Abstract
Obesity is a well-known risk factor for colorectal neoplasia. Yet, the associations of both metabolic and obesity status with metachronous colorectal neoplasia remain unclear. We conducted a cohort study of 9,331 adults who underwent screening colonoscopy and surveillance colonoscopy. Participants were classified as metabolically healthy if they had no metabolic syndrome component. Participants were categorized into four groups according to body mass index and metabolic status: metabolically healthy non-obese (MHNO; n = 2,745), metabolically abnormal non-obese (MANO; n = 3,267), metabolically healthy obese (MHO; n = 707), and metabolically abnormal obese (MAO; n = 2,612). MAO individuals [n = 159 advanced colorectal neoplasia (AN) cases, 6.1%] and MANO individuals (n = 167 AN cases, 5.1%) had a higher incidence of AN compared with MHNO individuals (n = 79 AN cases, 2.9%). In a multivariable model, the risk of metachronous AN was higher in MANO (hazard ratio [HR] 1.43, 95% confidence interval [CI] 1.12–1.84) and MAO (HR 1.52, 95% CI 1.18–1.96) than in MHNO. In contrast, the risk of metachronous AN was not significantly elevated in MHO. In subgroup analyses, with or without adenoma at baseline, MAO was a risk group for metachronous AN, and MHO was not. Our findings suggest that metabolic unhealthiness is a significant predictor for metachronous AN.
Highlights
The global epidemic of obesity continues to worsen, imposing considerable burdens on global health due to chronic diseases such as cardiovascular disease, type 2 diabetes, and some cancers[1,2,3]
We found that non-obese individuals with metabolic abnormalities were at higher risks of colorectal neoplasia than were non-obese individuals without metabolic abnormalities
Our results showed that metabolically healthy obese (MHO) individuals, based on body mass index (BMI), are not at an increased risk of colorectal neoplasia development, as compared with metabolically healthy non-obese individuals
Summary
The global epidemic of obesity continues to worsen, imposing considerable burdens on global health due to chronic diseases such as cardiovascular disease, type 2 diabetes, and some cancers[1,2,3]. Most obese individuals have one or more metabolic abnormalities. Recent interest has focused on a unique subgroup of obese individuals who do not have metabolic abnormalities. Non-obese individuals with metabolic abnormalities have been described[2, 11]. Previous studies on the effects of the metabolically healthy obese (MHO) phenotype on cardiovascular and neoplastic disease have yielded contradictory results[7, 12,13,14,15,16]. Recent studies concerning the association between colorectal neoplasia and these subgroups showed contrary results[14, 16]. We evaluated the risk of this disease according to both obesity and metabolic status. Years Male BMI (kg/m2) Smoking status Never Former Current Modest alcohol intake consumption Regular exercise Family history of CRC Aspirin use (%)
Sign-in/Register to view highlights & summary Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
