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Increasing changes in visceral adiposity is associated with higher risk for colorectal adenoma: Multilevel analysis in a prospective cohort
Author(s) -
Moon Jung Min,
Im Jong Pil,
Kim Donghee,
Han Yoo Min,
Soh Hosim,
Song Ji Hyun,
Yang Sun Young,
Kim Young Sun,
Yim Jeong Yoon,
Lim Seon Hee,
Kim Joo Sung
Publication year - 2021
Publication title -
journal of gastroenterology and hepatology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.214
H-Index - 130
eISSN - 1440-1746
pISSN - 0815-9319
DOI - 10.1111/jgh.15364
Subject(s) - medicine , hazard ratio , colorectal adenoma , prospective cohort study , adenoma , quartile , colonoscopy , body mass index , confidence interval , gastroenterology , adipose tissue , longitudinal study , cohort study , intra abdominal fat , endocrinology , colorectal cancer , obesity , insulin resistance , visceral fat , pathology , cancer
Background and Aim While many studies demonstrated an association between visceral adiposity and colorectal adenoma (CRA), the effect of longitudinal changes in body fat composition on CRA is unclear. We investigated the longitudinal association between changes in visceral adiposity and CRA occurrence. Methods Between 2006 and 2018, 732 (62.8%) of the 1165 subjects in a prospective cohort voluntarily underwent follow‐up abdominal fat computed tomography and colonoscopy. We defined incident and recurrent CRA as adenoma detected at follow‐up colonoscopy from negative and positive adenoma at baseline colonoscopy, respectively. Multilevel survival analysis examined the longitudinal association between changes in visceral fat and CRA. Results During a median follow‐up of 7.4 years, 400 (54.6%) subjects developed CRA. In multivariable analysis, increasing changes in visceral adipose tissue (VAT) area were associated with higher risk of incident adenoma (hazard ratio [HR] 1.21, 95% confidence interval [CI] 1.00–1.46 for change per 10 cm 2 increase; HR 1.79, 95% CI 1.08–2.97 for highest vs lowest quartile, P values for trend = 0.045). Likewise, increasing changes in VAT area were independently associated with a higher risk of recurrent adenoma (HR 1.35, 95% CI 1.13–1.62 for change per 10 cm 2 increase; HR 1.62, 95% CI 1.04–2.52 for highest vs lowest quartile, P values for trend = 0.001). Changes in subcutaneous adipose tissue area were not independently associated with CRA. Conclusion Increasing changes in VAT area were longitudinally associated with a higher risk of incident and recurrent CRA, independent of risk factors, suggesting that visceral adiposity may be an important target in CRA prevention.