Brief Article
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World J Gastroenterol. Dec 7, 2013; 19(45): 8349-8356
Published online Dec 7, 2013. doi: 10.3748/wjg.v19.i45.8349
Association of visceral obesity and early colorectal neoplasia
Eun Kyung Choe, Donghee Kim, Hwa Jung Kim, Kyu Joo Park
Eun Kyung Choe, Department of Surgery, Healthcare Research Institute, Seoul National University Hospital, Healthcare System Gangnam Center, Seoul 135-984, South Korea
Donghee Kim, Department of Internal Medicine, Healthcare Research Institute, Seoul National University Hospital, Healthcare System Gangnam Center, Seoul 135-984, South Korea
Hwa Jung Kim, Department of Clinical Epidemiology and Biostatistics, Asan Medical Center, University of Ulsan College of Medicine, Seoul 138-736, South Korea
Kyu Joo Park, Department of Surgery, Seoul National University College of Medicine, Seoul 110-799, South Korea
Author contributions: Kim D and Choe EK designed, and performed the research; Kim D and Kim HJ analyzed data and interpreted data; Choe EK, Kim D and Park KJ wrote the paper; all authors approved the final version
Supported by Grant from the Seoul National University Hospital Research Fund, No. 0420100610 (2010-1086)
Correspondence to: Donghee Kim, MD, PhD, Department of Internal Medicine, Healthcare Research Institute, Seoul National University Hospital, Healthcare System Gangnam Center, 39th FL., Gangnam Finance Center 737, Yeoksam-Dong, Gangnam-Gu, Seoul 135-984, South Korea. messmd@chol.com
Telephone: +82-2-21125500 Fax: +82-2-21125635
Received: August 5, 2013
Revised: September 3, 2013
Accepted: September 16, 2013
Published online: December 7, 2013
Processing time: 135 Days and 0.7 Hours
Abstract

AIM: To examine whether visceral adipose tissue (VAT) serves as a risk factor for colorectal adenoma-early colorectal cancer (CRC) sequence.

METHODS: A retrospective case-control study was conducted with 153 patients with stage I CRC, age/sex-matched 554 patients with colorectal adenoma and 557 normal controls. All subjects underwent various laboratory tests, abdominal fat computed tomography (CT), and colonoscopy. VAT was defined as an intra-abdominal adipose tissue area measured by CT scan. Adipose tissue area was measured at the level of the umbilicus from CT scan. We used the lowest quartile of VAT and subcutaneous adipose tissue area as a reference group.

RESULTS: The body mass index (BMI), total cholesterol, fasting glucose and VAT areas were significantly different among normal, adenoma and CRC groups. The VAT area was 120.6 ± 49.0 cm2 in normal controls, 130.6 ± 58.4 cm2 in adenoma group and 117.6 ± 51.6 cm2 in CRC group (P = 0.002). In univariate analysis, increased BMI was a risk factor for CRC compared to control (P = 0.025). However, VAT area was not a risk factor for CRC compared to control. In multivariate analysis that adjusted for smoking, alcohol consumption and subcutaneous adipose tissue area, VAT area was inversely related to CRC, compared to the adenoma (OR = 0.53, 95%CI: 0.31-0.92, highest quartile vs lowest quartile).

CONCLUSION: Our study shows that visceral obesity is not a risk factor for early CRC. Visceral obesity might influence the normal-adenoma sequence but not the adenoma-early carcinoma sequence.

Keywords: Adipose tissue; Visceral fat; Obesity; Colorectal cancer; Colorectal adenoma; Abdominal computed tomography

Core tip: This study showed that visceral obesity is not a risk factor for early colorectal cancer, although it is an independent risk factor for colorectal adenoma in previous studies. Therefore, these data suggest that visceral obesity might influence the normal-adenoma sequence but not the adenoma-early carcinoma sequence.