Association of obesity and advanced colon polyp in Korean adults

Abstract

Introduction: Colorectal cancer is one of the most common cancer worldwide. It is widely recognized that the majority of colorectal cancer arise from neoplastic polyps. Obesity has been associated with an increased risk for colonic adenomatous polyps and colorectal cancers. However, the influence of obesity on the development of advanced colon polyps is not clear. We tried to compare the clinical characteristics between the subjects with advanced polyps and the subjects without advanced polyps, and examined the relationship between advanced colon polyps and obesity in hearth check-up subjects in Korea. Methods: A total of 232 adenomatous polyp patients who diagnosed with colonoscopy for cancer screening between January 2005 and June 2008, were eligible. An advanced polyp was defined as an adenomatous polyp with one or more of the following features: (1) a diameter of 1 cm or larger, (2) a villous histology, and (3) high-grade dysplasia or adenocarcinoma. BMI was assessed, and histology, size, and location of the adenoma were examined for each patient. Total fat are, visceral fat area and subcutaneous fat area was measured for evaluation of abdominal obesity by abdominal computed tomography. Results: Of 232 patients, 175 (75.43%) were male and 57 (24.57%) were female. The clinical characteristics were different between male and female. The polyp number was significantly higher in male (1.61±0.09 vs. 1.19±0.07). And male had significant higher level of BMI (24.49±0.16 vs. 23.52±0.31), total abdominal fat area (280.50±6.79 vs. 229.50±10.15), and visceral fat area (150.53±4.67 vs. 82.98±5.95) than female. Advanced polyps had positive associations with polyp number, BMI, total fat area, subcutaneous fat area and visceral fat area in male. In female, advanced polyps had positive association with BMI and subcutaneous fat area. Conclusion: In asymptomatic patients with adenomatous colon polyps, significant clinical differences were found between male and female. Our data suggest that abdominal obesity increases the risk of advanced colon polyps.