: 24429895 DOI: 10.1007/s00535-013-0863-5] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/20/2013] [Accepted: 07/28/2013] [Indexed: 02/04/2023]
Abstract
BACKGROUND While diabetes is considered as a risk factor for colorectal cancer, there are few studies that address the association between glycemic statuses and different colon polyps, ranging from non-neoplastic polyps to advanced adenomatous polyps. METHODS A total of 6,348 participants, consisting of 3,777 men and 2,571 women, with a mean age of 50.5 years, were included for final analysis after excluding subjects with a past history of colorectal cancer, colon polyps/polypectomy, familial adenomatous polyposis, and colorectomy, or missing data. Diabetes and pre-diabetes were defined using the 2011 American Diabetes Association criteria. Subjects were classified into four groups: polyp-free, non-neoplastic polyps, non-advanced and advanced adenomatous polyps. RESULTS There were significant differences in the prevalence of diabetes and pre-diabetes among groups with different kinds of colon polyps. In addition, significant differences were also noted in age, total cholesterol, body mass index, triglyceride, high density lipoprotein-cholesterol, fasting plasma glucose, and the prevalence of male gender, hypertension, obesity, current smoking and alcohol drinking among groups. In the multinomial logistic regression analyses, diabetes was related to both non-advanced and advanced adenomatous polyps, while pre-diabetes was only related to non-advanced adenomatous polyps. In addition, age ≥65 years and male gender were associated with both non-advanced and advanced adenomatous polyps, while hypertension and current smoking were independently related to advanced and non-advanced adenomatous polyps, respectively. CONCLUSIONS Diabetes, but not pre-diabetes, was associated with a higher risk of advanced adenomatous polyps. In addition, both diabetes and pre-diabetes were important correlates of non-advanced adenomatous polyps.
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Rampal S, Yang MH, Sung J, Son HJ, Choi YH, Lee JH, Kim YH, Chang DK, Rhee PL, Rhee JC, Guallar E, Cho J. Association between markers of glucose metabolism and risk of colorectal adenoma. Gastroenterology 2014; 147:78-87.e3. [PMID: 24632359 DOI: 10.1053/j.gastro.2014.03.006] [Citation(s) in RCA: 34] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/22/2013] [Revised: 02/27/2014] [Accepted: 03/05/2014] [Indexed: 01/02/2023]
Abstract
BACKGROUND & AIMS Diabetes is a risk factor for colorectal cancer. We studied the association between markers of glucose metabolism and metabolic syndrome and the presence of colorectal adenomas in a large number of asymptomatic men and women attending a health screening program in South Korea. We also investigated whether these associations depend on adenoma location. METHODS In a cross-sectional study, we measured fasting levels of glucose, insulin, hemoglobin A1c, and C-peptide and calculated homeostatic model assessment (HOMA) values (used to quantify insulin resistance) for 19,361 asymptomatic South Korean subjects who underwent colonoscopy examinations from January 2006 to June 2009. Participants completed a standardized self-administered health questionnaire and a validated semiquantitative food frequency questionnaire. Blood samples were collected on the day of the colonoscopy; fasting blood samples were also collected. Robust Poisson regression was used to model the associations of glucose markers with the prevalence of any adenoma. RESULTS Using detailed multivariable-adjusted dose-response models, the prevalence ratios (aPR, 95% confidence interval [CI]) for any adenoma, comparing the 90th with the 10th percentile, were 1.08 (1.00-1.16; P = .04) for fasting glucose, 1.07 (0.99-1.15; P = .10) for insulin, 1.09 (1.02-1.18, P = .02) for HOMA, 1.09 (1.01-1.17; P = .02) for hemoglobin A1c, and 1.14 (1.05-1.24; P = .002) for C-peptide. The corresponding ratios for nonadvanced adenomas were 1.11 (0.99-1.25; P = .08), 1.10 (0.98-1.24; P = .12), 1.15 (1.02-1.29; P = .02), 1.14 (1.01-1.28; P = .03), and 1.20 (1.05-1.37; P = .007), respectively. The corresponding ratios for advanced adenomas were 1.32 (0.94-1.84; P = .11), 1.23 (0.87-1.75; P = .24), 1.30 (0.92-1.85; P = .14), 1.13 (0.79-1.61; P = .50), and 1.67 (1.15-2.42; P = .007), respectively. Metabolic syndrome was associated with the prevalence of any adenoma (aPR, 1.18; 95% CI, 1.13-1.24; P < .001), nonadvanced adenoma (aPR, 1.30; 95% CI, 1.20-1.40; P < .001), and advanced adenoma (aPR, 1.42; 95% CI, 1.14-1.78; P = .002). Associations were similar for adenomas located in the distal versus proximal colon. CONCLUSIONS Increasing levels of glucose, HOMA values, levels of hemoglobin A1c and C-peptide, and metabolic syndrome are significantly associated with the prevalence of adenomas. Adenomas should be added to the list of consequences of altered glucose metabolism.
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Affiliation(s)
- Sanjay Rampal
- Department of Social and Preventive Medicine, Julius Centre University of Malaya, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia; Department of Epidemiology and Welch Center for Prevention, Epidemiology, and Clinical Research, Johns Hopkins University Bloomberg School of Public Health, Baltimore, Maryland
| | - Moon Hee Yang
- Center for Health Promotion, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea
| | - Jidong Sung
- Center for Health Promotion, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea; Department of Internal Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea
| | - Hee Jung Son
- Center for Health Promotion, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea; Department of Internal Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea.
| | - Yoon-Ho Choi
- Center for Health Promotion, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea; Department of Internal Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea
| | - Jun Haeng Lee
- Department of Internal Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea
| | - Young-Ho Kim
- Department of Internal Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea
| | - Dong Kyung Chang
- Department of Internal Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea
| | - Poong-Lyul Rhee
- Department of Internal Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea
| | - Jong Chul Rhee
- Department of Internal Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea
| | - Eliseo Guallar
- Department of Epidemiology and Welch Center for Prevention, Epidemiology, and Clinical Research, Johns Hopkins University Bloomberg School of Public Health, Baltimore, Maryland; Department of Medicine and Welch Center for Prevention, Epidemiology, and Clinical Research, Johns Hopkins Medical Institutions, Baltimore, Maryland
| | - Juhee Cho
- Department of Epidemiology and Welch Center for Prevention, Epidemiology, and Clinical Research, Johns Hopkins University Bloomberg School of Public Health, Baltimore, Maryland; Department of Health Sciences and Technology, SAIHST, Sungkyunkwan University, Seoul, South Korea; Biostatistics and Clinical Epidemiology Center, Research Institute for Future Medicine, Samsung Medical Center Sungkyunkwan University School of Medicine, Seoul, South Korea.
