Abstract
BackgroundObesity increases the risk of colon cancer. It is also known that most colorectal cancers develop from adenomatous polyps. However, the effects of obesity and adipokines on colonic polyp formation are unknown.MethodsTo determine if BMI, waist circumference or adipokines are associated with colon polyps in males, 126 asymptomatic men (48–65 yr) were recruited at time of colonoscopy, and anthropometric measures as well as blood were collected. Odds ratios were determined using polytomous logistic regression for polyp number (0 or ≥3) and polyp type (no polyp, hyperplastic polyp, tubular adenoma).Results41% of the men in our study were obese (BMI ≥30). The odds of an obese individual having ≥3 polyps was 6.5 (CI: 1.3–33.0) times greater than those of a lean (BMI<25) individual. Additionally, relative to lean individuals, obese individuals were 7.8 (CI: 2.0–30.8) times more likely to have a tubular adenoma than no polyp. As BMI category increased, participants were 2.9 (CI: 1.5–5.4) times more likely to have a tubular adenoma than no polyps. Serum leptin, IP-10 and TNF-α were significantly associated with tubular adenoma presence. Serum leptin and IP-10 were significantly associated with increased likelihood of ≥3 polyps, and TNF-α showed a trend (p = 0.09).ConclusionsObese men are more likely to have at least three polyps and adenomas. This cross-sectional study provides evidence that colonoscopy should be recommended for obese, white males.
Highlights
The prevalence of obesity has risen dramatically over the past 20 years in the United States and other developed countries [1,2]
A firm association exists between obesity and colorectal cancer [3,4,5,6], the mechanisms leading to this increased risk are unknown
Despite the fact that most colorectal cancers develop from adenomatous polyps [7], the associations between obesity and colonic polyp promotion have been only minimally studied [8,9,10]
Summary
The prevalence of obesity has risen dramatically over the past 20 years in the United States and other developed countries [1,2]. A firm association exists between obesity and colorectal cancer [3,4,5,6], the mechanisms leading to this increased risk are unknown. Adipose tissue is recognized as an endocrine organ producing a variety of proteins, hormones and cytokines that are referred to collectively as adipokines [11]. These adipokines possess broad biological activities, including homeostatic and pathologic functions. As visceral adiposity increases so does the release of proinflammatory adipokines including IL-6, leptin and TNF-a. This is accompanied by decreased release of anti-inflammatory adipokines, including adiponectin [12]. The effects of obesity and adipokines on colonic polyp formation are unknown
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