RESEARCH ARTICLE
Metabolically-healthy obesity is associated with higher prevalence of colorectal adenoma Dong Hyun Sinn1, Yang Won Min1, Hee Jung Son1,2, Poong-Lyul Rhee1, Seung Woon Paik1, Sung Noh Hong1*, Geum-Youn Gwak1* 1 Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea, 2 Center for Health Promotion, Samsung Medical Center, Seoul, South Korea *
[email protected] (SNH);
[email protected] (GYG)
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OPEN ACCESS Citation: Sinn DH, Min YW, Son HJ, Rhee P-L, Paik SW, Hong SN, et al. (2017) Metabolically-healthy obesity is associated with higher prevalence of colorectal adenoma. PLoS ONE 12(6): e0179480. https://doi.org/10.1371/journal.pone.0179480 Editor: John Green, University Hospital Llandough, UNITED KINGDOM Received: February 13, 2017 Accepted: May 31, 2017 Published: June 21, 2017 Copyright: © 2017 Sinn et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. Data Availability Statement: By legal restrictions, it is mandatory to have approval for each specific case from the Samsung Medical Center Institutional Review Board, when providing raw data to third party. Anyone who want to request the data can contact directly to Samsung Medical Center Institutional Review Board or corresponding authors. Contact information: Samsung Medical Center Institutional Review Board, e-mail: hj0503.
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Abstract Background The risk of colorectal adenoma (CRA), an important precursor of colorectal cancer, is largely unknown among obese individuals without obesity-related metabolic abnormalities, a condition described as metabolically-healthy obese (MHO). The aim of this study was to examine the association among metabolic status, the different categories of body mass index (BMI), and CRA in a large cohort of adults.
Methods We analyzed the association among metabolic status, BMI categories and CRA in asymptomatic adults who underwent a first-time colonoscopy as part of the comprehensive health check-up program at the Health Promotion Center of Samsung Medical Center, from January 2005 to December 2012. Being metabolically healthy was defined as lacking any metabolic syndrome components and having a homeostasis model assessment of insulin resistance 1 criterion that made them ineligible for the study.
HOMA-IR, homeostasis model assessment of insulin resistance. https://doi.org/10.1371/journal.pone.0179480.t001
Measurement of variables During a comprehensive health check-up, demographic characteristics, smoking status, alcohol consumption, medical history, family history (including first-degree family history of CRC), and use of medications were collected through standardized, self-administered questionnaires (S1 and S2 Questionnaires). Smoking status was categorized into “never,” “former,” “current smoker,” or missing. Alcohol consumption was categorized as “no” or “yes,” according to the current drinking status. Height, weight and sitting blood pressure were measured by trained nurses. BMI was calculated as weight in kilograms, divided by height in meters, squared. BMI was classified according to Asian-specific criteria [14]: underweight, BMI