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Kim YJ, Lee KJ, Park SY, Han JH, Kwon KY, Kim JH. Association between Dyslipidemia and the Prevalence of Colon Polyps Based on a Health Evaluation of Subjects at a Hospital. Korean J Fam Med 2014; 35:143-51. [PMID: 24921033 PMCID: PMC4040432 DOI: 10.4082/kjfm.2014.35.3.143] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2010] [Accepted: 10/30/2013] [Indexed: 01/13/2023] Open
Abstract
Background Colonic neoplasm is associated with western diet intake and physical inactivity. These life styles are also risk factors for dyslipidemia and metabolic syndrome. The aim of this study was to evaluate the association between dyslipidemia and the prevalence of colon polyps including colon adenoma as a precancerous lesion of colonic neoplasms. Methods We selected subjects undergoing a colonoscopy for health screening at the Health Promotion Center of Eulji General Hospital from January 2006 to June 2010. Subjects with histories of cancers, dyslipidemia treatment, and other intestinal diseases like Crohn's disease and ulcerative colitis were excluded. The total numbers of subjects included in the study was 605. Chi-square test and t-test and were used for the analysis. Additionally we used multivariate logistic regression to adjust for sex, age, smoking, drinking, and other risk factors. Results The prevalence of colon polyps was 48.70% and 28.05% in males and females, respectively. When adjusting for variables that included age, body mass index, hypertension, diabetes mellitus, smoking, drinking, and exercise, dyslipidemia was not significantly associated with the prevalence of colon polyps. However upon analyzing adenomatous colon polyps in men, dyslipidemias due to triglycerides and high density lipoproteins were significant factors (odds ratio [OR], 2.13; confidence interval [CI], 1.14 to 3.98; OR, 2.24; CI, 1.15 to 4.34, respectively). Conclusion Dyslipidemia was not a significant factor in the prevalence of colon polyps. However it had a significant association with the prevalence of adenomatous colon polyps in men.
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Affiliation(s)
- Yeong-Ju Kim
- Department of Family Medicine, Eulji General Hospital, Eulji University School of Medicine, Seoul, Korea
| | - Kyung-Jin Lee
- Department of Family Medicine, Eulji General Hospital, Eulji University School of Medicine, Seoul, Korea
| | - Si-Young Park
- Department of Family Medicine, Eulji General Hospital, Eulji University School of Medicine, Seoul, Korea
| | - Jee-Hae Han
- Department of Family Medicine, Eulji General Hospital, Eulji University School of Medicine, Seoul, Korea
| | - Kil-Young Kwon
- Department of Family Medicine, Eulji General Hospital, Eulji University School of Medicine, Seoul, Korea
| | - Jung-Hwan Kim
- Department of Family Medicine, Eulji General Hospital, Eulji University School of Medicine, Seoul, Korea
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Lipka S, Zheng XE, Hurtado-Cordovi J, Singh J, Levine E, Vlacancich R, Krishnamachari B, Jung MK, Fu S, Takeshige U, Avezbakiyev B, Li T, Iqbal J, Rizvon K, Mustacchia P. Obesity, metabolic factors, and colorectal adenomas: a retrospective study in a racially diverse New York State Hospital. J Gastrointest Cancer 2014; 44:270-6. [PMID: 23307188 DOI: 10.1007/s12029-013-9476-8] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/28/2023]
Abstract
OBJECTIVE We studied a racially diverse population and the relationship with colorectal adenomas (CA) further looking for risks related to BMI and metabolic factors. DESIGNS Seven hundred seventy-nine patients who underwent screening colonoscopies between 2007 and 2009 meeting exclusion criteria were included. To evaluate the association between race, BMI, and other metabolic factors with having one or more CA detected at colonoscopy, adjusted odds ratios and 95 % CI were estimated using unconditional logistic regression models. OUTCOMES CA were detected in 167 out of 779 (21.4 %) patients. Compared to Whites, Hispanics were less likely to have one or more adenomas detected during a screening colonoscopy (OR = 0.52, 95 % CI, 0.31-0.88; p = 0.01). There was no significant statistical difference between Blacks and Whites, or other races and Whites. There was an association between the presence of CA and smoking (OR = 1.57, 95 % CI, 1.02-2.43; p = 0.04). CONCLUSION Our results showed that Hispanics were less likely to have an adenoma detected during a screening colonoscopy than Whites. No statistical significant difference was found between patients with metabolic factors and the presence of colorectal adenoma.
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Tal S, Melzer E, Chsherbakov T, Malnick S. Metabolic syndrome is associated with increased prevalence of advanced colorectal polyps. J Nutr Health Aging 2014; 18:22-5. [PMID: 24402384 DOI: 10.1007/s12603-013-0360-9] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
OBJECTIVES To examine the association between metabolic syndrome (MetS) and/or its components and colorectal neoplasms in adult population undergoing screening colonoscopy. DESIGN Cross-sectional study. SETTING Institute of Gastroenterology, Kaplan Medical Center, Rehovot, Israel. PARTICIPANTS Two hundred ninety nine consecutive outpatients undergoing screening colonoscopy. MEASUREMENTS MetS was determined according to the Adult Treatment Panel III of the National Cholesterol Education Program (ATP III) criteria. Blood test results and other clinical data were retrieved from the electronic medical records. RESULTS In 94 patients (31.8%) polyps were detected. Thirty two (34%) of the polyps were advanced. Eighty one percent of patients with an advanced polyp met the criteria for MetS. About the same MetS prevalence (84%) was found in men, but not in women. An advanced polyp was detected in 14% of patients with MetS, compared to 5% of patients without MetS. Odds ratio for having an advanced polyp in a patient with MetS compared to a patient without MetS was 10.64. CONCLUSION MetS was found to be a risk factor for advanced polyps. This association is suggestive of the need that patients with MetS should be urged to have a screening colonoscopy.
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Affiliation(s)
- S Tal
- Tal Sari, MD, Geriatric Medicine Department, Kaplan Medical Center, Rehovot, Israel, Tel. 972-8-9441573, Fax: 972-8-9441767,
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25
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Donohoe CL, O’Farrell NJ, Doyle SL, Reynolds JV. The role of obesity in gastrointestinal cancer: evidence and opinion. Therap Adv Gastroenterol 2014; 7:38-50. [PMID: 24381646 PMCID: PMC3871278 DOI: 10.1177/1756283x13501786] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/04/2023] Open
Abstract
There is increasing recognition of the impact of being overweight and obese on the development of cancers at diverse sites including the gastrointestinal tract. Large epidemiological studies indicate that up to 14% of tumours may be related to obesity. Pathophysiological mechanisms underpinning this association are not well understood and so are discussed in this review.
