1.The impact of metabolic syndrome combined with high-sensitivity C-reactive protein on the risk of digestive system malignant tumors: a prospective cohort study
Jiaxing LI ; Kuan LIU ; Chao MA ; Wanchao WANG ; Yuan TIAN ; Taixian JIANG ; Zhigang DONG ; Wenqiang WEI ; Shouling WU ; Siqing LIU
Chinese Journal of Digestion 2025;45(2):73-81
Objective:To explore the correlation between metabolic syndrome (MS), serum high-sensitivity C-reactive protein (hs-CRP) levels, their combination and the risk of digestive system malignancies.Methods:A prospective cohort study was conducted in the participants from the Kailuan cohort who took health examination in July 2006. Anthropometric parameters, epidemiological information, and laboratory test results were collected. Incidence and mortality of digestive system malignant tumors were collected through biennial health examinations and questionnaires. The follow-up period ended on December 31, 2021.According to MS status and hs-CRP levels (hs-CRP≤3 or >3 mg/L), the cohort was divided into 4 groups, induding MS -hs-CRP -, MS -hs-CRP +, MS + hs-CRP -, and MS + hs-CRP + group. Chi-squared test, one analysis of variance, and the Kruskal-Wallis H test were used for inter-group comparison among groups. Kaplan-Meier method was used to calculate the cumulative incidence of digestive system malignant tumors, and log-rank test was performed to compare the cumulative incidence among groups. Multivariable Cox proportional hazards regression models were used to evaluate the effects of MS and hs-CRP levels on the overall risk of digestive system malignant tumors, as well as the effects of their combination on the risk of digestive system malignant tumors of different site, and relevant confounding factors were adjusted.A sensitivity analysis was conducted by excluding individuals diagnosed with digestive system malignancies within one year of follow-up, as well as those taking antihypertensive, antidiabetic, or lipid-lowering medications. Results:A total of 92 916 participants were included in this study. Among them, 57 933 cases were in the MS -hs-CRP - group, 10 949 cases in the MS -hs-CRP + group, 18 412 cases in the MS + hs-CRP - group, and 5 622 cases in the MS + hs-CRP + group.The median follow-up period was 15.01 years (14.66 to 15.20 years). By the end of follow-up, these were 1 992 cases of new-onset digestive system malignant tumors. The cumulative incidence rates of digestive system malignant tumors of MS -hs-CRP -, MS -hs-CRP +, MS + hs-CRP -, and MS + hs-CRP + groups were 2.0%(1 164/57 933), 2.3%(249/10 949), 2.4%(440/18 412), and 2.5%(139/5 622), respectively. The difference in the cumulative incidence among the 4 groups was statistically significant ( χ2=14.09, P=0.003).The results of multivariate Cox analysis showed that, after hs-CRP level and other confounding factors were adjusted, the risk of developing digestive system malignant tumors in participants with MS was 21.4% higher than that in those without MS ( HR=1.214 (95% confidence interval (95% CI): 1.086 to 1.340), P<0.001). After MS status and other confounding factors were adjusted, the risk of developing digestive system malignant tumors in participants with high hs-CRP level (>3 mg/L) was 17.2% higher than those with low hs-CRP level (≤3 mg/L) ( HR=1.172 (95% CI: 1.042 to 1.303), P=0.008). After relevant confounding factors were adjusted, the risks of developing digestive system malignant tumors in the MS -hs-CRP +, MS + hs-CRP -, and MS + hs-CRP + groups increased by 17.2%, 21.4%, and 35.9%, respectively, as compared with that of the MS -hs-CRP - group ( HR=1.172 (95% CI: 1.017 to 1.399), P=0.028; HR=1.214 (95% CI: 1.074 to 1.356), P=0.002; HR=1.359 (95% CI: 1.135 to 1.635), P=0.001). Among the 4 groups, the overall risk of developing digestive system malignant tumors of MS + hs-CRP + group was the highest. After relevant confounding factors were adjusted, the risks of colorectal cancer, liver cancer, and pancreatic cancer of the MS + hs-CRP + group increased by 46.2%, 35.7%, and 88.3%, respectively, as compared with those of the MS -hs-CRP - group ( HR=1.462 (95% CI: 1.088 to 1.956), HR=1.357 (95% CI: 1.132 to 2.089), HR=1.883 (95% CI: 1.052 to 3.342)), suggesting that MS