Premium
Racial Differences in Measures of Obesity and Risk of Colon Adenoma
Author(s) -
Thompson Cheryl L.,
Berger Nathan A.,
Chak Amitabh,
Li Li
Publication year - 2012
Publication title -
obesity
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.438
H-Index - 199
eISSN - 1930-739X
pISSN - 1930-7381
DOI - 10.1038/oby.2011.295
Subject(s) - medicine , waist , obesity , odds ratio , quartile , colorectal adenoma , confidence interval , body mass index , waist–hip ratio , risk factor , colorectal cancer , waist to height ratio , abdominal obesity , adenoma , endocrinology , gastroenterology , cancer
Obesity is an established risk factor for several malignancies. However, the specific measurement of obesity most relevant to colon neoplasia is still debated, and evidence has suggested gender and racial differences in this measurement. In this study, we sought to compare which measurement—BMI, waist circumference (WC), waist‐to‐hip ratio (WHR) or waist‐to‐height ratio (WHtR)—is most strongly associated with development of colon adenomas, a precursor of colon cancer, and to investigate differences in this association between racial groups. We confirmed the strong association between WHR, as a measure of central obesity, and development of colon neoplasia. In our overall analysis, patients in the highest WHR quartile showed a substantial increase in risk of colon adenomas compared to patients in the lowest WHR quartile (odds ratio (OR) = 1.82, 95% confidence interval (CI): 1.12–2.71, P trend = 0.0017). In stratified analyses, we noted that strongly associated obesity measures in European Americans were WC (OR = 2.38, 95% CI = 1.45–3.92, P trend = 0.0004) and BMI (OR = 2.18, 95% CI = 1.37–3.49, P trend = 0.0015), whereas in African Americans, WHR was the strongest and the only obesity measure statistically significantly associated with adenoma risk (OR = 2.12, 95% CI = 1.05–4.30, P trend = 0.025). Our data highlight the importance of obesity in the development of early colon neoplasia and suggest substantial racial differences in the measures of obesity most strongly associated with risk of colon adenomas.