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KMID : 0988920190170030404
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Intestinal Research
2019 Volume.17 No. 3 p.404 ~ p.412
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Association of visceral adiposity and insulin resistance with colorectal adenoma and colorectal cancer
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Jung In-Sub
Shin Cheol-Min
Park Sung-Jae
Park Young-Soo
Yoon Hyuk
Jo Hyun-Jin
Kim Na-Young
Lee Dong-Ho
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Abstract
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Background/Aims: To examine whether visceral adiposity serves as a risk factor for colorectal cancer (CRC) and colorectal adenomas.
Methods: Two hundred healthy subjects, 200 patients with colorectal adenoma, and 151 patients with CRC (46 with early-stage and 105 with advanced-stage cancers) were enrolled at a tertiary referral hospital. All subjects underwent colonoscopy, and had laboratory data, and computed tomography (CT) scan available for abdominal fat measurement. An abdominal CT scan taken 1 to 4 years (mean interval, 20.6 months) before the diagnosis of CRC was also available in the 42 CRC patients.
Results: The mean areas of visceral adipose tissue (VAT) areas in the control, adenoma, early- and advanced-stage CRC groups were 94.6, 116.8, 110.4, and 99.7 cm2, respectively (P<0.001). The risk of adenoma positively correlated with VAT area and the visceral-to-total fat ratio (P for trend <0.01), but the risk of CRC did not (P>0.05). The risk of both adenoma and CRC positively correlated with fasting plasma glucose levels (P for trend <0.05). In patients with early-stage cancer (n=17), VAT area decreased when the CT scan at diagnosis was compared with that taken before the diagnosis of CRC, but superficial adipose tissue area did not, so visceral-to-total fat ratio significantly decreased (46.6% vs. 50.7%, respectively, P=0.018)
Conclusions: VAT area is related to the risk of colorectal adenoma. However, VAT decreases from the early stages of CRC. Impaired fasting glucose has a role in colorectal carcinogenesis.
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KEYWORD
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Adipose tissue, Intra-abdominal fat, Obesity, Colorectal neoplasms, Tomography, X-ray computed
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