combined with high hs-CRP was a significant risk factor for increased incidences of colorectal cancer, liver cancer, and pancreatic cancer ( P=0.012, 0.016 and 0.033). After participants diagnosed with new digestive system malignancies within one year of follow-up and those taking antihypertensive, antidiabetic, or lipid-lowering medications (108 cases, 10 680 cases, 2 344 cases, 906 cases) were excluded, the results of sensitivity analysis indicated the increased risk of digestive system malignant tumors in the MS -hs-CRP +, MS + hs-CRP -, and MS + hs-CRP + groups were 12.1%, 21.4%, 28.7%; 18.2%, 21.4%, 24.8%; 16.4%, 21.4%, 32.2%; 17.3%, 20.4%, 35.8%. Among the 3 groups, the increased risk of developing digestive system malignant tumors of MS + hs-CRP + group was the highest. Conclusion:MS and hs-CRP >3 mg/L are both independent risk factors for developing digestive system malignant tumors, and their combination further increases the risk of developing digestive system malignant tumors.
2.Current status and prospects of botulinum toxin type-A combined with platelet-rich plasma injection
Siqing WANG ; Ningjie CHEN ; Haitao WANG ; Qingpeng XU ; Doudou CHAI ; Shuang YAN
Chinese Journal of Medical Aesthetics and Cosmetology 2025;31(5):451-456
In recent years, botulinum toxin type-A (BTX-A) combined with cosmetic injections and radiofrequency lasers have been widely implemented to achieve better tissue repair. Among these therapies, platelet-rich plasma (PRP), rich in growth factors, has demonstrated notable efficacy in promoting tissue regeneration and repair. However, there is some controversy regarding the combined use of these two biomaterials in the treatment of various diseases. This review summarizes the current status of their combined application in peripheral neuropathic pain, seborrheic alopecia, and facial rejuvenation, also analyzes the advantages, interactions, and influencing factors of the combined application. Although the effectiveness and safety of PRP combined with BTX-A injection therapy in many of the above diseases are relatively high, the conclusion should still be carried out in the future multi-center, large-sample clinical studies to improve the credibility and representativeness of the results.
3.Risk assessment analysis of infectious disease prevention and control in schools of Shangcheng District, Hangzhou
YAO Ying, YU Kuangming, SUN Jiayi, JIANG Siqing, WANG Hui
Chinese Journal of School Health 2025;46(6):868-872
Objective:
To establish a risk assessment system for infectious disease prevention and control in schools in Shangcheng District, Hangzhou and determine risk levels for each school, and propose corresponding risk management measures, so as to provide a scientific reference for infectious disease prevention and control in primary and secondary schools.
Methods:
Based on the Failure Mode and Effects Analysis (FMEA) method, potential failure analysis and current situation investigation of infectious disease prevention and control risks were conducted in 110 primary and secondary schools from 2022 to 2024 in Shangcheng District, Hangzhou. Risk levels were classified using K-Means cluster analysis.
Results:
Through expert panel discussions using FMEA, 6 first level indicators and 28 second level indicators were identified. The top three risk priority numbers were implementation of required prevention and control measures for clustered infectious disease outbreaks in schools in the past three years ( 189.00 ), student morning/afternoon health checks (168.00), and reporting status of clustered infectious disease outbreaks in schools in the past three years (144.00). The comprehensive prevention scores of schools ranged from 61.00 to 98.00 (mean: 87.40 ). There were no statistically significant differences in the average scores(primary school: 88.17±7.39, nine year consistent education: 86.26±7.68, junior high school: 85.55±8.20, and high school: 88.72±4.91) and risk level distribution of schools with different educational stages( F/H=0.95,1.47, P >0.05).K-Means cluster analysis divided the schools into 5 risk levels with cluster centers at 93.25, 85.78, 79.69, 70.29, 61.00 ( F=309.21, P <0.05), with 80% of schools classified as low risk or below.
