肥胖、2型糖尿病与大肠腺瘤腺癌的相关性研究  

Correlation between obesity, type Ⅱ diabetes and colorectal neoplastic lesions

作　　者：冯娟[1] 左赞[1] 郭强[1] 

机构地区：[1]昆明医学院附属昆华医院云南省第一人民医院消化科,昆明650032

出　　处：《中华消化内镜杂志》2010年第7期356-359,共4页Chinese Journal of Digestive Endoscopy

基　　金：基金项目：云南省社会发展科技计划-社会事业发展专项项目资助（2009cA09）

摘　　要：目的 初步探讨体质量指数（BMI）、2型糖尿病与大肠腺瘤腺癌的相关性.方法 2008年7月至2009年7月间,选择年龄为20～86岁的大肠镜检查患者971例,测量身高、体重,并记录有无糖尿病及病程.根据肠镜检查及活检病理结果纳入研究组（即腺瘤腺癌组,总计471例）和正常对照组（500例）.利用多因素Logistic回归进行相关性分析.结果 调整了可能的混杂因素后,肥胖组患大肠腺瘤腺癌的危险度是正常组的2.55倍,其中肥胖组男性患大肠腺瘤腺癌的危险度是正常组的3.32倍,而女性中不同BMI指数大肠腺瘤腺癌的患病率差异无统计学意义.超重组差异无统计学意义.2型糖尿病的患者引起大肠腺瘤腺癌的危险度是无糖尿病患者的约2.10倍,其中,病程〈6年引起大肠腺瘤腺癌的危险度是病程≥6年的约3.00倍,且风险与性别无关.糖尿病合并肥胖患者患大肠腺瘤腺癌的危险度是糖尿病无合并肥胖患者的3.05倍.结论 肥胖与大肠腺瘤腺癌的发生显著相关,肥胖男性患病风险明显大于女性.2型糖尿病患者患大肠腺瘤腺癌的风险较高,且糖尿病合并肥胖的患者患大肠腺瘤腺癌的风险显著高于糖尿病无肥胖的患者.Objective To investigate the correlation between body mass index （ BMI） , type Ⅱ diabetes and colorectal neoplastic lesions including adenoma and adenocarcinoma. Methods A total of 971 subjects, aged 20-86, who underwent colonoscopy from July 2008 to July 2009 were included. The body height and weight were measured, and history of type Ⅱ diabetes was recorded. Based on the results of colonoscopy and pathology, the subjects were divided into study group （with confirmed adenoma or adenocarcinoma; n =471） and normal control group （n = 500）. All data were analyzed by using logistic multi-factors regression. Results With adjustment for some potential mixed factors, obesity group run 2. 55 times of risk of colorectal adenoma or adencarcinoma compared with the normal weight group （OR = 2.55, 95% CI： 1.26-3.05, P =0.027）, among which obese male＇s risk was 3. 32 （OR =3.32, 95% CI： 1. 50-6. 86, P = 0.007） times of that in normal weight males. There was no correlation between female＇s BMI and incidence of colorectal adenoma ＆ adencarcinoma. Patients with type Ⅱ diabetes ran 2. 10 times of risk of developing colorectal neoplastic lesions compared with those without （ OR = 2.10, 95% CI： 1. 25 - 3. 57, P = 0.010）. Incidence of colorectal adenoma ＆ adencarcinoma was 3 times higher in those with type II diabetes less than 6 years, compared with those with history more than 6 years （ OR = 3.00, 95% CI： 1.05 - 10. 86, P =0. 040）, which was not correlated with gender of diabetic patients. Those with both type Ⅱ diabetes and obesity had 3.05 times of risk of colorectal adenoma ＆ adencarcinoma, compared with non-obese diabetic patients （OR = 3.05,95% CI： 1.08 - 18.41, P - 0.041）. Conclusion Obesity is positively correlated with colorectal adenoma and adencarcinoma, and obese males run higher risk than females. Type Ⅱ diabetes also leads to a higher incidence of colorectal neoplastic lesions, which will run even higher when combined with o-besity.

关 键 词：肥胖症 糖尿病 2型 大肠腺瘤 大肠腺癌 

分 类 号：R735.34[医药卫生—肿瘤] R587.1[医药卫生—临床医学]