Indexed on: 17 May '17Published on: 17 May '17Published in: The Journal of clinical endocrinology and metabolism
Metabolic factors such as obesity and insulin resistance have been suggested as risk factors for colorectal neoplasms (CRN), but few studies have investigated the associations between metabolic status, obesity, and CRN.To investigate the relationship between metabolic status, obesity and CRN in Koreans who underwent colonoscopy during health screening.Retrospective, cross-sectional.Subjects were divided into four groups based on metabolic and obesity criteria, (1) metabolically healthy nonobese (MHNO), (2) metabolically healthy obese (MHO), (3) metabolically unhealthy nonobese (MUNO), and (4) metabolically unhealthy obese (MUO). Main Outcome Measures: Multiple regression analysis was used to identify risk factors for CRN and advanced CRN, with the MHNO group as reference.10,235 subjects were included: 5,096 MHNO, 1,538 MHO, 1,746 MUNO, and 1,855 MUO. Of these, 3,297 had CRN (32.2%), and 434 (4.2%) had advanced CRN. The proportions of subjects with CRN in each group were: MHNO 25.8%, MHO 33.9%, MUNO 38.9%, and MUO 42.0% (P for trend <0.001). Risk of CRN was increased in the MHO (OR 1.239, 95%CI 1.082-1.418, P=0.002), the MUNO (OR 1.233, 95%CI 1.086-1.400, P=0.001) and the MUO groups (OR 1.510, 95%CI 1.338-1.706, P<0.001), while risk of advanced CRN was increased in the MUNO (OR 1.587, 95%CI 1.222-2.062, P=0.001) and the MUO groups (OR 1.456, 95%CI 1.116-1.900, P=0.006).Obesity was a risk factor for CRN with metabolically unhealthy status adding risk. For advanced CRN, obesity by itself was not a risk factor, but metabolically unhealthy status increased the risk.