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Affiliation(s)
- Claire L. Donohoe
- Department of Surgery, Trinity Centre for Health Sciences, Trinity College Dublin/ St James’ Hospital, Dublin, Ireland
| | - Naoimh J. O’Farrell
- Department of Surgery, Trinity Centre for Health Sciences, Trinity College Dublin/ St James’ Hospital, Dublin, Ireland
| | - Suzanne L. Doyle
- Department of Surgery, Trinity Centre for Health Sciences, Trinity College Dublin/ St James’ Hospital, Dublin, Ireland
| | - John V. Reynolds
- Department of Surgery, Trinity Centre for Health Sciences, Trinity College Dublin/ St James’ Hospital, Dublin 8, Ireland
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26
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Orannapalai N, Attawettayanon W, Kanngern S, Boonpipattanapong T, Sangkhathat S. Predicting the occurrence of cancer-associated colorectal polyp using a metabolic risk score. Mol Clin Oncol 2013; 2:124-128. [PMID: 24649320 DOI: 10.3892/mco.2013.204] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2013] [Accepted: 10/14/2013] [Indexed: 12/14/2022] Open
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/m2 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 IU/l, alanine transaminase (SGPT) >50 IU/l 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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Affiliation(s)
- Nuengruetai Orannapalai
- Department of Surgery, Faculty of Medicine, Prince of Songkla University, Hat Yai, Songkhla 90110, Thailand
| | - Worapat Attawettayanon
- Department of Surgery, Faculty of Medicine, Prince of Songkla University, Hat Yai, Songkhla 90110, Thailand
| | - Samornmas Kanngern
- Anatomical Pathology Unit, Department of Pathology, Faculty of Medicine, Prince of Songkla University, Hat Yai, Songkhla 90110, Thailand ; ; Tumor Biology Research Unit, Faculty of Medicine, Prince of Songkla University, Hat Yai, Songkhla 90110, Thailand
| | - Teeranut Boonpipattanapong
- Department of Surgery, Faculty of Medicine, Prince of Songkla University, Hat Yai, Songkhla 90110, Thailand ; ; Tumor Biology Research Unit, Faculty of Medicine, Prince of Songkla University, Hat Yai, Songkhla 90110, Thailand
| | - Surasak Sangkhathat
- Department of Surgery, Faculty of Medicine, Prince of Songkla University, Hat Yai, Songkhla 90110, Thailand ; ; Tumor Biology Research Unit, Faculty of Medicine, Prince of Songkla University, Hat Yai, Songkhla 90110, Thailand
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Association between Obesity, Serum Lipids, and Colorectal Polyps in Old Chinese People. Gastroenterol Res Pract 2013; 2013:931084. [PMID: 24198829 PMCID: PMC3806499 DOI: 10.1155/2013/931084] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/12/2013] [Revised: 09/10/2013] [Accepted: 09/11/2013] [Indexed: 02/07/2023] Open
Abstract
Background. Colorectal cancer mostly arises from the polyps of colon. The aim of our study was to examine the association of body mass index (BMI) and serum lipids with the colorectal polyps in old Chinese people. Methods. The risk of developing colorectal polyps was studied in 244 subjects (212 men and 32 women, 74.63 ± 11.63 years old) who underwent colonoscopy for the first time from January 2008 to July 2012 at the Navy General Hospital, Beijing, China. According to the results of colonoscopy, all the subjects were divided into 112 normal control, 38 right colorectal polyps, 53 left colorectal polyps, and 41 both right and left colorectal polyps groups. The total plasma cholesterol, plasma triglyceride, plasma creatinine concentration, blood urinary nitrogen, and fasting glucose were determined using a multichannel analyzer. Results. There were significant differences among normal control, right colorectal polyps, left colorectal polyps, and both right and left polyps groups, which were the BMI, total cholesterol, triglycerides, creatinine, and urinary nitrogen. In binary logistic regression analysis, there were two risk factors associated with the occurrence of colorectal polyps, which included BMI and systolic blood pressure. Conclusions. Colorectal polyps were significantly associated with increased BMI, total cholesterol, and triglycerides levels.
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Loke SS, Yang KD, Chen KD, Chen JF. Erosive esophagitis associated with metabolic syndrome, impaired liver function, and dyslipidemia. World J Gastroenterol 2013; 19:5883-5888. [PMID: 24124334 PMCID: PMC3793143 DOI: 10.3748/wjg.v19.i35.5883] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/22/2013] [Accepted: 07/19/2013] [Indexed: 02/06/2023] Open
Abstract
AIM: To investigate whether erosive esophagitis is correlated with metabolic syndrome and its components, abnormal liver function, and lipoprotein profiles.
METHODS: We conducted a cross-sectional, case control study of subjects who underwent upper endoscopy during a health examination at the Health Management and Evaluation Center of a tertiary medical care facility located in Southern Taiwan. Metabolic syndrome components, body mass index (BMI), liver function, dyslipidemia, and cardiovascular risk factors, as defined by the ratio of total cholesterol to high-density lipoprotein cholesterol (HDL-C), and the ratio of low-density lipoprotein cholesterol to HDL-C were compared between individuals with and without erosive esophagitis. Risk factors for erosive esophagitis were evaluated by multivariate logistic regression.
RESULTS: Erosive esophagitis was diagnosed in 507 of 5015 subjects who were individually age and sex matched to 507 esophagitis-free control subjects. In patients with erosive esophagitis, BMI, waist circumference, blood pressure, fasting plasma glucose, triglyceride levels, aspartate aminotransferase, alanine aminotransferase, the ratio of total cholesterol to HDL-C, and the ratio of low-density lipoprotein cholesterol to HDL-C were significantly higher and HDL-C was significantly lower compared to patients without erosive esophagitis (all P < 0.05). In a multivariate analysis, central obesity (OR = 1.38; 95%CI: 1.0-1.86), hypertension (OR = 1.35; 95%CI: 1.04-1.76), hypertriglyceridemia (OR = 1.34; 95%CI: 1.02-1.76), cardiovascular risk factors as defined by a ratio of total cholesterol to HDL-C > 5 (OR = 1.45; 95%CI: 1.06-1.97), and aspartate aminotransferase (OR = 1.59; 95%CI: 1.08-2.34) were significantly associated with erosive esophagitis.
CONCLUSION: Metabolic syndrome, impaired liver function, and a higher ratio of total cholesterol to HDL-C were associated with erosive esophagitis.
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Song JH, Kim YS, Yang SY, Chung SJ, Park MJ, Lim SH, Yim JY, Kim JS, Jung HC. Physical activity and other lifestyle factors in relation to the prevalence of colorectal adenoma: a colonoscopy-based study in asymptomatic Koreans. Cancer Causes Control 2013; 24:1717-26. [PMID: 23754755 DOI: 10.1007/s10552-013-0247-4] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2013] [Accepted: 06/03/2013] [Indexed: 12/24/2022]
Abstract
PURPOSE To evaluate physical activity and other lifestyle risk factors in relation to the prevalence of colorectal adenomas in asymptomatic Koreans. METHODS A total of 1,526 asymptomatic subjects who underwent a colonoscopy were enrolled. Lifestyle factors such as physical activity and smoking data were obtained using a questionnaire. The subjects were grouped into three exposure levels by tertiles of metabolic equivalent hours per week. We evaluated the risk factors in subjects with adenomas by risk stratification (low-risk adenoma group vs. high-risk adenoma group) and by anatomic location (proximal colon, distal colon, rectum, and multiple locations). The high-risk adenoma group was defined as subjects with advanced adenomas or multiple (≥ 3) adenomas. RESULTS A total of 456 participants had colorectal adenomas, and 861 had no polyps. In multivariate analyses, higher levels of physical activity were associated with a significantly decreased risk of colorectal adenomas (OR = 0.56, 95% CI 0.40-0.79). This inverse association was stronger for the risk of high-risk adenomas (OR = 0.39, 95% CI 0.21-0.73) than for low-risk adenomas (OR = 0.62, 95% CI 0.43-0.89). The negative relation of physical activity was significant for distal colon adenomas (OR = 0.54, 95% CI 0.30-0.95) and the adenomas with multiple locations (OR = 0.39, 95% CI 0.21-0.72). CONCLUSIONS Increased physical activity is associated with a reduced prevalence of colorectal adenomas. The inverse association between physical activity and adenoma was stronger for the risk of advanced or multiple adenomas.
