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      Gender difference in metabolic syndrome and incident colorectal adenoma : A prospective observational study (KCIS No.42)

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          Abstract

          This community-based study aimed to elucidate whether there is a gender difference in the effect of metabolic syndrome (MetS) and its individual components on an elevated risk for incident colorectal adenoma.

          A prospective cohort study was conducted by enrolling 59,767 subjects aged 40 years or older between 2001 and 2009 in Keelung, Taiwan, to test this hypothesis, excluding those with a prior history of colorectal cancer and those with colorectal cancer diagnosed at the first screening. Cox proportional hazards regression models were used to assess the effect of MetS in terms of a dichotomous classification, each individual component and the number of components for males and females.

          Colorectal adenoma was present in 2.7% (n = 652) of male participants and 1.1% (n = 403) of female participants. The prevalence rate of MetS was 26.7% and 23.3% for males and females, respectively. The effect of MetS on colorectal adenoma was statistically significant and similar for the 2 genders, with an adjusted hazard ratio (aHR) of 1.33 (95% CI: 1.13–1.58) in males and 1.33 (95% CI: 1.06–1.66) in females after adjustment for confounders. However, MetS led to higher risk of advanced colorectal adenoma in men than in women. Regarding the effect of each component of MetS on colorectal adenoma, abnormal waist circumference and hypertriglyceridemia led to an elevated risk of colorectal adenoma in both genders. A rising risk of colorectal adenoma among females was noted in those with a moderately higher level of glycemia (100–125 mg/dL, aHR = 1.44, 95% CI: 1.12–1.85). Hypertriglyceridemia and high blood pressure were associated with an increased risk of advance colorectal adenoma in males.

          Both male and female subjects with MetS had a higher risk of colorectal adenoma. The contributions from individual components of MetS varied by gender. These findings suggest that the possible risk reduction of colorectal adenoma through metabolic syndrome-based lifestyle modifications may differ between genders.

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          Harmonizing the metabolic syndrome: a joint interim statement of the International Diabetes Federation Task Force on Epidemiology and Prevention; National Heart, Lung, and Blood Institute; American Heart Association; World Heart Federation; International Atherosclerosis Society; and International Association for the Study of Obesity.

          K Alberti, Robert H. Eckel, Scott M. Grundy … (2009)
          A cluster of risk factors for cardiovascular disease and type 2 diabetes mellitus, which occur together more often than by chance alone, have become known as the metabolic syndrome. The risk factors include raised blood pressure, dyslipidemia (raised triglycerides and lowered high-density lipoprotein cholesterol), raised fasting glucose, and central obesity. Various diagnostic criteria have been proposed by different organizations over the past decade. Most recently, these have come from the International Diabetes Federation and the American Heart Association/National Heart, Lung, and Blood Institute. The main difference concerns the measure for central obesity, with this being an obligatory component in the International Diabetes Federation definition, lower than in the American Heart Association/National Heart, Lung, and Blood Institute criteria, and ethnic specific. The present article represents the outcome of a meeting between several major organizations in an attempt to unify criteria. It was agreed that there should not be an obligatory component, but that waist measurement would continue to be a useful preliminary screening tool. Three abnormal findings out of 5 would qualify a person for the metabolic syndrome. A single set of cut points would be used for all components except waist circumference, for which further work is required. In the interim, national or regional cut points for waist circumference can be used.
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            Obesity and risk of colorectal cancer: a meta-analysis of 31 studies with 70,000 events.

