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Changes in Abdominal Obesity Affect the Risk of Metachronous Advanced Colorectal Neoplasia Development after Polypectomy

Yonsei Medical Journal 2020년 61권 7호 p.579 ~ 586
정윤석 ( Jung Yoon-Suk ) - Sungkyunkwan University School of Medicine Kangbuk Samsung Hospital Department of Internal Medicine

김남희 ( Kim Nam-Hee ) - Sungkyunkwan University School of Medicine Kangbuk Samsung Hospital Department of Internal Medicine
박정호 ( Park Jung-Ho ) - Sungkyunkwan University School of Medicine Kangbuk Samsung Hospital Department of Internal Medicine
박동일 ( Park Dong-Il ) - Sungkyunkwan University School of Medicine Kangbuk Samsung Hospital Department of Internal Medicine
손정일 ( Sohn Chong-Il ) - Sungkyunkwan University School of Medicine Kangbuk Samsung Hospital Department of Internal Medicine

Abstract


Purpose: The impact of changes in body mass index and waist circumference on the development of metachronous colorectal neoplasia (CRN) after polypectomy has rarely been examined. We evaluated the association between changes in overall/abdominal obesity and metachronous CRN risk.

Materials and Methods: We studied patients who underwent ≥1 adenoma removal and surveillance colonoscopy. Patients were classified into the following four groups based on the changes in overall obesity from index to follow-up colonoscopy: non-obesity persisted (group 1), obesity to non-obesity (group 2), non-obesity to obesity (group 3), and obesity persisted (group 4). Patients were also divided into another four groups based on similar changes in abdominal obesity (groups 5?8).

Results: The number of patients in groups 1, 2, 3, and 4 was 5074, 457, 643, and 3538, respectively, and that in groups 5, 6, 7, and 8 was 4229, 538, 656, and 2189, respectively. Group 4 had a significantly higher risk of metachronous CRN compared to groups 1 and 2. However, metachronous advanced CRN (ACRN) risk was not different among groups 1, 2, 3, and 4. Metachronous CRN risk in group 8 (abdominal obesity persisted) was higher than that in groups 5 (non-abdominal obesity persisted) and 7 (non-abdominal obesity to abdominal obesity), and tended to be higher than that in group 6 (abdominal obesity to non-abdominal obesity). Additionally, group 8 had a significantly higher risk of metachronous ACRN compared to groups 5, 6, and 7.

Conclusion: Changes in obesity affected the metachronous CRN risk. In particular, changes in abdominal obesity affected the metachronous ACRN risk.

키워드

Metachronous advanced colorectal neoplasia; waist circumference; obesity
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