J Bone Metab.  2019 Aug;26(3):161-167. 10.11005/jbm.2019.26.3.161.

Association between Colorectal Adenoma and Hand Grip Strength in the Elderly

• Moon JH
• Kim YJ
• Oh YH
• Kong MH
• Kim HJ

• KMID: 2457435
• DOI: http://doi.org/10.11005/jbm.2019.26.3.161

Abstract

BACKGROUND
Obesity is known as an important risk factor for colorectal adenoma. However, for the elderly with changes in body composition, reduced muscle, and increased fat, the body mass index (BMI), one of the most commonly used indicators of obesity, is limited in predicting a link to colorectal cancer. This study aimed to investigate the relationship between colorectal adenoma and grip strength that can predict muscle reduction in the elderly.
METHODS
This study included 262 participants aged ≥65 years who underwent medical examination between June 2015 and August 2018. The control group comprised participants with normal findings or hyperplasia and other benign lesions, except adenoma on colonoscopy, whereas the adenoma group consisted of participants with more than one adenoma. Grip strength was alternately measured twice for each hand using a hydraulic dynamometer.
RESULTS
The grip strength was statistically lower in the adenoma group than in the control group among women (P=0.042). For both sexes, grip strength was significantly lower in participants with ≥5 adenomas than in those with <5 adenomas (P=0.021, P=0.007). Similarly, men with large adenomas (≥7 mm) exhibited significantly lower grip strength than did those with small adenomas (<7 mm) (P=0.004). Even after correction for age, BMI, smoking status, alcohol consumption, exercise, insulin resistance, hypertension, and diabetes, the negative correlation between grip strength and number of adenomas among men and women remained (P=0.034, P=0.019).
CONCLUSIONS
A significant relationship between hand grip strength and number of colorectal adenomas was noted.

Keyword

Adenoma; Aged; Body composition; Hand strength

MeSH Terms

Adenoma*
Aged*
Alcohol Drinking
Body Composition
Body Mass Index
Colonoscopy
Colorectal Neoplasms
Female
Hand Strength*
Hand*
Humans
Hyperplasia
Hypertension
Insulin Resistance
Male
Obesity
Risk Factors
Smoke
Smoking
Smoke

Reference

1. Statistics Korea. 2017 Annual report on the causes of death statistics. Daejeon: Statistics Korea;2017.

2. Waye JD. Colon polyps: problems, promises, prospects. Am J Gastroenterol. 1986; 81:101–103.

3. Levine JS, Ahnen DJ. Clinical practice. Adenomatous polyps of the colon. N Engl J Med. 2006; 355:2551–2557.

4. Bardou M, Barkun AN, Martel M. Obesity and colorectal cancer. Gut. 2013; 62:933–947.

5. Ji JH, Park BJ, Park YS, et al. Clinicopathologic study of colorectal polyps and obesity in Korean adult. Korean J Gastroenterol. 2007; 49:10–16.

6. Moghaddam AA, Woodward M, Huxley R. Obesity and risk of colorectal cancer: a meta-analysis of 31 studies with 70,000 events. Cancer Epidemiol Biomarkers Prev. 2007; 16:2533–2547.

7. Kim KS, Moon HJ, Choi CH, et al. The frequency and risk factors of colorectal adenoma in health-check-up subjects in South Korea: Relationship to abdominal obesity and age. Gut Liver. 2010; 4:36–42.

8. Yoon JH, Kim J, Lee SY, et al. What is the most reliable obesity index in Korean elderly population? Korean J Obes. 2012; 21:140–147.

9. Newman AB, Lee JS, Visser M, et al. Weight change and the conservation of lean mass in old age: the Health, Aging and Body Composition Study. Am J Clin Nutr. 2005; 82:872–878. quiz 915-6.

10. Roubenoff R. Sarcopenic obesity: the confluence of two epidemics. Obes Res. 2004; 12:887–888.

11. Hughes VA, Frontera WR, Wood M, et al. Longitudinal muscle strength changes in older adults: influence of muscle mass, physical activity, and health. J Gerontol A Biol Sci Med Sci. 2001; 56:B209–B217.

12. Wu SW, Wu SF, Liang HW, et al. Measuring factors affecting grip strength in a Taiwan Chinese population and a comparison with consolidated norms. Appl Ergon. 2009; 40:811–815.

13. Chen L, Nelson DR, Zhao Y, et al. Relationship between muscle mass and muscle strength, and the impact of comorbidities: a population-based, cross-sectional study of older adults in the United States. BMC Geriatr. 2013; 13:74.

14. Ha YC, Yoo JI, Park YJ, et al. Measurement of uncertainty using standardized protocol of hand grip strength measurement in patients with sarcopenia. J Bone Metab. 2018; 25:243–249.

15. Jung YS, Kim NH, Ryu S, et al. Association between low relative muscle mass and the risk of colorectal neoplasms. J Clin Gastroenterol. 2017; 51:e83–e89.

16. Park YS, Kim JW, Kim BG, et al. Sarcopenia is associated with an increased risk of advanced colorectal neoplasia. Int J Colorectal Dis. 2017; 32:557–565.

17. Hong JT, Kim TJ, Pyo JH, et al. Impact of sarcopenia on the risk of advanced colorectal neoplasia. J Gastroenterol Hepatol. 2019; 34:162–168.

18. Roubenoff R, Parise H, Payette HA, et al. Cytokines, insulin-like growth factor 1, sarcopenia, and mortality in very old community-dwelling men and women: the Framingham Heart Study. Am J Med. 2003; 115:429–435.

19. Balkwill F, Charles KA, Mantovani A. Smoldering and polarized inflammation in the initiation and promotion of malignant disease. Cancer Cell. 2005; 7:211–217.

20. Oh HJ, Ryu KH, Park BJ, et al. Osteoporosis and osteoporotic fractures in gastrointestinal disease. J Bone Metab. 2018; 25:213–217.

21. Kim TN. Diverse abnormal body composition phenotypes: Interaction between muscle, fat, and bone. Korean J Obes. 2015; 24:9–16.

22. Renehan AG, Frystyk J, Flyvbjerg A. Obesity and cancer risk: the role of the insulin-IGF axis. Trends Endocrinol Metab. 2006; 17:328–336.

23. Cruz-Jentoft AJ, Bahat G, Bauer J, et al. Sarcopenia: revised European consensus on definition and diagnosis. Age Ageing. 2019; 48:16–31.

24. Chen LK, Liu LK, Woo J, et al. Sarcopenia in Asia: consensus report of the Asian Working Group for Sarcopenia. J Am Med Dir Assoc. 2014; 15:95–101.

25. Kim KM, Jang HC, Lim S. Differences among skeletal muscle mass indices derived from height-, weight-, and body mass index-adjusted models in assessing sarcopenia. Korean J Intern Med. 2016; 31:643–650.

26. Lee JH, Song CH, Yum KS, et al. Age associated changes in body mass index and body fat distribution. J Korean Acad Fam Med. 2003; 24:1010–1016.

27. Kim H. Age- and gender-related differences of muscle mass in Korean. Korean J Obes. 2012; 21:220–227.

28. Guerra RS, Amaral TF, Sousa AS, et al. Comparison of jamar and bodygrip dynamometers for handgrip strength measurement. J Strength Cond Res. 2017; 31:1931–1940.