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Affiliation(s)
- Ji Hyun Song
- Department of Internal Medicine, Healthcare Research Institute, Seoul National University Hospital Healthcare System Gangnam Center, 39th Floor, Gangnam Finance Center, 737 Yeoksam-dong, Gangnam-gu, Seoul, 135-984, Korea
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Forootan M, Tabatabaeefar M, Yahyaei M, Maghsoodi N. Metabolic syndrome and colorectal cancer: a cross-sectional survey. Asian Pac J Cancer Prev 2013; 13:4999-5002. [PMID: 23244098 DOI: 10.7314/apjcp.2012.13.10.4999] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022] Open
Abstract
INTRODUCTION There is epidemiological evidence indicating that the metabolic syndrome increases the risk of colorectal cancer. Since there is little information about this issue in Iran, the present study was conducted to evaluate prevalence of metabolic syndrome and its components in patients with colorectal cancer. MATERIAL AND METHODS This cross-sectional survey involved 200 patients with a new diagnosis of colorectal cancer. Demographic information of patients was collected through the interview with them. Components of metabolic syndrome including fasting glucose serum, triglyceride, high density lipoprotein, blood pressure and waist circumference were measured for all of the patients. RESULTS A total of 72 colorectal cancer patients (36%) met metabolic syndrome criteria with rates of 76% for women and 24% for men. BMI in metabolic syndrome patients was higher than other colorectal cancer patients. Disease history including hypertension, diabetes and cardiovascular disease was most frequent in metabolic syndrome patients. Pathological characteristics of colorectal cancer were not significantly associated with the disease. CONCLUSION The findings of present study indicated that the prevalence of metabolic syndrome in CRC patients is relatively high. Therefore, further analytical and multi centric studies are needed to better understand the role of metabolic syndrome in development of CRC in Iran. If this association is confirmed in future studies, metabolic syndrome patients should be considered in CRC screening programs.
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Affiliation(s)
- Mojgan Forootan
- Gastroenterology and Liver Diseases Research Center, Shaheed Beheshti University of Medical Sciences, Tehran, Iran
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Yang MH, Rampal S, Sung J, Choi YH, Son HJ, Lee JH, Kim YH, Chang DK, Rhee PL, Kim JJ, Rhee JC, Chun HK, Guallar E, Cho J. The association of serum lipids with colorectal adenomas. Am J Gastroenterol 2013; 108:833-41. [PMID: 23545715 DOI: 10.1038/ajg.2013.64] [Citation(s) in RCA: 60] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
OBJECTIVES There is suggestive but sparse evidence that dyslipidemia is associated with colorectal neoplasms. We investigated the association of serum lipid and apolipoprotein concentrations with the prevalence of colorectal adenomas. METHODS Cross-sectional study of 19,281 consecutive participants aged 40-79 years undergoing screening colonoscopy at the Center for Health Promotion of the Samsung Medical Center in Korea from January 2006 to June 2009. RESULTS We identified 5,958 participants with colorectal adenomas (30.9%), including 5,504 (28.5%) with non-advanced adenomas and 454 (2.4%) with advanced adenomas. The adjusted relative prevalence ratios (aRPRs) comparing the fourth with the first quartiles of serum triglycerides were 1.35 (95% confidence interval (CI) 1.20-1.52; P trend<0.001) for non-advanced adenomas and 1.45 (95% CI 1.02-2.06; P trend=0.005) for advanced adenomas. Higher levels of high-density lipoprotein (HDL) cholesterol and apolipoprotein A-1 (ApoA-1) were significantly associated with 12% (Q4 vs. Q1 aRPR 1.12; 95% CI 1.00-1.26; P trend=0.049) and 17% (Q4 vs. Q1 aRPR 1.17; 95% CI 1.04-1.31; P trend=0.004) higher prevalence of non-advanced adenoma. There was also a non-significant association between higher levels of low-density lipoprotein (LDL) cholesterol (Q4 vs. Q1 aRPR 1.22; 95% CI 0.91-1.66; P trend= 0.12) and apolipoprotein B (ApoB) (Q4 vs. Q1 aRPR 1.32; 95% CI 0.94-1.83; P trend=0.07) with higher prevalence of advanced adenoma. There was no association between total cholesterol levels with colorectal adenoma. CONCLUSIONS In this large cross-sectional study, higher levels of serum triglycerides were significantly associated with an increasing prevalence of both non-advanced and advanced colorectal adenomas, while higher levels of ApoA-1 and HDL cholesterol were significantly associated with an increasing prevalence of non-advanced adenomas.
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Affiliation(s)
- Moon Hee Yang
- Center for Health Promotion, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
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Pyo JH, Kim ES, Chun HJ, Keum B, Jeen YT, Lee HS, Kim CD, Ryu HS, Kim YH, Lee JE. Fasting blood sugar and serum triglyceride as the risk factors of colorectal adenoma in korean population receiving screening colonoscopy. Clin Nutr Res 2013; 2:34-41. [PMID: 23429421 PMCID: PMC3572815 DOI: 10.7762/cnr.2013.2.1.34] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/01/2013] [Revised: 01/07/2013] [Accepted: 01/14/2013] [Indexed: 01/28/2023] Open
Abstract
In several previously reported studies, metabolic syndrome (MS) was found to be associated with colorectal adenomas. While the incidence of colorectal adenoma is growing in Korean population, there are only few studies that examined the association between MS and colorectal adenoma in Korea. The aim of this study was to investigate relationships between prevalence of colorectal adenoma and MS components. We conducted a cross sectional study using data from individuals who had undergone complete colonoscopy for health examinations at the Health Promotion Center of Korea University Medical Center from July 1, 2004 to July 31, 2010. A total of 7481 subjects (4459 males and 3022 females) were included; 1733 subjects with pathologically proven adenoma were assigned to the case group, and other 5748 subjects were assigned to the non-case group. All the participants underwent colonoscopy and received blood biochemical tests (fasting blood sugar [FBS], insulin, lipid profile, hemoglobin, blood urea nitrogen [BUN], creatinine). Univariate analysis showed that the prevalence of colorectal adenoma was higher in individuals with higher blood pressure, body mass index (BMI), total cholesterol (TC), triglyceride (TG), FBS and lower high-density lipoprotein cholesterols (HDL-C) levels, compared to those with low levels. Multiple logistic regression analysis revealed that high levels of BMI (OR 1.17, 95% CI 1.01-1.34, P trend = 0.01), TG (OR 1.27, 95% CI 1.07-1.51, P trend = 0.006), and FBS (OR 1.19 95% CI 1.01-1.40, P trend = 0.05) were significantly associated with prevalence of colorectal adenoma. Subjects with high levels of BMI, TG and FBS have increased prevalence of developing colorectal adenoma in Korea.
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Affiliation(s)
- Jeung Hui Pyo
- Division of Gastroenterology and Hepatology, Department of Internal Medicine, Institute of Digestive Disease and Nutrition, Korea University College of Medicine, Seoul 136-705, Korea
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Kim MC, Kim CS, Chung TH, Jeong J, Lee SH, Kim SR, Jung SW, Park NH, Yoo CI. MONW phenotype is associated with advanced colorectal adenoma in Korean men. Obesity (Silver Spring) 2012; 20:1876-81. [PMID: 21372806 DOI: 10.1038/oby.2011.34] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/02/2023]
Abstract
The aim of this study was to investigate whether there was a relationship between colorectal adenoma and metabolically obese but normal weight (MONW) among Korean men and women. The MONW phenotype is defined as a BMI <25, but fulfilling the metabolic syndrome (MS) criteria with a modified waist circumference (≥90 cm for men and ≥85 cm for women) appropriate for Korean. A total of 3,430 subjects (2,263 men and 1,167 women; 23-75 years old) were included in the study. Colorectal adenomas were diagnosed in 775 men and 199 women. The rate of advanced adenomas in males was 24.3% and in females 21.1%. A significant association between MONW and advanced colorectal adenoma was found in men (age-adjusted odds ratio (OR) = 1.92, 95% confidence interval (CI): 1.06-3.47) but not in women (age-adjusted OR = 1.80, 95% CI: 0.50-6.45). The findings suggest that men with MONW may have an increased risk of developing advanced colorectal adenoma whereas this does not seem true for females.
