Abstract
INTRODUCTION: In Japan, the incidence and mortality rate of colorectal cancer (CRC) has been increased and CRC is considered to be one of obesity-related malignancies. Adiponectin is an adipocyte-specific adipokine, which possesses pleiotropic properties on various disease including atherosclerotic diseases, cardiovascular diseases, inflammatory diseases and tumors. In addition, recent studies have demonstrated that high-molecular-weight (HMW) form of adiponectin is active form of this adipokine. The objective of the present study was to investigate whether HMW adiponectin was a risk factor for colorectal neoplasia (CRN; adenomatous polyp ≥5 mm in size and cancer) using comprehensive health checkup data. METHODS: We conducted a retrospective analysis in clinical practice at a single center. Among 10138 subjects who took comprehensive health checkup at our hospital between in August 2012 and December 2016, 315 subjects who underwent screening both colonoscopy and optional metabolic syndrome course were enrolled. HMW adiponectin was measured using commercially available ELISA kit. We evaluated demographic characteristics, anthropometric measurements, visceral fat area (VFA) measured by CT, hematological metabolic parameters, degree of liver fat evaluated by ultrasonography, and current smoking and drinking habits as variables. Association between variables and CRN was evaluated by univariate analysis using t-test, χ2 test, Mann-Whitney test, and then by multivariate analysis using multiple logistic regression model. A P value <0.05 was considered statistically significant. RESULTS: Of 315 subjects (men: 228, women: 87) analyzed, 97 subjects were diagnosed as MetS (30.8%) and 33 subjects had CRN (10.5%). Subjects with MetS had more CRN (12 subjects, 12.4%) compared with those without MetS (21 subjects, 9.6%) (n.s.). Univariate analysis identified significant association of sex, age, VFA, systolic blood pressure, current smoking habits, drinking habits and ≥10 kg weight gain compared with the body weight at the age of twenty with CRN prevalence. Moreover, HMW adiponectin level was inversely corelated with CRN prevalence (P = 0.003). Logistic regression analysis revealed that age, systolic blood pressure, current smoking, and HMW adiponectin level were independent factors associated with CRN prevalence (Table 1). CONCLUSION: The present study demonstrated that decreased levels of HMW adiponectin is a risk factor for colorectal neoplasia in Japan.
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