Abdominal obesity as the colorectal adenomas risk factor
Keywords:Colonoscopy, Polyps Colon, Obesity, BMI
Obesity is a risk factor for many diseases, including colorectal cancer. Aim: to study association of the constitutional features (height, weight, waist circumference) with detection of colon polyps on the screening colonoscopy.
Materials and methods: Constitutional features (height, weight, waist circumference) of 145 patients were assessed with detection of colon polyps on the screening colonoscopy for the period from 2013to 2015. Exclusion criteria were: cancer of any location in history, surgery within the past two years, the inflammatory bowel diseases (Crohn's disease, ulcerative colitis), autoimmune diseases (rheumatoid arthritis, HIV, AIDS, SLE), diabetes, chronic liver or kidney disease, family polyposis.
Results: the presence of adenomas (OR = 6.0 CI: 2,2-16,7); multiplicity of polyps (the possibility that there will be ≥ 3 polyps was 6.4, CI: 1,4-29,9) were significantly higher in obese patients than in those with normal weight. Subjects with a waist circumference in the highest tertile (>115 cm), were 4.6 times more likely to identify ≥ 3 polyps than those with waist circumference in the lowest tertile (<96 cm) . The probability of detection of adenomas in patients with a waist circumference in the highest tertile were 6.2 times higher than in the lowest tertile.
Conclusions. Visceral obesity is associated with a morphological type and number of colon polyps. The presence of visceral obesity significantly increases the risk of colon adenomas. Increased visceral fat layer is an indication for colonoscopy especially of the right half of the colon examination. Screening colonoscopy should be recommended for the obese patients after 50 y.o. in order to diagnose adenomas of the colon and colorectal cancer.
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