BACKGROUND : Several large studies of obesity and the risk of adenomatous colorectal polyps have found no association among women but a reasonably consistent positive association among men. In women, a positive association that is stronger among or limited to those who are premenopausal has been suggested by studies that stratified analyses by age, although no previous study has examined the association according to menopausal status.
SUBJECTS AND METHODS : The risk of developing colorectal polyps was studied in 4, 053 of our female‘Human Dry Dock’subjects. They constitute a subset of 4, 053 (2, 476 premenopausal, 1, 577 postmenopausal) women originally examined from April 1998 to March 2004 and who underwent colonoscopy. Eligible women were 26-84 years old (mean age±SD : 48.1±7.9) and were free of invasive cancer, hyperplasia and familial polyposis. Adenomatous polyps were found in 235 (117 premenopausal, 118 postmenopausal) subjects but not in the remaining 3, 818 (2, 359 premenopausal, 1, 459 postmenopausal) subjects.
RESULTS : We found that obesity (body mass index : BMI ≥ 25) was associated with an approximately two-fold increased risk of colorectal polyps among premenopausal women compared with non-obese subjects (BMI < 25) (odds ratio 1.68, 95% confidence interval 1.18 - 2.53,
p = 0.01) . There was no association between obesity and colorectal polyps among postmenopausal women (
p = 0.89), and only a weak positive association in the entire cohort.
CONCLUSIONS : Our data suggest that obesity is associated with a two-fold increased risk of colorectal polyps in premenopausal women but not in postmenopausal women. Effect modification by menopausal status may better explain the inconsistent or weak findings in previous studies than the presumed lack of an association among women. These results should be confirmed by additional epidemiological studies.
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