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. 2020 Jun;7(1):e000400.
doi: 10.1136/bmjgast-2020-000400.

Visceral Adiposity Index is a predictor of incident colorectal cancer: a population-based longitudinal study

Takuro Okamura  1 , Yoshitaka Hashimoto  1 , Masahide Hamaguchi  2 , Akihiro Obora  3 , Takao Kojima  3 , Michiaki Fukui  1
Affiliations

Visceral Adiposity Index is a predictor of incident colorectal cancer: a population-based longitudinal study

Takuro Okamura et al. BMJ Open Gastroenterol. 2020 Jun.

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.

Keywords: colorectal cancer; epidemiology; obesity.

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Conflict of interest statement

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.

Figures

Figure 1
Figure 1
Study flow diagram for the registration of participants. HDL, high-density lipoprotein; NAGALA, NAfld in the Gifu Area, Longitudinal Analysis.
Figure 2
Figure 2
Kaplan-Meier analysis of incident colorectal cancer (CRC). Log-rank tests were used to determine the association among the Visceral Adiposity Index tertiles. Bonferroni correction was performed to correct familiar error, and a p value <0.0083 was considered significant. Compared with the lowest tertile, the highest tertile showed a significantly higher risk of incident CRC (p<0.001), and the middle tertile did not (p=0.562). Compared with the middle tertile, the highest tertile did not show a significantly higher risk of incident CRC (p=0.122).
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