Yun Kyung Cho1, Jiwoo Lee2, Hwi Seung Kim2, Joong-Yeol Park2, Woo Je Lee2, Ye-Jee Kim3, Chang Hee Jung2. 1. Department of Internal Medicine, Hallym University Sacred Heart Hospital, Hallym University College of Medicine, Anyang, Republic of Korea. 2. Department of Internal Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea. 3. Department of Clinical Epidemiology and Biostatistics, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea.
Abstract
BACKGROUND: The association of the risk of colorectal cancer (CRC) with obesity or obesity-induced metabolic disturbances remains controversial. We assessed the association of metabolic health status with incident CRC among subjects with obesity. METHODS: This study included 319,397 subjects from the Korean National Health Insurance Service-National Health Screening Cohort. Transitions in metabolic health status and obesity were examined during 2009-2010 and 2011-2012. We categorized subjects with obesity into four separate groups according to their dynamic metabolic health status: metabolically healthy obesity (MHO), MHO to metabolically unhealthy obesity (MUO), MUO to MHO, and stable MUO. Subjects were followed up from 2009 to 2015 for incident CRC. RESULTS: The stable MHO group showed no increased risk of incident CRC (hazard ratio [HR], 0.97; 95% confidence interval [CI], 0.83-1.14). However, the MHO to MUO group had a higher risk of incident CRC than the stable metabolically healthy nonobese (MHNO) group (HR, 1.34; 95% CI, 1.15-1.57). Among patients with MUO at baseline, those in the subgroup who transitioned to MHO group were not at increased risk of CRC (HR, 1.06; 95% CI, 0.91-1.25), whereas those who remained in the stable MUO group had a higher risk of incident CRC than those in the stable MHNO group (HR, 1.29; 95% CI, 1.19-1.41). CONCLUSIONS: The transition of metabolic health was a determining factor for CRC among subjects with obesity. Hence, maintenance or recovery of metabolic health should be addressed to prevent CRC in individuals with obesity.
BACKGROUND: The association of the risk of colorectal cancer (CRC) with obesity or obesity-induced metabolic disturbances remains controversial. We assessed the association of metabolic health status with incident CRC among subjects with obesity. METHODS: This study included 319,397 subjects from the Korean National Health Insurance Service-National Health Screening Cohort. Transitions in metabolic health status and obesity were examined during 2009-2010 and 2011-2012. We categorized subjects with obesity into four separate groups according to their dynamic metabolic health status: metabolically healthy obesity (MHO), MHO to metabolically unhealthy obesity (MUO), MUO to MHO, and stable MUO. Subjects were followed up from 2009 to 2015 for incident CRC. RESULTS: The stable MHO group showed no increased risk of incident CRC (hazard ratio [HR], 0.97; 95% confidence interval [CI], 0.83-1.14). However, the MHO to MUO group had a higher risk of incident CRC than the stable metabolically healthy nonobese (MHNO) group (HR, 1.34; 95% CI, 1.15-1.57). Among patients with MUO at baseline, those in the subgroup who transitioned to MHO group were not at increased risk of CRC (HR, 1.06; 95% CI, 0.91-1.25), whereas those who remained in the stable MUO group had a higher risk of incident CRC than those in the stable MHNO group (HR, 1.29; 95% CI, 1.19-1.41). CONCLUSIONS: The transition of metabolic health was a determining factor for CRC among subjects with obesity. Hence, maintenance or recovery of metabolic health should be addressed to prevent CRC in individuals with obesity.
Authors: Tanja Stocks; Annekatrin Lukanova; Tone Bjørge; Hanno Ulmer; Jonas Manjer; Martin Almquist; Hans Concin; Anders Engeland; Göran Hallmans; Gabriele Nagel; Steinar Tretli; Marit B Veierød; Håkan Jonsson; Pär Stattin Journal: Cancer Date: 2010-12-17 Impact factor: 6.860
Authors: D Samocha-Bonet; V D Dixit; C R Kahn; R L Leibel; X Lin; M Nieuwdorp; K H Pietiläinen; R Rabasa-Lhoret; M Roden; P E Scherer; S Klein; E Ravussin Journal: Obes Rev Date: 2014-07-25 Impact factor: 9.213
Authors: Daphne P Guh; Wei Zhang; Nick Bansback; Zubin Amarsi; C Laird Birmingham; Aslam H Anis Journal: BMC Public Health Date: 2009-03-25 Impact factor: 3.295
Authors: Neil Murphy; Amanda J Cross; Mustapha Abubakar; Mazda Jenab; Krasimira Aleksandrova; Marie-Christine Boutron-Ruault; Laure Dossus; Antoine Racine; Tilman Kühn; Verena A Katzke; Anne Tjønneland; Kristina E N Petersen; Kim Overvad; J Ramón Quirós; Paula Jakszyn; Esther Molina-Montes; Miren Dorronsoro; José-María Huerta; Aurelio Barricarte; Kay-Tee Khaw; Nick Wareham; Ruth C Travis; Antonia Trichopoulou; Pagona Lagiou; Dimitrios Trichopoulos; Giovanna Masala; Vittorio Krogh; Rosario Tumino; Paolo Vineis; Salvatore Panico; H Bas Bueno-de-Mesquita; Peter D Siersema; Petra H Peeters; Bodil Ohlsson; Ulrika Ericson; Richard Palmqvist; Hanna Nyström; Elisabete Weiderpass; Guri Skeie; Heinz Freisling; So Yeon Kong; Kostas Tsilidis; David C Muller; Elio Riboli; Marc J Gunter Journal: PLoS Med Date: 2016-04-05 Impact factor: 11.069