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Affiliation(s)
- Moon-Chan Kim
- Department of Family Medicine, Ulsan University Hospital, University of Ulsan College of Medicine, Ulsan, South Korea
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Park W, Lee H, Kim EH, Yoon JY, Park JC, Shin SK, Lee SK, Lee YC, Kim WH, Noh SH. Metabolic syndrome is an independent risk factor for synchronous colorectal neoplasm in patients with gastric neoplasm. J Gastroenterol Hepatol 2012; 27:1490-7. [PMID: 22432868 DOI: 10.1111/j.1440-1746.2012.07128.x] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
BACKGROUND AND AIM There are no data on how metabolic syndrome (MetS) affects the prevalence of synchronous colorectal neoplasm (CRN) in gastric neoplasm (GN) patients. The aim of this study was to investigate a model for risk stratification for colorectal screening by evaluating the clinical characteristics of synchronous CRN in GN patients classified according to the presence of MetS. METHODS A cross-sectional, case-control study of 492 patients (368 males and 124 females) with GN, and 492 age-matched healthy controls undergoing simultaneous upper endoscopy and colonoscopy, was conducted. RESULTS The GN group involved 446 patients without MetS, and 46 patients with MetS. In total, 177 (39.7%) and 28 (60.9%) synchronous CRN were detected in GN patients without MetS and with MetS, respectively (P=0.006). A total of 143 (34.7%) synchronous colorectal adenomas were detected in GN patients without MetS, whereas 17 (48.6%) were detected in GN patients with MetS (P=0.101), as well as more synchronous colorectal cancers (11.2% vs 37.9%, P<0.001). A multivariate logistic regression analysis revealed that the presence of GN (OR=1.54, 95% CI: 1.18-2.00, P=0.001) and the presence of MetS (odds ratio=1.82, 95% confidence interval: 1.19-2.78, P=0.006) were significant independent risk factors associated with the prevalence of CRN. The frequency of synchronous CRN in GN patients with MetS was 1.96 times greater than that in the GN group without MetS. CONCLUSION The risk of synchronous CRN is significantly increased by the presence of GN, especially in MetS patients. Screening for synchronous CRN is highly recommended for GN patients with MetS.
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Affiliation(s)
- Wan Park
- Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Korea
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Sheen YJ, Sheu WHH. Links among type 2 diabetes, cancer and metformin use: what have we learned? Diabetes Res Clin Pract 2012; 97:169-71. [PMID: 22497968 DOI: 10.1016/j.diabres.2012.03.014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/16/2012] [Accepted: 03/19/2012] [Indexed: 10/28/2022]
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Liao W, Wei H, Wang X, Qiu Y, Gou X, Zhang X, Zhou M, Wu J, Wu T, Kou F, Zhang Y, Bian Z, Xie G, Jia W. Metabonomic variations associated with AOM-induced precancerous colorectal lesions and resveratrol treatment. J Proteome Res 2012; 11:3436-48. [PMID: 22519469 DOI: 10.1021/pr300284h] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
Resveratrol (Res), 3,5,4'-trihydroxy-trans-stilbene, is an antioxidant found in the skin of red grapes and in several other plants. This phenolic compound has been recently reported to possess cancer chemopreventive activity that inhibits the process of carcinogenesis. However, the mechanisms underlying its anticancer effects remain largely unresolved. In this study, we investigated the chemoprotective effects of dietary Res in an azoxymethane (AOM) induced precancerous colorectal lesion model in male Wistar rats. The metabolic alterations in urine, sera, and colonic tissues of experimental rats perturbed by AOM intervention as well as the Res treatment were measured by a gas chromatography time-of-flight mass spectrometry (GC-TOFMS) analysis. Significant alterations of metabolites were observed in AOM group in urine, sera, and colonic tissues, which were attenuated by Res treatment and concurrent with the histopathological improvement with significantly decreased aberrant crypt foci (ACF) incidence. Representative metabolites include depleted glucose, β-hydroxybutyrate (ketone body), hypoxanthine, and elevated branched chain amino acids (isoleucine and valine) and tryptophan in colonic tissue, as well as elevated serum aminooxyacetate and urinary 4-hydroxyphenylacetate and xanthurenate. These metabolic changes suggest that the preventive effect of Res is associated with attenuation of impaired glucose and lipid metabolism and elevated protein breakdown in colonic tissues from AOM-exposed rats. It also appears that Res induced significant metabolic alterations independent of the AOM-induced metabolic changes. The significantly altered metabolites identified in Res-AOM group relative to AOM group include arachidonate, linoleate, glutamate, docosahexaenoate, palmitelaidate, 2-aminobutyrate, pyroglutamate, and threonate, all of which are involved in inflammation and oxidation processes. This suggests that Res exerts the chemopreventive effects on ACF formation by anti-inflammatory and antioxidant mechanisms in addition to amelioration of AOM-induced mitochondrial disruption.
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Affiliation(s)
- Wen Liao
- Center for Chinese Medical Therapy and Systems Biology, Shanghai University of Traditional Chinese Medicine , Shanghai 201204, China
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Kim BC, Shin A, Hong CW, Sohn DK, Han KS, Ryu KH, Park BJ, Nam JH, Park JW, Chang HJ, Choi HS, Kim J, Oh JH. Association of colorectal adenoma with components of metabolic syndrome. Cancer Causes Control 2012; 23:727-35. [PMID: 22450737 DOI: 10.1007/s10552-012-9942-9] [Citation(s) in RCA: 62] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2011] [Accepted: 03/07/2012] [Indexed: 12/13/2022]
Abstract
PURPOSE Recently, some studies have shown that diabetes mellitus and metabolic syndrome increase the risk of colorectal neoplasms. Although the mechanism is not known, those have been proposed to contribute to this phenomenon, including insulin resistance, oxidative stress, and adipokine production. The objective of this study was to assess the association between metabolic risk factors and colorectal neoplasm. METHODS Study participants visited the National Cancer Center, Korea, for screening (2007-2009). A total of 1,771 diagnosed adenoma patients and 4,667 polyp-free controls were included. The association between risk factors and colorectal neoplasm was evaluated using logistic regression models. RESULTS High waist circumference, blood pressure, and serum triglyceride levels were associated with an increased risk of colorectal adenoma. Metabolic syndrome (MS) was associated with an increased risk of adenoma (OR = 1.44, 95 % CI = 1.23-1.70). The association between MS and colorectal adenoma was observed regardless of advanced/low-risk adenoma, and multiplicity. MS affected right colon adenomas (OR = 1.50, 95 % CI = 1.22-1.85), left colon adenomas (OR = 1.36, 95 % CI = 1.05-1.76), and adenomas in multiple anatomical locations (OR = 1.59, 95 % CI = 1.19-2.12), but was not associated with rectum. CONCLUSION Central obesity, triglyceride level, and MS are risk factors for colorectal adenoma including advanced adenoma and multiplicity.
