2009, Volume 15 No. 1

ARTICLE 1

Obesity and Risk of Colorectal Adenomatous Polyps: a Case-Control Study in Hospital Kuala Lumpur

Ramadas A¹, Kandiah M², Zarida H³, Yunus Gul AG⁴ & Faizal JA^4
1 School of Medicine and Health Sciences, Monash University, Sunway Campus, Bandar Sunway, Selangor, Malaysia
² Department of Nutrition and Dietetics, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, Serdang, Selangor, Malaysia
³ Department of Pathology, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, Serdang, Selangor, Malaysia
⁴ Department of Surgery, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, Hospital Kuala Lumpur, Malaysia

ABSTRACT
Colorectal adenomas are precursor lesions of colorectal cancer. Several studies have proposed that obesity is a risk factor for colorectal adenoma. This case-control study examined the relationship between body mass index (BMI), waist circumference, waistto-hip ratio (WHR), body fat percentage and colorectal adenomatous polyps (CRA) in patients who have had a colonoscopy at the Hospital Kuala Lumpur (HKL). Fifty-nine patients (42 males and 17 females) positively identified as having CRA and 59 polypfree subjects were recruited as controls (33 males and 26 females). A pre-tested questionnaire was used to collect socio-economic information, while anthropometric measurements were determined directly by established methods. The mean BMI of female case subjects was significantly higher than control females (25.63 + 4.87 kg/m2 vs. 23.86 + 3.70 kg/m2, p<0.05) but the difference in BMI was not significant in men. The mean WHR of male subjects was significantly higher in the case group (0.92 + 0.07 vs. 0.90 + 0.06, p<0.05). After adjusting for confounders, waist circumference was the only indicator that was found to significantly increase the risk for CRA in women (OR = 6.349, 95% CI = 1.063 – 37.919). Higher BMI, WHR and body fat percentage showed a non-significant risk in female subjects. In men, none of the obesity indicators were found to be significant risk factors for CRA. These findings suggest that abdominal obesity may be a contributing factor to CRA risk particularly in women. A prospective study is needed to confirm the role of obesity in the development of CRA in Malaysians.


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