Relation Between Obesity, Type 2 Diabetes And Colorectal Adenoma, Colorectal Adencarcinoma

[Objective]:To investigate the relationship between obesity,type 2 diabetes and colorectal adenoma,colorectal adencarcinoma.[Methods]:A total of 971 subjects who underwent colonoscopy in The first people's hospital of Yunnan province from July 2008 to July 2009 were selected, body height, weight were measured, having or not having type 2 diabetes and the diagnosed duration were record.According to the colonoscopic and pathological result, we divided the 971 subjects into study group(adenoma, adencarcinoma group;n=471,include adenoma371 cases, adencarcinoma 73 cases, adencarcinoma and adenoma 17 cases) and normal control group(n=500). Among the total,male was 499 cases,female was 472 cases,≤35 aged group 160 cases,35-59 aged group 505 cases,≥60 aged group 306 cases.Otherwise we selected 60 patients who have diagnosed type 2 diabetes mellitus as subjects, the subjects wre classified as followe:study group which had adenoma or adencarcinoma,40 cases, control group which had not such findings,20 cases. Among the total,24 cases are male,36 cases are female. Type 2 diabetes diagnosed<6 years is 32 cases,duration in the≥6 years is 28 cases.All data were analyzed using logistic multi-factors regression.[Results]:Obesity is a independent risk factor to cause adenoma or adencarcinoma.The case rate of overweight group compared with normal-weight group showed no significant difference. After adjustment for some potential confounding factors, Obesity group experienced 2.55 fold increased risk(OR=2.55, 95% CI=1.26-3.05, P=0.027) of colorectal adenoma and adencarcinoma compared to the normal weight, in men the risk is 3.32(OR=3.32,95% CI=1.50-6.86, P= 0.007),in women the case rate based on BMI showed no significant difference. There was no association in overweight group. The type 2 diabetes patients experienced 2.10 fold increased risk(OR=2.10,95% CI=1.50-6.86, P=0.007) of colorectal adenoma and adencarcinoma compared to the none cases. Age is a risk factor for colorectal adenoma or adencarcinoma.The average age of adenoma and adencarcinoma group was ten year higher than the normal control group, the difference has statistical significance(P<0.01). The 35-59 aged group experienced 1.54 fold increased risk of colorectal adenoma and adencarcinoma compared to the≤35 group (95% CI=1.07-2.21, P=0.01). The≥60 aged group experienced 2.45 fold increased risk of colorectal adenoma and adencarcinoma compared to the≤35 group (95% CI=1.91-3.69, P= 0.011). The≥60 aged group experienced 1.62 fold increased risk of colorectal adenoma and adencarcinoma compared to the 35-59 group (95% CI=1.18-2.18, P =0.001).Type 2 diabetes is a independent risk factor to cause adenoma or adencarcinoma.Colorectal adenoma and adencarcinoma risk was higher among type 2 diabetes.And the risk especially higher among type 2 diabetes diagnosed<6 years, compared with type 2 diabetes of longer duration in the>6 years duration,OR=3.00(OR=3.00,95% CI=1.05-10.86, P=0.04); No different statistically significantly by sex. These patients had both type 2 diabetes and obesity experienced 3.05 fold increased risk(OR=3.05,95% CI=1.08-18.41, P=0.041) of colorectal adenoma and adencarcinoma compared to the patients had single factor.[Conclusion]:Obesity is positively associated with colorectal adenomas and adencarcinoma,the risk is highly increased in men. The type 2 diabetes have higher risk of colorectal adenomas and adencarcinoma. The old-aged cases have significantly higher risk of colorectal adenomas and adencarcinoma than the young group and middle-aged group. The type 2 diabetes merged obesity was significantly associated to an increased risk for colorectal adenomas and adencarcinoma.