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Affiliation(s)
- Byung Chang Kim
- Center for Colorectal Cancer, Research Institute and Hospital of National Cancer Center, Goyang-si, Korea
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Kim MC, Kim CS, Chung TH, Park HO, Yoo CI. Metabolic syndrome, lifestyle risk factors, and distal colon adenoma: A retrospective cohort study. World J Gastroenterol 2011; 17:4031-7. [PMID: 22046093 PMCID: PMC3199563 DOI: 10.3748/wjg.v17.i35.4031] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/26/2010] [Revised: 05/19/2011] [Accepted: 05/26/2011] [Indexed: 02/06/2023] Open
Abstract
AIM: To investigate relationships between colorectal adenoma incidence, metabolic syndrome (MS) components and lifestyle factors.
METHODS: We conducted a retrospective cohort study using data from individuals who had multiple sigmoidoscopies for colon cancer at the Health Promotion Center of Ulsan University Hospital in Korea from 1998 to 2007.
RESULTS: By multivariate analysis, the incidence of distal colon adenoma was increased by more than 1.76 times in individuals with at least one component of MS compared to those without a component of MS. After adjustment for age, gender, smoking, drinking, and physical exercise, only high body mass index (BMI) was significantly associated with the incidence of distal colon adenoma (Hazard ratio 1.66, 95% confidence interval 1.05-2.62).
CONCLUSION: Our results suggest that high BMI may increase the risk of colorectal adenoma in Korean adults.
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Metabolic syndrome is associated with increased risk of recurrent colorectal adenomas in Korean men. Int J Obes (Lond) 2011; 36:1007-11. [PMID: 21894158 DOI: 10.1038/ijo.2011.177] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
OBJECTIVE Because of the high incidence of recurrent colorectal adenomas, regular surveillance by colonoscopy is recommended. However, there is still a shortage of information on the factors that influence the incidence of recurrent colorectal adenomas in patients with a history of these lesions. The aim of this study was to determine the association between the development of recurrent colorectal adenomas, metabolic syndrome and obesity. SUBJECTS AND METHODS The hospital-based cohort was composed of 193 patients who had recurrent colorectal adenomas removed between January 2002 and December 2003. The Cox proportional hazard model was used to determine hazard ratio (HR) and 95% confidence interval (CI) between obesity, metabolic syndrome and other factors, and the incidence of recurrent adenomatous polyps. RESULTS The mean follow-up period was 4.8 person-years. In all, 78 of the patients (40.4%) had recurrent colorectal adenomas. In the overall recurrent adenoma group, significant associations between metabolic syndrome (HR, 1.33; 95% CI, 1.02-1.73), waist circumference (WC) ≥ 90 cm (HR, 1.42; 95% CI, 1.06-1.90) and waist-hip ratio (WHR) ≥ 0.9 (HR, 2.03; 95% CI, 1.55-2.68) were found. Moreover, advanced adenomas were significantly associated with metabolic syndrome (HR, 2.81; 95% CI, 1.86-4.25), body mass index ≥ 25 kg m(-2) (HR, 2.69; 95% CI, 1.64-4.42), WC (HR, 2.16; 95% CI, 1.31-3.54) and WHR (HR, 1.99; 95% CI, 1.28-3.11). In addition, current smoking (HR, 2.60; 95% CI, 1.09-6.25) and alcohol consumption (HR, 2.20; 95% CI, 1.10-4.39) were also significantly associated with recurrent advanced adenoma. CONCLUSION Metabolic syndrome and obesity were significantly associated with the development of recurrent colorectal adenomas in Korean adult males. Furthermore, these associations were more strongly associated with advanced adenomas.
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Suh S, Kang M, Kim MY, Chung HS, Kim SK, Hur KY, Kim JH, Lee MS, Lee MK, Kim KW. Korean type 2 diabetes patients have multiple adenomatous polyps compared to non-diabetic controls. J Korean Med Sci 2011; 26:1196-200. [PMID: 21935276 PMCID: PMC3172658 DOI: 10.3346/jkms.2011.26.9.1196] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/25/2011] [Accepted: 08/02/2011] [Indexed: 12/21/2022] Open
Abstract
We tested the correlation between diabetes and aggressiveness of colorectal polyps in diabetic patients and matched non-diabetic controls. We retrospectively studied 3,505 type 2 diabetes (T2DM) patients without gastrointestinal symptoms who underwent colonoscopy for colorectal cancer at Samsung Medical Center, Seoul, Korea from August 1995 to August 2009. We matched 495 non-diabetic subjects with colon polyps to the diabetic patients in whom polyps were detected by year of colonoscopy, age, sex and body mass index (BMI). Among the 3,505 T2DM patients screened, 509 were found to have 1,136 colon polyps. Those with diabetes had a greater proportion of adenomatous polyps (62.8% vs 53.6%) compared to the control. Multivariate logistic regression analysis identified DM, male gender, age and BMI as independent risk factors for multiple polyps (more than three polyps). Polyp multiplicity in diabetic patients was significantly associated with male gender (OR 2.360, P = 0.005), age (OR 1.033, P = 0.005) and BMI (OR 1.077, P = 0.028). Neither aspirin nor metformin use affected either size or number of polyps in diabetic patients. Male patients older than 65 yr with T2DM and BMI greater than 25 have increased risk for multiple adenomatous polyps and should be screened with colonoscopy to prevent colorectal cancer.
