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Abstract
Objective The Visceral Adiposity Index (VAI) is a marker of visceral fat accumulation and dysfunction. We aimed to investigate the association between VAI and incident colorectal cancer (CRC).
Design In this historical cohort study of 27 921 (16 434 men and 11 487 women) participants, we divided the participants into tertiles according to VAI. We calculated VAI: men, VAI = (waist circumference (WC)/(39.68+1.88 × body mass index (BMI))) × (triglycerides (TG)/1.03) × (1.31/high-density lipoprotein cholesterol (HDL)); women, VAI = (WC/(36.58+1.89 × BMI)) × (TG/0.81) × (1.52/HDL). We performed Cox proportional hazard models, adjusting for sex, age, smoking, alcohol consumption, exercise, haemoglobin A1c and systolic blood pressure.
Results During the median 4.4-year follow-up, 116 participants developed CRC. Compared with the lowest tertile, the HRs of incident CRC in the middle and the highest tertiles were 1.30 (95% CI 0.76 to 2.28, p=0.338) and 2.41 (1.50 to 4.02, p<0.001) in univariate analysis. Moreover, the HRs of incident CRC in the middle and the highest tertiles were 1.27 (0.73 to 2.23, p=0.396) and 1.98 (1.15 to 3.39, p=0.013) after adjusting for covariates.
Conclusions VAI can be a predictor of incident CRC. For early detection, we should encourage people with high VAI to undergo screening for CRC.
- colorectal cancer
- epidemiology
- obesity
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Footnotes
Contributors TO contributed to the data research and analyses and wrote the manuscript. YH originated and designed the study, analysed the data and reviewed the manuscript for intellectual content. MH contributed to data research and the manuscript organisation and reviewed and edited the manuscript. AO and TK contributed to originate the study, data research and contributed to the discussion. MF analysed the data and reviewed and edited the manuscript. MH is the guarantor of this work and, as such, had full access to all of the data in the study and takes responsibility for the integrity of the data and the accuracy of the data analysis. All authors were involved in the writing of the manuscript and approved the manuscript’s final version.
Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.
Competing interests YH received grants from Asahi Kasei Corporation outside the submitted work. MF received grants from AstraZeneca, Astellas Pharma, Nippon Boehringer Ingelheim Co., Daiichi Sankyo Co., Eli Lilly Japan K.K., Kyowa Hakko Kirin Co., Kissei Pharmaceutical Co., MSD K.K., Mitsubishi Tanabe Pharma Corp., Novo Nordisk Pharma, Sanwa Kagaku Kenkyusho Co., Sanofi K.K., Ono Pharmaceutical Co., and Takeda Pharmaceutical Co., outside the submitted work. The sponsors were not involved in the study design; in the collection, analysis, interpretation of data; in the writing of this manuscript; or in the decision to submit the article for publication. The authors, their immediate families, and any research foundations with which they are affiliated have not received any financial payments or other benefits from any commercial entity related to the subject of this article. The authors declare that although they are affiliated with a department that is supported financially by pharmaceutical company, the authors received no current funding for this study, and this does not alter their adherence to all the journal policies on sharing data and materials.
Patient consent for publication Not required.
Ethics approval The present study was approved by Asahi University Hospital’s Ethics Committee and was based on Declaration of Helsinki. Approval number is 2018-09-01.
Provenance and peer review Not commissioned; externally peer reviewed.
Data availability statement The datasets during and/or analysed during the current study available from the corresponding author on reasonable request.