Changes in Adult BMI and Waist Circumference Are Associated with Increased Risk of Advanced Colorectal Neoplasia

Wambui G. Gathirua-Mwangi, Patrick Monahan, Yiqing Song, Terrell W. Zollinger, Victoria Champion, Timothy E. Stump, Thomas Imperiale

Research output: Contribution to journalArticle

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Abstract

Background: Waist circumference (WC) is a stronger predictor of colon cancer (CRC) risk than body mass index (BMI). However, how well change in either WC or BMI predicts risk of advanced colorectal neoplasia (AN) is unclear. Aims: To determine the relationship between change in BMI and WC from early adulthood to later age and the risk of AN and which change measure is a stronger predictor. Methods: In 4500 adults, ages 50–80, with no previous neoplasia and undergoing screening colonoscopy, BMI and WC at age 21 and at time of screening were reported. Changes in BMI and WC were defined using universal risk cutoffs. Known CRC risk factors were controlled in the logistic models. Results: Overall, model statistics showed WC change (omnibus test χ2 = 10.15, 2 DF, p value = 0.006) was a statistically stronger predictor of AN than BMI change (omnibus test χ2 = 5.66, 5 DF, p value = 0.34). Independent of BMI change, participants who increased WC (OR 1.44; 95% CI 1.05–1.96) or maintained a high-risk WC (OR 2.50; 95% CI 1.38–4.53) at age 21 and at screening had an increased risk of AN compared to those with a low-risk WC. Study participants who were obese at age 21 and at screening had an increased risk of AN (OR 1.87; 95% CI 1.08–3.23) compared to those who maintained a healthy BMI. Maintaining an overweight BMI or increasing BMI was not associated with AN. Conclusions: Maintaining an unhealthy BMI and WC throughout adult life may increase risk of AN. WC change may be a better predictor of AN than BMI change.

Original languageEnglish (US)
Pages (from-to)1-9
Number of pages9
JournalDigestive Diseases and Sciences
DOIs
StateAccepted/In press - Oct 5 2017

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Waist Circumference
Body Mass Index
Neoplasms
Colonoscopy
Colonic Neoplasms
Logistic Models

Keywords

  • BMI change
  • Cancer
  • Colorectal neoplasia
  • Obesity
  • Precancerous polyps
  • Waist circumference change

ASJC Scopus subject areas

  • Physiology
  • Gastroenterology

Cite this

Changes in Adult BMI and Waist Circumference Are Associated with Increased Risk of Advanced Colorectal Neoplasia. / Gathirua-Mwangi, Wambui G.; Monahan, Patrick; Song, Yiqing; Zollinger, Terrell W.; Champion, Victoria; Stump, Timothy E.; Imperiale, Thomas.

In: Digestive Diseases and Sciences, 05.10.2017, p. 1-9.

Research output: Contribution to journalArticle

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title = "Changes in Adult BMI and Waist Circumference Are Associated with Increased Risk of Advanced Colorectal Neoplasia",
abstract = "Background: Waist circumference (WC) is a stronger predictor of colon cancer (CRC) risk than body mass index (BMI). However, how well change in either WC or BMI predicts risk of advanced colorectal neoplasia (AN) is unclear. Aims: To determine the relationship between change in BMI and WC from early adulthood to later age and the risk of AN and which change measure is a stronger predictor. Methods: In 4500 adults, ages 50–80, with no previous neoplasia and undergoing screening colonoscopy, BMI and WC at age 21 and at time of screening were reported. Changes in BMI and WC were defined using universal risk cutoffs. Known CRC risk factors were controlled in the logistic models. Results: Overall, model statistics showed WC change (omnibus test χ2 = 10.15, 2 DF, p value = 0.006) was a statistically stronger predictor of AN than BMI change (omnibus test χ2 = 5.66, 5 DF, p value = 0.34). Independent of BMI change, participants who increased WC (OR 1.44; 95{\%} CI 1.05–1.96) or maintained a high-risk WC (OR 2.50; 95{\%} CI 1.38–4.53) at age 21 and at screening had an increased risk of AN compared to those with a low-risk WC. Study participants who were obese at age 21 and at screening had an increased risk of AN (OR 1.87; 95{\%} CI 1.08–3.23) compared to those who maintained a healthy BMI. Maintaining an overweight BMI or increasing BMI was not associated with AN. Conclusions: Maintaining an unhealthy BMI and WC throughout adult life may increase risk of AN. WC change may be a better predictor of AN than BMI change.",
keywords = "BMI change, Cancer, Colorectal neoplasia, Obesity, Precancerous polyps, Waist circumference change",
author = "Gathirua-Mwangi, {Wambui G.} and Patrick Monahan and Yiqing Song and Zollinger, {Terrell W.} and Victoria Champion and Stump, {Timothy E.} and Thomas Imperiale",
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T1 - Changes in Adult BMI and Waist Circumference Are Associated with Increased Risk of Advanced Colorectal Neoplasia

