RESUMO
BACKGROUND: Cancer is one of the most common causes of death among morbidly obese individuals. Obese individuals have a well-documented increased risk of colon cancer. No guidelines are available for the workup of bariatric surgery patients in relation to colon cancer. METHODS: The indications for screening colonoscopy at the Bariatric and Metabolic Institute Abu Dhabi (BMI Abu Dhabi) include all patients older than 50 years [40 years if patients are United Arab Emirates (UAE) nationals] with unexplained abdominal symptoms, anemia of unknown cause, or a family or personal history of colonic pathology. This study retrospectively reviewed the charts of all the patients who had colonoscopy during the period January 2009 to January 2013. The patients were divided into two groups: group A [patients with a body mass index (BMI) > 30 kg/m(2)] and group B (patients with a BMI < 30 kg/m(2)). The demographics and the prevalence of polyps and cancer in the two groups were compared. RESULTS: During the study period, 341 colonoscopies were performed: 137 for patients with a BMI higher than 30 kg/m(2) (mean age, 44 years) and 204 for patients with a BMI lower than 30 kg/m(2) (mean age, 46 years) (P > 0.05). The overall prevalence of adenomatous polyps was 6.74 % and that of cancer was 1.75 %. Further analysis showed that the prevalences of adenomatous polyps and cancer were respectively 12.4 and 2.1 % for the patients with a BMI higher than 30 kg/m(2), whereas the prevalences were respectively 2.9 and 0.9 % for the patients with BMI lower than 30 kg/m(2) (P < 0.001). CONCLUSION: The risk for the development of colonic adenomatous polyps and cancer is high among young obese individuals in the Middle East. Guidelines are needed to establish criteria for screening in this group of individuals.
Assuntos
Cirurgia Bariátrica , Neoplasias do Colo/epidemiologia , Pólipos do Colo/epidemiologia , Colonoscopia/estatística & dados numéricos , Programas de Rastreamento/métodos , Guias de Prática Clínica como Assunto , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Índice de Massa Corporal , Neoplasias do Colo/complicações , Neoplasias do Colo/diagnóstico , Pólipos do Colo/complicações , Pólipos do Colo/diagnóstico , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Obesidade Mórbida/complicações , Prevalência , Estudos Retrospectivos , Fatores de Risco , Emirados Árabes Unidos/epidemiologia , Adulto JovemRESUMO
BACKGROUND: Leptin is a hormone mainly produced by adipose tissue. It acts on both energy intake and expenditure to maintain relative stability of body weight and energy storage over long period of time. Variation in size of the tetranucleotide repeat located at the 3' end of leptin gene (LEP3'HVR) can influence leptin expression. OBJECTIVES: To predict the association of LEP3'HVR and obesity. MATERIALS AND METHODS: A case control study consisting of 40 individuals with normal BMI (control group) and 35 individuals with abnormal BMI. LEP3'HVR polymorphic region was amplified by polymerase chain reaction, and fragments were analyzed by agarose gel electrophoresis. Statistical analysis was done using SPSS (SPSS, Chicago, Ill). RESULTS: The frequency of LEP3'HVR class I was 52.8% in individuals with abnormal BMI versus 42.5% in the individuals with normal BMI. The homozygous class I (I/I) genotype was identified in 40% of the individuals with abnormal BMI vs 25% of the control group. Individuals with I/I genotypes showed a higher prevalence of obesity when compared with homozygous class II/II genotype (odds ratio, 1.9; 95% confidence interval, 0.6-5.6). CONCLUSION: Class (I/I) genotype of LEP3'HVR was associated with increase risk of obesity.