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Affiliation(s)
- Sunghwan Suh
- Division of Endocrinology and Metabolism, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Mira Kang
- Center for Health Promotion, Samsung Medical Center, Seoul, Korea
| | - Mi Yeon Kim
- Division of Endocrinology and Metabolism, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Hye Soo Chung
- Division of Endocrinology and Metabolism, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Soo Kyoung Kim
- Division of Endocrinology and Metabolism, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Kyu Yeon Hur
- Division of Endocrinology and Metabolism, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Jae Hyeon Kim
- Division of Endocrinology and Metabolism, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Myung-Shik Lee
- Division of Endocrinology and Metabolism, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Moon Kyu Lee
- Division of Endocrinology and Metabolism, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Kwang-Won Kim
- Division of Endocrinology and Metabolism, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
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Stadlmayr A, Aigner E, Steger B, Scharinger L, Lederer D, Mayr A, Strasser M, Brunner E, Heuberger A, Hohla F, Steinwendner J, Patsch W, Datz C. Nonalcoholic fatty liver disease: an independent risk factor for colorectal neoplasia. J Intern Med 2011; 270:41-9. [PMID: 21414047 DOI: 10.1111/j.1365-2796.2011.02377.x] [Citation(s) in RCA: 86] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
BACKGROUND AND AIMS Nonalcoholic fatty liver disease (NAFLD) is the hepatic manifestation of insulin resistance (IR), and IR is associated with an increased risk of colorectal carcinoma (CRC). Increased echogenicity suggesting NAFLD is a frequent incidental finding on ultrasound examination. We aimed to systematically evaluate whether NAFLD is an independent risk factor for colonic neoplasia. PATIENTS AND METHODS One thousand two hundred and eleven patients (603 males, 60.6 ± 9.6 years; 608 females, 61.1 ± 10.3 years) who underwent screening colonoscopy according to national screening recommendations for CRC were evaluated in a cross-sectional study. Colorectal adenomas were classified as tubular adenoma, advanced adenoma (villous features, size ≥ 1 cm or high-grade dysplasia) or carcinoma. NAFLD was diagnosed by increased echogenicity on ultrasound examination after serological exclusion of infectious, immunological, hereditary or alcoholic aetiology. RESULTS Nonalcoholic fatty liver disease was diagnosed in 367 (60.8%) males and in 265 (43.5%) females. The total rate of adenomas was increased in subjects with NAFLD (243/367 vs. 107/236 in males, P = 0.010; 94/265 vs. 78/343 in females; P = 0.014). In particular, more tubular adenomas (127/367 vs. 56/236; P = 0.006), adenomas of the rectum (40/367 vs. 8/236; P = 0.004) and more cancers (6/367 vs. 1/236; P < 0.001) were observed in males with NAFLD. In females with NAFLD, more tubular adenomas (59/265 vs. 48/343; P = 0.011) and adenomas of the proximal colon (51/265 vs. 40/343; P = 0.041) were observed. Multivariate regression analyses demonstrated an independent association of colorectal adenomas with hepatic steatosis after adjustment for age, sex, body mass index and glucose intolerance (OR 1.47; 95% CI 1.079-2.003; P = 0.015). CONCLUSION Patients with NAFLD undergoing screening colonoscopy reveal significantly more CRC precursor lesions and early CRC compared with subjects without NAFLD. This elevated risk is independent from other manifestations of IR. These findings suggest that detecting fatty liver on ultrasound should heighten the awareness for referral to screening colonoscopy.
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Affiliation(s)
- A Stadlmayr
- Department of Internal Medicine, Oberndorf Hospital, Oberndorf, Austria
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Renin-angiotensin system inhibitors suppress azoxymethane-induced colonic preneoplastic lesions in C57BL/KsJ-db/db obese mice. Biochem Biophys Res Commun 2011; 410:108-13. [PMID: 21640075 DOI: 10.1016/j.bbrc.2011.05.115] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2011] [Accepted: 05/19/2011] [Indexed: 12/28/2022]
Abstract
Obesity-related metabolic abnormalities, including chronic inflammation and oxidative stress, increase the risk of colorectal cancer. Dysregulation of the renin-angiotensin system (RAS) also plays a critical role in obesity-related metabolic disorders and in several types of carcinogenesis. In the present study, we examined the effects of an angiotensin-converting enzyme (ACE) inhibitor and angiotensin-II type 1 receptor blocker (ARB), both of which inhibit the RAS, on the development of azoxymethane (AOM)-initiated colonic premalignant lesions in C57BL/KsJ-db/db (db/db) obese mice. Male db/db mice were given 4 weekly subcutaneous injections of AOM (15 mg/kg body weight), and then, they received drinking water containing captopril (ACE inhibitor, 5mg/kg/day) or telmisartan (ARB, 5mg/kg/day) for 7 weeks. At sacrifice, administration of either captopril or telmisartan significantly reduced the total number of colonic premalignant lesions, i.e., aberrant crypt foci and β-catenin accumulated crypts, compared to that observed in the control group. The expression levels of TNF-α mRNA in the colonic mucosa of AOM-treated db/db mice were decreased by captopril and telmisartan. Captopril lowered the expression levels of TNF-α, IL-1β, IL-6, and PAI-1 mRNAs, while telmisartan lowered the expression levels of COX-2, IL-1β, IL-6, and PAI-1 mRNAs in the white adipose tissues of these mice. In addition, these agents significantly reduced the levels of urinary 8-OHdG, a surrogate marker of oxidative damage to DNA, in the experimental mice. These findings suggested that both ACE inhibitor and ARB suppress chemically-induced colon carcinogenesis by attenuating chronic inflammation and reducing oxidative stress in obese mice. Therefore, targeting dysregulation of the RAS might be an effective strategy for chemoprevention of colorectal carcinogenesis in obese individuals.
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Adiposity and the risk of colorectal adenomatous polyps: a meta-analysis. Cancer Causes Control 2011; 22:1021-35. [PMID: 21604177 DOI: 10.1007/s10552-011-9777-9] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2010] [Accepted: 05/07/2011] [Indexed: 01/29/2023]
Abstract
OBJECTIVE The findings from epidemiological studies addressing the association between adiposity and the risk of colorectal adenomatous polyps are inconsistent. We performed a meta-analysis of epidemiological studies including cross-sectional, case-control, and cohort studies. METHODS We searched PubMed and EMBASE in June, 2010. All searched articles were reviewed and selected independently by two evaluators according to pre-determined selection criteria. RESULTS We included 25 studies (nine cross-sectional studies, eleven case-control studies, and five prospective cohort studies) that comprised a total of 300,671 participants and 20,903 cases in the final analysis. When all studies were pooled, the odds ratio (OR) or relative risk (RR) of adiposity and abdominal adiposity for colorectal adenomatous polyp risk was 1.43 (95% confidence interval (CI) 1.23-1.67; n = 22) and 1.42 (95% CI 1.30-1.56; n = 12), respectively. Similarly, an increased risk of colorectal adenomatous polyps was observed in most of the subgroup meta-analyses. CONCLUSIONS Overall, we found that adiposity and abdominal adiposity significantly increased the risk of colorectal adenomatous polyps in a meta-analysis of epidemiological studies.
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Sun ZJ, Huang YH, Wu JS, Yang YC, Chang YF, Lu FH, Chang CJ. The association of serum lipids with the histological pattern of rectosigmoid adenoma in Taiwanese adults. BMC Gastroenterol 2011; 11:54. [PMID: 21575164 PMCID: PMC3112117 DOI: 10.1186/1471-230x-11-54] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/20/2010] [Accepted: 05/15/2011] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND The mortality rate of colorectal cancer ranks third behind lung and hepatic cancer in Taiwan. Colorectal cancer mostly arises from adenomatous polyps of left colon. The aim of our study was to examine the association of serum lipids with the histological pattern of rectosigmoid adenoma. METHODS There were 2,506 eligible examinees aged 20 and above who underwent sigmoidoscopy as a screening examination in National Cheng Kung University Hospital between January 2003 and October 2006. They were classified into three groups: tubular adenoma (333 subjects), villous-rich (tubulovillous/villous) adenoma (53 subjects) and normal (2,120 subjects). We defined high total cholesterol (TC) as a level ≧200 mg/dl, low high-density lipoprotein cholesterol (HDL-C) as a level <40 mg/dL, and high triglyceride (TG) as a level ≧200 mg/dl according to the third report of the National Cholesterol Education Program expert panel on detection, evaluation, and treatment of high blood cholesterol in adults. Adenoma histology was classified as tubular, tubulovillous and villous according to the proportion of villous part. RESULTS Among the study population, 333 subjects (13.3%) had tubular adenomas and 53 subjects (2.1%) had villous-rich adenomas. The odds ratio (OR) for villous-rich adenoma in subjects with TG≧200 mg/dL compared to those with TG < 200 mg/dL was 3.20 (95% confidence interval [CI]:1.71-6.01), after adjusting for age, gender, general obesity, central obesity, diabetes, hypertension, smoking, and alcohol consumption. If further taking high TC and low HDL-C into consideration, the OR was 4.42 (95% CI:2.03-9.63). CONCLUSIONS Our study showed that subjects with high serum TG tended to have a higher risk of tubulovillous/villous adenoma in rectosigmoid colon. Therefore, reducing the serum TG level might be one method to prevent the incidence of colorectal cancer.