            Alireza Moghaddam, Mark Woodward, Rachel Huxley (2007)
            Colorectal cancer is the second most common cause of death and illness in developed countries. Previous reviews have suggested that obesity may be associated with 30% to 60% greater risk of colorectal cancer, but little consideration was given to the possible effect of publication bias on the reported association. Relevant studies were identified through EMBASE and MEDLINE. Studies were included if they had published quantitative estimates of the association between general obesity [defined here as body mass index (BMI) > or = 30 kg/m(2)] and central obesity (measured using waist circumference) and colorectal cancer. Random-effects meta-analyses were done, involving 70,000 cases of incident colorectal cancer from 31 studies, of which 23 were cohort studies and 8 were case-control studies. After pooling and correcting for publication bias, the estimated relative risk of colorectal cancer was 1.19 [95% confidence interval (95% CI), 1.11-1.29], comparing obese (BMI > or = 30 kg/m(2)) with normal weight (BMI <25 kg/m(2)) people; and 1.45 (95% CI, 1.31-1.61), comparing those with the highest, to the lowest, level of central obesity. After correcting for publication bias, the risk of colorectal cancer was 1.41 (95% CI, 1.30-1.54) in men compared with 1.08 (95% CI, 0.98-1.18) for women (P(heterogeneity) <0.001). There was evidence of a dose-response relationship between BMI and colorectal cancer: for a 2 kg/m(2) increase in BMI, the risk of colorectal cancer increased by 7% (4-10%). For a 2-cm increase in waist circumference, the risk increased by 4% (2-5%). Obesity has a direct and independent relationship with colorectal cancer, although the strength of the association with general obesity is smaller than previously reported.
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              Association of Obesity With Risk of Early-Onset Colorectal Cancer Among Women

              Po-Hong Liu, Kana Wu, Kimmie Ng … (2018)
              Colorectal cancer (CRC) incidence and mortality among individuals younger than 50 years (early-onset CRC) are increasing. The reasons for such increases are largely unknown, although the increasing prevalence of obesity may be partially responsible.
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                Author and article information

                Journal
                Journal ID (nlm-ta): Medicine (Baltimore)
                Journal ID (iso-abbrev): Medicine (Baltimore)
                Journal ID (publisher-id): MEDI
                Title: Medicine
                Publisher: Lippincott Williams & Wilkins (Hagerstown, MD )
                ISSN (Print): 0025-7974
                ISSN (Electronic): 1536-5964
                Publication date Collection: 04 June 2021
                Publication date (Electronic): 04 June 2021
                Volume: 100
                Issue: 22
                Electronic Location Identifier: e26121
                Affiliations
                [a ]Institute of Environmental and Occupational Health Science, College of Public Health, National Taiwan University, Taipei
                [b ]Department of Health Care Management, College of Management, Chang Gung University, Taoyuan
                [c ]Division of Hepatogastroenterology, Department of Internal Medicine, Kaohsiung Chang Gung Memorial Hospital, Kaohsiung
                [d ]Institute of Epidemiology and Preventive Medicine, College of Public School
                [e ]Department of Internal Medicine, College of Medicine
                [f ]Innovation and Policy Center for Population Health and Sustainable Environment, College of Public Health, National Taiwan University
                [g ]Department of Medical Research, National Taiwan University Hospital
                [h ]School of Oral Hygiene, College of Oral Medicine
                [i ]TMU Research Center of Cancer Translational Medicine, Taipei Medical University, Taipei
                [j ]Department of Family Medicine, Far Eastern Memorial Hospital, New Taipei City, Taiwan.
                Author notes
                [∗ ]Correspondence: Chih-Dao Chen, Department of Family Medicine, Far Eastern Memorial Hospital, New Taipei City, Taiwan, No.21 Sector, 2 Nanya S Road, Banciao District, New Taipei City, Taiwan (e-mail: cdchen0815@ 123456gmail.com ).
                Article
                Publisher ID: MD-D-20-05675 Accession ID: 26121
                DOI: 10.1097/MD.0000000000026121
                PMC ID: 8183717
                PubMed ID: 34087861
                SO-VID: ae2a03f7-a822-43f6-a850-824a3c4d5fd1
                Copyright © Copyright © 2021 the Author(s). Published by Wolters Kluwer Health, Inc.
                License:

                This is an open access article distributed under the terms of the Creative Commons Attribution-Non Commercial License 4.0 (CCBY-NC), where it is permissible to download, share, remix, transform, and buildup the work provided it is properly cited. The work cannot be used commercially without permission from the journal. http://creativecommons.org/licenses/by-nc/4.0

                History
                Date received : 12 June 2020
                Date revision received : 18 April 2021
                Date accepted : 10 May 2021
                Categories
                Subject: 4400
                Subject: Research Article
                Subject: Observational Study
                Custom metadata
                OPEN-ACCESS TRUE

                Keywords: cohort studies,colorectal adenoma,metabolic syndrome
                Data availability:
                Keywords: cohort studies, colorectal adenoma, metabolic syndrome

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