Intest Res.  2019 Jul;17(3):404-412. 10.5217/ir.2018.00072.

Association of visceral adiposity and insulin resistance with colorectal adenoma and colorectal cancer

• Jung IS
• Shin CM
• Park SJ
• Park YS
• Yoon H
• Jo HJ
• Kim N
• Lee DH

• KMID: 2454749
• DOI: http://doi.org/10.5217/ir.2018.00072

Abstract

BACKGROUND/AIMS
To examine whether visceral adiposity serves as a risk factor for colorectal cancer (CRC) and colorectal adenomas.
METHODS
Two hundred healthy subjects, 200 patients with colorectal adenoma, and 151 patients with CRC (46 with early-stage and 105 with advanced-stage cancers) were enrolled at a tertiary referral hospital. All subjects underwent colonoscopy, and had laboratory data, and computed tomography (CT) scan available for abdominal fat measurement. An abdominal CT scan taken 1 to 4 years (mean interval, 20.6 months) before the diagnosis of CRC was also available in the 42 CRC patients.
RESULTS
The mean areas of visceral adipose tissue (VAT) areas in the control, adenoma, early- and advanced-stage CRC groups were 94.6, 116.8, 110.4, and 99.7 cm², respectively (P<0.001). The risk of adenoma positively correlated with VAT area and the visceral-to-total fat ratio (P for trend <0.01), but the risk of CRC did not (P>0.05). The risk of both adenoma and CRC positively correlated with fasting plasma glucose levels (P for trend <0.05). In patients with early-stage cancer (n=17), VAT area decreased when the CT scan at diagnosis was compared with that taken before the diagnosis of CRC, but superficial adipose tissue area did not, so visceral-to-total fat ratio significantly decreased (46.6% vs. 50.7%, respectively, P=0.018)
CONCLUSIONS
VAT area is related to the risk of colorectal adenoma. However, VAT decreases from the early stages of CRC. Impaired fasting glucose has a role in colorectal carcinogenesis.

Keyword

Adipose tissue; Intra-abdominal fat; Obesity; Colorectal neoplasms; Tomography, X-ray computed

MeSH Terms

Abdominal Fat
Adenoma*
Adipose Tissue
Adiposity*
Blood Glucose
Carcinogenesis
Colonoscopy
Colorectal Neoplasms*
Diagnosis
Fasting
Glucose
Healthy Volunteers
Humans
Insulin Resistance*
Insulin*
Intra-Abdominal Fat
Obesity
Risk Factors
Tertiary Care Centers
Tomography, X-Ray Computed
Glucose
Insulin

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