AU - Gathirua-Mwangi, Wambui G.

AU - Monahan, Patrick

AU - Song, Yiqing

AU - Zollinger, Terrell W.

AU - Champion, Victoria

AU - Stump, Timothy E.

AU - Imperiale, Thomas

PY - 2017/10/5

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N2 - Background: Waist circumference (WC) is a stronger predictor of colon cancer (CRC) risk than body mass index (BMI). However, how well change in either WC or BMI predicts risk of advanced colorectal neoplasia (AN) is unclear. Aims: To determine the relationship between change in BMI and WC from early adulthood to later age and the risk of AN and which change measure is a stronger predictor. Methods: In 4500 adults, ages 50–80, with no previous neoplasia and undergoing screening colonoscopy, BMI and WC at age 21 and at time of screening were reported. Changes in BMI and WC were defined using universal risk cutoffs. Known CRC risk factors were controlled in the logistic models. Results: Overall, model statistics showed WC change (omnibus test χ2 = 10.15, 2 DF, p value = 0.006) was a statistically stronger predictor of AN than BMI change (omnibus test χ2 = 5.66, 5 DF, p value = 0.34). Independent of BMI change, participants who increased WC (OR 1.44; 95% CI 1.05–1.96) or maintained a high-risk WC (OR 2.50; 95% CI 1.38–4.53) at age 21 and at screening had an increased risk of AN compared to those with a low-risk WC. Study participants who were obese at age 21 and at screening had an increased risk of AN (OR 1.87; 95% CI 1.08–3.23) compared to those who maintained a healthy BMI. Maintaining an overweight BMI or increasing BMI was not associated with AN. Conclusions: Maintaining an unhealthy BMI and WC throughout adult life may increase risk of AN. WC change may be a better predictor of AN than BMI change.

AB - Background: Waist circumference (WC) is a stronger predictor of colon cancer (CRC) risk than body mass index (BMI). However, how well change in either WC or BMI predicts risk of advanced colorectal neoplasia (AN) is unclear. Aims: To determine the relationship between change in BMI and WC from early adulthood to later age and the risk of AN and which change measure is a stronger predictor. Methods: In 4500 adults, ages 50–80, with no previous neoplasia and undergoing screening colonoscopy, BMI and WC at age 21 and at time of screening were reported. Changes in BMI and WC were defined using universal risk cutoffs. Known CRC risk factors were controlled in the logistic models. Results: Overall, model statistics showed WC change (omnibus test χ2 = 10.15, 2 DF, p value = 0.006) was a statistically stronger predictor of AN than BMI change (omnibus test χ2 = 5.66, 5 DF, p value = 0.34). Independent of BMI change, participants who increased WC (OR 1.44; 95% CI 1.05–1.96) or maintained a high-risk WC (OR 2.50; 95% CI 1.38–4.53) at age 21 and at screening had an increased risk of AN compared to those with a low-risk WC. Study participants who were obese at age 21 and at screening had an increased risk of AN (OR 1.87; 95% CI 1.08–3.23) compared to those who maintained a healthy BMI. Maintaining an overweight BMI or increasing BMI was not associated with AN. Conclusions: Maintaining an unhealthy BMI and WC throughout adult life may increase risk of AN. WC change may be a better predictor of AN than BMI change.

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KW - Obesity

KW - Precancerous polyps

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