SAN ANTONIO (EGMN) – Overweight and obese adults had an increased risk of recurrent adenomas during short-term and long-term follow-up, based on data from patients with colorectal adenomas at baseline.
Previous studies have shown a short-term association between obesity and increased risk of adenoma recurrence, said Dr. Adeyinka Laiyemo of Howard University in Washington. To assess the long-term impact of overweight and obesity on adenoma risk, Dr. Laiyemo and colleagues reviewed data from participants in the Polyp Prevention Trial, a multicenter study of the effect of a low-fat, high-fiber diet on adenoma recurrence. The results were presented at the annual scientific meeting of the American College of Gastroenterology.
Upon completion of the 4-year (short-term) study, a subset of 760 participants agreed to continue in an extended, passive long-term follow-up without dietary restrictions. Their colonoscopy reports were analyzed for up to 12 years, with an average follow-up period of 8.4 years.
During the long-term follow-up, obese patients had a significant 20% increase in risk for any adenoma and a 25% nonsignificant increase in risk for an advanced adenoma, compared with patients of normal weight. Overweight patients had an 18% significant increase in risk of any adenoma and a 14% nonsignificant increase in risk of advanced adenoma, compared with normal-weight patients.
Analysis of the initial 4-year follow-up period also showed increased risk for participants with excess body weight. Obese patients had a 19% increase in risk for any adenoma and a 23% increase in risk for advanced adenoma compared with normal-weight patients, although neither of these were statistically significant. Overweight patients had a 23% significant increase in risk for any adenoma and a 18% nonsignificant increase in risk for advanced adenomas compared with normal-weight patients during the 4-year period.
The average age of the participants was 60 years, and 66% were men. Approximately 25% of the participants were of normal weight (body mass index less than 25 kg/m2), 50% were overweight (BMI of 25-29), and 25% were obese (BMI of 30 or higher).
“This suggests that lifestyle modification should be encouraged,” Dr. Laiyemo said. The study was strengthened by the inclusion of patients from eight different centers, but was limited by the lack of data on morbidly obese patients, he added.
More research is needed to determine whether overweight or obese patients with baseline polyps should be reexamined more frequently than normal-weight patients. For now, however, if these patients have baseline polyps, they need to know that their risk for recurrent adenomas is increased, Dr. Amy E. Foxx-Orenstein of the Mayo Clinic, Scottsdale, Arizona, said at a press conference.
Another message that patients need to hear is that a good prep is important, to get the best possible information from each colonoscopy, Dr. David A. Johnson of Eastern Virginia School of Medicine, Norfolk, said at the press conference.
Dr. Laiyemo had no financial conflicts to disclose.
Copyright (c) 2010 Elsevier Global Medical News. All rights reserved. This material may not be published, broadcast, rewritten, or redistributed.
圣安东尼奥(EGMN)——华盛顿霍华德大学Adeyinka Laiyemo博士在美国胃肠病学会科学年会上报告称，超重和肥胖的成人结直肠腺瘤患者短期和长期复发性腺瘤风险增加。
此前研究显示肥胖与短期腺瘤复发风险增加相关。为评估超重和肥胖对腺瘤风险的长期影响，Laiyemo博士及其同事对已完成4年（短期）研究的部分患者进行延长的、无饮食限制的被动长期随访。平均年龄为60岁，66%为男性。大约25%的患者为正常体重(BMI<25 kg/m2)，50%为超重(2 5≤BMI≤29)，25%为肥胖(BMI ≥30)。平均随访时间为8.4年，结肠镜报告分析长达12年。
结果显示，与正常体重患者相比，肥胖和超重患者在长期随访期间所有腺瘤风险分别显著增加20%和18%，进展期腺瘤风险分别非显著增加25%和14%。
对最初4年随访分析也显示超重与风险增加有关。与正常体重患者相比虽然无统计学意义，但肥胖患者所有腺瘤和进展期腺瘤风险分别增加19%和23%。而超重患者所有腺瘤风险显著增加23%，进展期腺瘤风险非显著增加18%。
研究表明，超重或肥胖息肉患者其腺瘤复发风险增加，应鼓励改变其生活方式，但是否应该接受更频繁的复查尚需更多的研究。
研究者无经济利益冲突声明。
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