J Gastroenterology H:内脏肥胖的增加与结直肠腺瘤的风险增加有关

2021-07-18 MedSci原创 MedSci原创

结直肠癌是全世界第三大最常见的癌症,也是第二大常见癌症全球癌症相关死亡的主要原因。在结肠癌的二级预防中的腺瘤筛查的重要性已得到证明。因此,识别有患结直肠腺瘤风

      结直肠癌是全世界第三大最常见的癌症,也是第二大常见癌症全球癌症相关死亡的主要原因。在结肠癌的二级预防中的腺瘤筛查的重要性已得到证明。因此,识别有患结直肠腺瘤风险的受试者至关重要。在临床实践中,对这些高危患者进行早期干预可能会阻止结直肠腺瘤的发展并减少结直肠癌的发生。众所周知的结直肠腺瘤的危险因素是吸烟、缺乏身体活动、饮食习惯、肥胖和大量饮酒。早期研究检查了体重指数 (BMI) 可作为替代指标。虽然许多研究表明内脏肥胖与结直肠腺瘤 (CRA) 之间存在关联,但体脂肪成分的纵向变化对 CRA 的影响尚不清楚。因此,本项研究调查了内脏肥胖变化与 CRA 发生之间的纵向关联。

 

      在本项前瞻性队列中共纳入了 1165 名受试者,所有受试者中有 732 名(62.8%)自愿接受后续腹部脂肪计算机断层扫描和结肠镜检查。研究人员将新发和复发 CRA 定义为在随访结肠镜检查时分别从基线结肠镜检查时阴性和阳性腺瘤中检测到的腺瘤。

 

      在 7.4 年的中位随访期间,400 (54.6%) 名受试者出现了 CRA。在多变量分析中,内脏脂肪组织 (VAT) 面积的变化增加与发生腺瘤的风险较高相关( [HR] 1.21,95% [CI] 1.00–1.46 ;P= 0.045)。同样,VAT 面积的变化增加与复发性腺瘤的风险增加独立相关(HR 1.35,95% CI 1.13–1.62 每增加1个单位变化;HR 1.62, 95% CI 1.04–2.52 最高与最低四分位数,P= 0.001)。但是皮下脂肪组织面积的变化与 CRA 不独立相关。

图:结直肠腺瘤发生的危险因素

      本项研究证实VAT 面积增加的变化与更高的 CRA 事件和复发风险纵向相关,这表明内脏肥胖可能是 CRA 预防的重要目标。

 

 

原始出处:

Jung Min Moon. Et al. Increasing changes in visceral adiposity is associated with higher risk for colorectal adenoma: Multilevel analysis in a prospective cohort.Journal of Gastroenterology and Hepatology.2021.

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    2021-07-18 SR~young海东

    谈癌色变

    0

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    2021-07-18 周伟杰

    学习了

    0

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    2021-07-18 ms7000001053200935

    学习了

    0

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