140 Protective Effect of a Phytoestrogen-Enriched Diet on the Increase in Visceral Sensitivity and Intestinal Permeability Induced by Acute Stress in Female Rats

Abstract

Background: Studies have suggested obesity as a risk factor for colorectal adenoma recurrence. It is unknown if weight change affects the risk of adenoma recurrence. Aim: We sought to examine whether weight change over a four year period is associated with subsequent colorectal adenoma recurrence. Methods: A total of 1,826 participants with a history of colorectal adenoma had body weight measured at baseline and 4 years later in the Polyp Prevention Trial. Adenoma recurrence was determined by end of trial colonoscopy. We used multinomial regression models to estimate adjusted relative risk ratios (RRR) and 95% confidence intervals (CI) to evaluate body mass index (BMI), weight change over 4 years and the risk of incident non-advanced and advanced adenoma recurrence. Results: A total of 605 (33.1%) participants had non-advanced adenoma recurrence while 118 (6.5%) had advanced adenoma recurrence. Although relative risks in this data set did not quite reach statistical significance, the analytic results suggest that baseline adiposity, especially BMI ≥ 30 kg/m2, is positively associated with adenoma recurrence. When compared with participants with BMI < 25 kg/m2 (n = 466) at baseline, there was an elevated risk of nonadvanced adenoma and advanced adenoma recurrence among participants with BMI = 25 29 kg/m2 (n = 868) (RRR = 1.23; 95%CI: 0.95-1.59 and RRR = 1.02; 95%CI: 0.61-1.68, respectively) and among those with BMI ≥ 30 kg/m2 (n = 492) (RRR = 1.27; 95%CI: 0.951.70 and RRR = 1.63; 95%CI: 0.96-2.78, respectively). When compared with those with relatively stable weight (less than 5 pound weight change) over the 4-year trial, weight gain or loss was not associated with adenoma recurrence (Table); this was consistent regardless of the baseline BMI. Conclusions: We observed a suggestive positive association between baseline BMI and adenoma recurrence; however, weight loss or gain over 4 years does not affect adenoma recurrence irrespective of baseline weight. Adjusted for age, sex, non-steroidal anti-inflammatory drug use, smoking and family history of colorectal cancer