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Affiliation(s)
- Zih-Jie Sun
- Department of Family Medicine, National Cheng Kung University College of Medicine and Hospital, Dou-Liou Branch, No.345, Zhuangjing Rd., Douliou City, Yunlin County 640, Taiwan
| | - Ying-Hsiang Huang
- Department of Family Medicine, National Cheng Kung University Hospital, No.138, Shengli Rd., East Dist., Tainan City 701, Taiwan
| | - Jin-Shang Wu
- Department of Family Medicine, National Cheng Kung University Hospital, No.138, Shengli Rd., East Dist., Tainan City 701, Taiwan
| | - Yi-Ching Yang
- Department of Family Medicine, National Cheng Kung University Hospital, No.138, Shengli Rd., East Dist., Tainan City 701, Taiwan
| | - Ying-Fang Chang
- Department of Family Medicine, National Cheng Kung University Hospital, No.138, Shengli Rd., East Dist., Tainan City 701, Taiwan
| | - Feng-Hwa Lu
- Department of Family Medicine, National Cheng Kung University Hospital, No.138, Shengli Rd., East Dist., Tainan City 701, Taiwan
| | - Chih-Jen Chang
- Department of Family Medicine, National Cheng Kung University Hospital, No.138, Shengli Rd., East Dist., Tainan City 701, Taiwan
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Hu NC, Chen JD, Lin YM, Chang JY, Chen YH. Stepwise relationship between components of metabolic syndrome and risk of colorectal adenoma in a Taiwanese population receiving screening colonoscopy. J Formos Med Assoc 2011; 110:100-8. [PMID: 21377064 DOI: 10.1016/s0929-6646(11)60016-8] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2009] [Revised: 12/01/2009] [Accepted: 03/19/2010] [Indexed: 12/19/2022] Open
Abstract
BACKGROUND/PURPOSE Metabolic syndrome (MS) is a cluster of diseases related to insulin resistance and is an important cardiovascular risk factor. In addition, MS has been linked to some malignancies, including colorectal cancer. Colon adenoma is a well-established pre-malignant lesion of colorectal cancer. The aim of this study was to determine the effect of various components of MS on the risk of colorectal adenoma. METHODS From October 2004 to April 2006, 3106 subjects who had undergone complete colonoscopy for health examinations at the hospital were enrolled. MS was defined according to the modified National Cholesterol Education Program Adult Treatment Panel III definition for South Asians and Chinese. Multivariate logistic regression was used to analyze the association between components of MS and colorectal adenoma. RESULTS Of the 3106 subjects, the mean age was 47.1 ± 10.8 years and there were 397 (13%) subjects with pathologically proven colorectal adenoma. Male sex, old age (=50 years), current smokers, and abdominal obesity were associated with increasing risk of colorectal adenoma. MS was associated with increased risk of colorectal adenoma (odds ratio: 1.71, 95% confidence interval: 1.34-2.71), and this risk increased with the number of metabolic components. Multiple and synchronous adenomas of the proximal and distal colon were positively associated with MS. CONCLUSION Subjects with metabolic syndrome have increased risk of developing colorectal adenoma. Screening colonoscopy for prevention of colorectal adenoma might be warranted when abdominal obesity or more than three components of MS are present.
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Affiliation(s)
- Nien-Chih Hu
- Department of Family Medicine, Shin Kong Wu Ho-Su Memorial Hospital, 95 Wen Chang Road, Shih Lin, Taipei 111, Taiwan
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Abstract
Currently, significant amount of epidemiologic evidence is present to suggest that metabolic syndrome increases the risk of developing colorectal cancer. This evidence is based on studies of the evaluate determinants of the metabolic syndrome (obesity), clinical consequences of metabolic syndrome (type 2 diabetes and hypertension) and serum component of metabolic syndrome (hypertriglyceridemia, hyperglycemia and low high-density lipoprotein cholesterol), as well as markers of hyperinsulinemia. Although the exact pathogenesis of this relationship is unknown, it seems that hyperinsulinemia may play a pivotal role in increasing CRC risk.
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48
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Lipscombe L. Insulin, Insulin Resistance, and Cancer Associations. ENERGY BALANCE AND CANCER 2011. [DOI: 10.1007/978-1-4419-9911-5_5] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
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Sato T, Takeda H, Sasaki Y, Kawata S. Increased Homeostasis Model Assessment-Insulin Resistance Is a Risk Factor for Colorectal Adenoma in Japanese Males. TOHOKU J EXP MED 2011; 223:297-303. [DOI: 10.1620/tjem.223.297] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Affiliation(s)
- Takeshi Sato
- Department of Gastroenterology, Yamagata University Faculty of Medicine
| | | | - Yu Sasaki
- Department of Gastroenterology, Yamagata University Faculty of Medicine
| | - Sumio Kawata
- Department of Gastroenterology, Yamagata University Faculty of Medicine
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Lin YL, Chiang JK, Lin SM, Tseng CE. Helicobacter pylori infection concomitant with metabolic syndrome further increase risk of colorectal adenomas. World J Gastroenterol 2010; 16:3841-6. [PMID: 20698048 PMCID: PMC2921097 DOI: 10.3748/wjg.v16.i30.3841] [Citation(s) in RCA: 27] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/04/2010] [Revised: 05/10/2010] [Accepted: 05/17/2010] [Indexed: 02/06/2023] Open
Abstract
AIM To investigate the association of colorectal adenomas with both Helicobacter pylori (H. pylori) infection and metabolic syndrome. METHODS Using a cross-sectional hospital-based study, we analyzed physical examination data from 9311 healthy subjects with overnight physical examinations performed between January 2004 and December 2006. Examined data included gender, age, life style, anthropometric measurements, blood pressure, biochemical and hematological studies, H. pylori infection detected by esophagogastroduodenoscopy and biopsy urease tests, and colorectal adenomas detected with a complete total colonoscopy. RESULTS The prevalence values for H. pylori infection, metabolic syndrome, and colorectal adenoma were 39.2%, 18.7%, and 20.7%, respectively. Colorectal adenoma risk factors included male gender [odd ratio (OR): 2.005, 95% confidence interval (CI): 1.740-2.310, P < 0.001], advanced age (OR: 1.046, 95% CI: 1.040-1.052, P < 0.001), smoking (OR: 1.377, 95% CI: 1.146-1.654, P = 0.001), increased body fat (OR: 1.016, 95% CI: 1.007-1.026, P = 0.001), higher white blood cell count (OR: 1.038, 95% CI: 1.005-1.073, P = 0.025), H. pylori infection (OR: 1.366, 95% CI: 1.230-1.517, P < 0.001), and metabolic syndrome (OR: 1.408, 95% CI: 1.231-1.610, P < 0.001). In addition, concomitant H. pylori infection with metabolic syndrome further increased the probability of colorectal adenomas. CONCLUSION Our study revealed H. pylori infection with concomitant metabolic syndrome might further increase the risk of colorectal adenomas.
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