肥胖与大肠腺瘤相关性的研究  

Case control study of the correlation between obesity and colorectal adenoma

作　　者：王娜[1] 黄志刚[1] 陈锡美[1] 叶荣菊[1] 王慧[1] 张霞[1] 张建培[1] 

机构地区：[1]上海同济大学附属同济医院消化内科,200065

出　　处：《中华消化内镜杂志》2008年第9期453-457,共5页Chinese Journal of Digestive Endoscopy

摘　　要：目的初步探讨体重指数（BMI）、腰围（WC）、腰臀比（WHR）与大肠癌的癌前病变腺瘤的相关性。方法2006年12月至2007年12月选择无大肠癌病史且年龄在25～88岁的结肠镜检查患者，测量身高、体重、腰围、臀围，根据肠镜检查及活检病理结果纳入大肠腺瘤组（250例）和正常对照组（289例），利用多因素Logistic回归进行相关性分析。结果肥胖或腹型肥胖（以WC划分）患大肠腺瘤的调整后OR值分别为2．48（95％CI=1．19—5．20）和1．75（95％CI=1．15～2．66），P〈0．05和P〈0．01，其中男性调整后的OR值分别为4．10（95％CI：1．26—13．31）和1．70（95％CI=1．00—2．88），P均〈0．05，超重组未达到统计学差异；肥胖者患进展期和非进展期腺瘤的调整后OR值分别为2．71（95％CI=1．01～7．29）和2．39（95％CI=1．05～5．47），P均〈0．05；腹型肥胖者（以WC划分）患非进展期腺瘤的调整后OR值为2．03（95％CI：1．25—3．28），P〈0．01；但在进展期腺瘤组未达到统计学差异。超重组在进展期和非进展期腺瘤的患病风险较正常人群均无明显统计学差异。以WHR划分的腹型肥胖在各种分析中均无统计学意义。结论肥胖尤其是腹型肥胖与大肠腺瘤的发生显著相关，肥胖男性患病风险明显大于女性，肥胖对各期腺瘤的发生均显著相关。Objective To investigate the association between body mass index （BMI）, waist circumference （WC）, waist hip ratio （WHR） and the risk of colorectal adenoma, which was considered as a precancerous lesion. Methods Subjects aging from 25 to 88 years old who underwent colonoscopy at Tongji Hospital from December 2006 to December 2007 were selected and assigned into the adenoma group （ n = 250） and the control group （ n = 289 ） according to the findings of the colonoscopy. The body height, weight, waist and hip circumference of every subject were measured respectively. The logistic multi-factors regression analysis was applied to analyze the data. Results When obesity was determined by BMI or WC, the risk of adenoma in pure obesity group and abdominal adiposity group was 2.48 （95% CI = 1.19 -5. 20, P 〈 0. 05 ） and 1.75 （ 95% CI = 1.15 - 2. 66, P 〈 0. 01 ）, respectively. The corresponding value in male was 4. 10 （95% CI = 1.26 ～ 13.31, P 〈0. 05） and 1.70 （95% CI = 1.00 ～2. 88, P〈0. 05）. The risk of advanced and non-advanced adenoma in pure obesity was 2.71 （95% CI = 1.01～ 7. 29, P 〈 0. 05） and 2. 39 （95% CI = 1.05～5.47, P 〈0. 05） ; the risk of non-advanced adenoma in abdominal adiposity group was 2. 03 （95% CI = 1.25～ 3.28, P 〈0. 01 ）, but no significant difference in risk of advanced adenoma was detected. When obesity was determined by WHR, no significant difference was found in any regarding. Conclusion Obesity and abdominal adiposity are associated with the risk of colorectal adenoma, both advanced and non-advanced, which is more obvious in male.

关 键 词：肥胖症 大肠 腺瘤 病例对照研究 

分 类 号：R735[医药卫生—肿瘤] R589[医药卫生—临床医学]