Dataset Information

Metabolic health is a determining factor for incident colorectal cancer in the obese population: A nationwide population-based cohort study.

ABSTRACT:

Background

The association of the risk of colorectal cancer (CRC) with obesity or obesity-induced metabolic disturbances remains controversial. We assessed the association of metabolic health status with incident CRC among subjects with obesity.

Methods

This study included 319,397 subjects from the Korean National Health Insurance Service-National Health Screening Cohort. Transitions in metabolic health status and obesity were examined during 2009-2010 and 2011-2012. We categorized subjects with obesity into four separate groups according to their dynamic metabolic health status: metabolically healthy obesity (MHO), MHO to metabolically unhealthy obesity (MUO), MUO to MHO, and stable MUO. Subjects were followed up from 2009 to 2015 for incident CRC.

Results

The stable MHO group showed no increased risk of incident CRC (hazard ratio [HR], 0.97; 95% confidence interval [CI], 0.83-1.14). However, the MHO to MUO group had a higher risk of incident CRC than the stable metabolically healthy nonobese (MHNO) group (HR, 1.34; 95% CI, 1.15-1.57). Among patients with MUO at baseline, those in the subgroup who transitioned to MHO group were not at increased risk of CRC (HR, 1.06; 95% CI, 0.91-1.25), whereas those who remained in the stable MUO group had a higher risk of incident CRC than those in the stable MHNO group (HR, 1.29; 95% CI, 1.19-1.41).

Conclusions

The transition of metabolic health was a determining factor for CRC among subjects with obesity. Hence, maintenance or recovery of metabolic health should be addressed to prevent CRC in individuals with obesity.

SUBMITTER: Cho YK

PROVIDER: S-EPMC7826459 | biostudies-literature | 2021 Jan

REPOSITORIES: biostudies-literature

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Publications

Metabolic health is a determining factor for incident colorectal cancer in the obese population: A nationwide population-based cohort study.

Cho Yun Kyung YK Lee Jiwoo J Kim Hwi Seung HS Park Joong-Yeol JY Lee Woo Je WJ Kim Ye-Jee YJ Jung Chang Hee CH

Cancer medicine 20201120 1

<h4>Background</h4>The association of the risk of colorectal cancer (CRC) with obesity or obesity-induced metabolic disturbances remains controversial. We assessed the association of metabolic health status with incident CRC among subjects with obesity.<h4>Methods</h4>This study included 319,397 subjects from the Korean National Health Insurance Service-National Health Screening Cohort. Transitions in metabolic health status and obesity were examined during 2009-2010 and 2011-2012. We categorize ...[more]

PMID: 33216467

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Project description:BackgroundThe association between metabolic syndrome and increased cardiovascular disease (CVD) risk is well-established. However, in patients with incident CVD, the relationship between obesity, metabolic health, and subsequent CVD and mortality outcomes are less well-established. This study investigated the association between body mass index (BMI), metabolic health and the risk of subsequent cardiovascular mortality and morbidity outcomes in patients with incident CVD events.MethodsThis cohort study identified 130 685 patients from the nationwide Clinical Practice Research Datalink (CPRD GOLD) and Hospital Episode Statistics (HES) databases in the United Kingdom. Patients were ≥18 years with incident CVD [coronary heart disease (CHD), stroke, or peripheral vascular disease (PVD)] between 1 January 1998 and 31 December 2017. BMI (in kg/m2 ) was categorized as underweight (<18.5), normal (18.5-24.9), overweight (25.0-29.9) and obese (≥30). Within each BMI category, patients were grouped by increasing count of 1, 2 or 3 metabolic risk factors [RF] (dyslipidaemia, diabetes mellitus and hypertension) and were regarded as metabolically unhealthy while absence of these factors was considered metabolically healthy (MH). Multivariable Cox regression was used to assess the risk (hazard ratio with 95% confidence interval) of subsequent outcomes (non-fatal CHD, stroke, PVD, incident heart failure, CVD-mortality and all-cause mortality) in BMI subgroups with incremental count of metabolic RFs.ResultsDuring a median follow-up of 13.0 years, a higher BMI was associated with reduced risk for stroke, PVD, CVD-mortality and all-cause mortality within each metabolic risk category, while increasing metabolic RFs within each BMI subgroup accounted for increasing risks. When compared with patients with normal BMI and no RF, CVD-mortality risk in overweight patients with no RF was 0.76 (0.70-0.84), and in obese patients with no RF was 0.85 (0.76-0.96). The respective risk for all-cause mortality in patients with overweight and no RF was 0.69 (0.65-0.72), and in obese patients with no RF was 0.75 (0.70-0.79). Subsequent outcomes of stroke and PVD showed similar trends. In contrast, the risk of subsequent non-fatal CHD events and incident HF increased with higher BMI and with incremental metabolic risk factors within each BMI category. Underweight was constantly associated with increased risk for all outcomes regardless of the presence of metabolic RFs except for non-fatal CHD events.ConclusionsIn patients with incident CVD, overweight and obesity were related to a more favourable prognosis for subsequent stroke, PVD and mortality (CVD-related and all-cause) irrespective of the presence of other metabolic risk factors.

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Dataset Information

Metabolic health is a determining factor for incident colorectal cancer in the obese population: A nationwide population-based cohort study.

Background

Methods

Results

Conclusions

Publications

Metabolic health is a determining factor for incident colorectal cancer in the obese population: A nationwide population-based cohort study.

Similar Datasets

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