Does high body fatness increase the risk of presence and growth of colorectal adenomas followed up in situ for 3 years?

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Abstract
Obesity is an increasing problem for industrialized nations. The incidence of colorectal cancer has also risen during the last decades. However, information is scarce about the association between the colorectal cancer precursors, adenomatous polyps, and body composition. Our aim was to find out if body fatness is related to the presence of polyps and of growth of adenomas of < or =9 mm observed in situ over 3 yr. Twenty-eight outpatients with colorectal polyps and 50-75 yr of age were compared with 34 sex- and age-matched (+/-5 yr) polyp-free healthy controls. The polyp patients were randomly selected from a double blind 3-yr placebo-controlled endoscopic follow-up and intervention study against growth and recurrence of polyps among 116 polyp-bearing outpatients. Triceps skinfold thickness (TSF) was measured by a Harpenden caliper and total body fat percentage (BF%) by Futrex 5000. Dietary intake was calculated in a 5-day dietary record by weighing. Demograpic data, including smoking and alcohol habits, were registered by an interview and self-administrated questionnaires. Weight and height were measured. TSF and BF% ranked 66% of the individuals into the same quartiles, and 34% were ranked into the adjacent quartiles. The coefficient of correlation between TSF and BF% was highly significant (r = 0.90, p < 0.01, n = 62). TSF, BF%, and body mass index (kg/m2) did not differ between polyp patients and controls in either crude or adjusted analyses. Adenoma growth was, however, highly associated with increasing levels of TSF (p = 0.004), BF% (p = 0.02), and body mass index (p = 0.006). Our data suggest that high body fatness is a promoter of adenoma growth. Similar results were obtained with the caliper and Futrex 5000, which lends credibility to this study. For repeated documentation, a larger study population should be investigated. To our knowledge, this is the first case-control study to investigate the relationship between body composition and growth of adenoma by follow-up in situ over 3 yr.