腹部脂肪分布与结直肠息肉的相关性

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摘要目的：研究腹部脂肪组织分布等因素与结直肠息肉发生的相关性，为结直肠息肉的病因研究和建立有效的预防控制措施提供临床依据。方法：以回顾性病例对照研究方法分析330例结直肠息肉患者与546例对照患者，采用多排螺旋CT与MATLAB2013软件测定其腹部内脏脂肪组织（VAT）、皮下脂肪组织（SAT）、总脂肪组织（TAT）、内脏脂肪比率（VAT/TAT）水平，并检测血脂水平，分别比较息肉组与对照组、不同病理类型息肉组、不同大小及个数息肉组、不同性别息肉组与对照组的脂肪分布情况。结果：息肉组与对照组间VAT、VAT/TAT、BMI差异有统计学意义（P＜0.01），不同息肉病理类型组间、不同息肉大小及不同个数息肉组间的VAT、SAT分布差异无统计学意义（P＞0.05）。多因素分析显示，男性高VAT（OR=2.544，95%CI：1.551～4.173）与VAT/TAT（OR=2.103，95%CI：1.262～3.516）是结直肠息肉发生的危险因素（P＜0.05），而SAT、BMI、血脂与结直肠息肉发生无明显相关性（P＞0.05）。在女性人群中，息肉组与对照组间的VAT与SAT差异均无统计学意义（P＞0.05）。结论：VAT与SAT与结直肠息肉的病理类型、数量、大小无关。女性结直肠息肉发生与VAT和SAT均无关。男性SAT与结直肠息肉发生无关，但内脏型肥胖与结直肠息肉的发生密切相关。

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	叶骅骏
	徐含烟
	蒋学佩
	何茜茜
	黄智铭

关键词 ：结直肠息肉, 脂肪组织, 内脏脂肪面积

Abstract：Objective: To investigate the correlation between distribution of adipose tissue and the risk of colorectal polyps and to provide clinical evidence for the etiology of colorectal polyps and building efficient prophylactic measures. Methods: 330 patients with colorectal polyps (Polyps group) and 546 controls without colorectal polyps (non-polyp group) were retrospectively analyzed. All subjects underwent computerized tomography (CT). With the MATLAB2013 analysis software and obesity was evaluated by visceral adipose tissue (VAT), subcutaneous adipose tissue (SAT), total adipose tissue (TAT), VAT/TAT, body mass index (BMI). The obesity between different gender, different pathological type, different number of polyp, different size of polyp was compared. Results: There were significant differences in the VAT, VAT/TAT and BMI between polyps group and non-polyp group. There were no significant differences in the levels of VAT, SAT, VAT/TAT between colorectal polyps with different pathological type, size and number (P>0.05). Multivariate analysis showed a higher VAT (OR=2.544, 95%CI: 1.551-4.173) and VAT/TAT (OR=2.103, 95%CI: 1.262-3.516) were independently associated with the risk of colorectal polyps in male (P<0.05), while no significant difference in female (P>0.05). Conclusion: VAT and SAT are not correlated with the pathological type, size and number of colorectal polyps. VAT and SAT are not correlated with colorectal polyps in female. Visceral adiposity measured by VAT, VAT/TAT is associated with an increased risk of colorectal polyps in male, while the SAT is not associated with the risk of colorectal polyps in male.

Key words： colorectal polyps adipose tissue visceral adipose tissue

收稿日期: 2017-06-30

基金资助:国家自然科学基金资助项目（81570495）。

通讯作者: 黄智铭，主任医师，Email：wyyyhzhiming@126.com

作者简介: 叶骅骏（1990-），男，浙江温州人，住院医师，硕士

链接本文:

https://xb.wmu.edu.cn/CN/ 或 https://xb.wmu.edu.cn/CN/Y2018/V48/I7/490

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