定量CT评估内脏脂肪及皮下脂肪与结直肠腺瘤的相关性

Correlation between visceral adipose tissue and colorectal adenoma assessed by quantitative CT

目的 应用定量CT评估腹部内脏脂肪(VAT)及皮下脂肪(SAT),探讨腹部脂肪分布与结直肠腺瘤的相关性。方法 回顾性收集佛山市第一人民医院2022年1月~2023年7月经病理确诊的100例结直肠腺瘤患者作为腺瘤组,又将腺瘤分为早期腺瘤(n=36)和进展型腺瘤(n=64),之后收集我院同期的无腺瘤健康人群158例作为正常组,收集基本临床资料并运用定量CT测量腹部L2/3椎间隙水平的VAT及SAT面积。分别比较腺瘤组与正常组、不同病理类型腺瘤组的脂肪分布情况,采用Logistic回归分析评估VAT、SAT与结直肠腺瘤发病风险的相关性。结果 腺瘤组的VAT面积高于正常组(P=0.015),而SAT的差异无统计学意义(P>0.05);进展型腺瘤组VAT面积高于早期腺瘤(P=0.021)。Logistic回归分析显示,年龄、高血脂、BMI、VAT及VAT肥胖为结直肠腺瘤发生的独立危险因素(OR=2.044、1.325、1.147、1.895、2.185,P<0.05)。结论 VAT与结直肠腺瘤的发病存在一定联系,VAT越高,发生腺瘤的风险可能也越高,也更有可能演变成进展期腺瘤,而SAT与腺瘤的发生则无必然联系。

Objective To evaluate abdominal visceral fat(VAT)and subcutaneous fat(SAT)by quantitative CT,and to explore the correlation between abdominal fat distribution and colorectal adenoma.Methods A total of 100 patients with colorectal adenoma diagnosed by pathology in Foshan First People's Hospital from January 2022 to July 2023 were retrospectively collected as the adenoma group.The adenomas were divided into early adenomas(n=36)and advanced adenomas(n=64).Then,158 healthy people without adenoma in our hospital during the same period were collected as the normal group.Basic clinical data were collected,and quantitative CT was used to measure the VAT and SAT areas at the L2/3 intervertebral space level in the abdomen.The fat distribution of the adenoma group was compared with the normal group and the adenoma groups of different pathological types.Logistic regression analysis was used to evaluate the correlation between VAT,SAT and the risk of colorectal adenoma.Results The VAT area of the adenoma group was higher than that of the normal group(P=0.015),while the difference in SAT was not statistically significant(P>0.05),the VAT area of the advanced adenoma group was higher than that of the early adenoma(P=0.021).Logistic regression analysis showed.Age,hyperlipidemia,BMI,VAT and VAT obesity were independent risk factors for colorectal adenoma(OR=2.044,1.325,1.147,1.895,2.185,P<0.05).Conclusion VAT is associated with the incidence of colorectal adenoma.The higher VAT,the higher risk of adenoma and more likely it is to develop into advanced adenoma.However,SAT is not necessarily associated with the occurrence of adenoma.