Background: We aimed to evaluate the interaction between colorectal adenoma risks among asymptomatic individuals in terms of metabolic health status and obesity, and examine the normal waist-to-hip ratio (WHR) in adults with colorectal adenoma risk. Methods: A cross-sectional, retrospective study was conducted at MacKay Memorial Hospital involving 16,996 participants who underwent bidirectional gastrointestinal endoscopy between 2013 and 2023. The study recorded important clinicopathological characteristics, including age, body mass index and WHR, Framingham Risk Score (FRS), blood glucose level, andHelicobacter pylori(H. pylori) infection status. Results: Multivariate logistic regression analysis demonstrated that elevated hemoglobin A1C (HbA1c), increased FRS, positiveH. pyloriinfection, and WHR ≥ 0.9 are independent risk factors for colorectal adenoma. In examining the interaction between FRS and WHR using multivariate logistic regression to evaluate adenoma risk, the OR for the interaction term was 0.95, indicating a decline in adenoma risk when considering the interaction between these two factors. Incorporating HbA1c into the analysis, evaluating the interaction between FRS and WHR still demonstrated a statistically significant impact on adenoma risk (OR 0.96,p< 0.001). Participants with WHR < 0.9, elevated FRS, positiveH. pyloriinfection, and increased HbA1c levels were associated with a higher risk of colorectal adenoma formation. Remarkably, the increased risk of adenoma due to rising HbA1c levels was statistically significant only for those with a WHR < 0.9. Conclusions: An increase in FRS and HbA1c or a positiveH. pyloriinfection still warrants vigilance for colorectal adenoma risk when WHR is 0.9. These factors interacted with each other and were found to have a minimal decline in adenoma risk when considering the interaction between WHR and FRS.
背景：本研究旨在评估无症状个体中代谢健康状况与肥胖对结直肠腺瘤风险的交互作用，并探讨结直肠腺瘤风险人群中成年人的正常腰臀比（WHR）范围。方法：在马偕纪念医院开展了一项横断面回顾性研究，纳入了2013年至2023年间接受双向胃肠内镜检查的16,996名参与者。研究记录了重要的临床病理特征，包括年龄、体重指数、腰臀比、弗雷明汉风险评分（FRS）、血糖水平以及幽门螺杆菌（H. pylori）感染状态。结果：多因素逻辑回归分析显示，糖化血红蛋白（HbA1c）升高、FRS增加、幽门螺杆菌感染阳性以及WHR≥0.9是结直肠腺瘤的独立危险因素。通过多因素逻辑回归评估FRS与WHR交互作用对腺瘤风险的影响，交互项的比值比（OR）为0.95，表明在考虑这两个因素的交互作用时腺瘤风险有所下降。将HbA1c纳入分析后，评估FRS与WHR的交互作用仍显示对腺瘤风险具有统计学显著影响（OR 0.96，p<0.001）。WHR<0.9、FRS升高、幽门螺杆菌感染阳性以及HbA1c水平升高的参与者与较高的结直肠腺瘤形成风险相关。值得注意的是，HbA1c水平升高导致的腺瘤风险增加仅在WHR<0.9的人群中具有统计学显著性。结论：当WHR为0.9时，FRS和HbA1c升高或幽门螺杆菌感染阳性仍需警惕结直肠腺瘤风险。这些因素相互之间存在交互作用，在考虑WHR与FRS的交互作用时，腺瘤风险呈现轻微下降趋势。
肿瘤(癌症)患者之家