Conclusion
The infectious disease prevention and control risk assessment system for primary and secondary schools can be established, and hierarchical management can be conducted according to school risk levels, thereby improving the efficiency and effectiveness of school infectious disease prevention and control, and enhancing the precision and sustainability of prevention efforts.
4.Traditional Chinese Medicine Prevents and Treats Cerebral Ischemia-reperfusion Injury by Regulating Nrf2 Signaling Pathway: A Review
Siqing WU ; Jun WANG ; Mingsan MIAO ; Jinxin MIAO
Chinese Journal of Experimental Traditional Medical Formulae 2025;31(13):286-295
Cerebral ischemia-reperfusion injury (CIRI), a common cerebrovascular disease damage, has garnered increasing attention in the treatment of acute ischemic stroke. Restoration of blood flow and reperfusion to ischemic brain tissue is the key to treatment, while this process often triggers a variety of complex pathophysiological responses, such as oxidative stress, apoptosis, inflammation, mitochondrial dysfunction, angiogenic abnormalities, and disruption of the blood-brain barrier. These responses not only impede the recovery of neurological functions but also may lead to damage or even death of nerve cells, seriously affecting the neurological function and quality of survival of patients. As an important transcription factor, nuclear factor E2-related factor 2 (Nrf2) has the pharmacological effect of alleviating CIRI by regulating antioxidant, anti-apoptosis, anti-inflammation, mitochondrial function, angiogenesis, and blood-brain barrier pathways. This reveals the potential mechanism of traditional Chinese medicine (TCM) in intervening in CIRI and shows the potential of Nrf2 as a new pathway for dealing with ischemia stroke. This paper comprehensively analyzes the effects and mechanisms of active components and compound prescription of TCM in treating CIRI by modulating the Nrf2 signaling pathway, while pointing out the shortcomings of available studies and proposing a multidimensional exploration. This review aims to provide patients with more comprehensive, safe, and effective therapeutic regimens and improve the quality of survival and prognosis of patients. In addition, in-depth research on TCM should be promoted to reveal the potential mechanism for treating CIRI, providing new ideas and directions for the development of novel therapeutic drugs and methods.
5.Traditional Chinese Medicine Prevents and Treats Cerebral Ischemia-reperfusion Injury by Regulating Nrf2 Signaling Pathway: A Review
Siqing WU ; Jun WANG ; Mingsan MIAO ; Jinxin MIAO
Chinese Journal of Experimental Traditional Medical Formulae 2025;31(13):286-295
Cerebral ischemia-reperfusion injury (CIRI), a common cerebrovascular disease damage, has garnered increasing attention in the treatment of acute ischemic stroke. Restoration of blood flow and reperfusion to ischemic brain tissue is the key to treatment, while this process often triggers a variety of complex pathophysiological responses, such as oxidative stress, apoptosis, inflammation, mitochondrial dysfunction, angiogenic abnormalities, and disruption of the blood-brain barrier. These responses not only impede the recovery of neurological functions but also may lead to damage or even death of nerve cells, seriously affecting the neurological function and quality of survival of patients. As an important transcription factor, nuclear factor E2-related factor 2 (Nrf2) has the pharmacological effect of alleviating CIRI by regulating antioxidant, anti-apoptosis, anti-inflammation, mitochondrial function, angiogenesis, and blood-brain barrier pathways. This reveals the potential mechanism of traditional Chinese medicine (TCM) in intervening in CIRI and shows the potential of Nrf2 as a new pathway for dealing with ischemia stroke. This paper comprehensively analyzes the effects and mechanisms of active components and compound prescription of TCM in treating CIRI by modulating the Nrf2 signaling pathway, while pointing out the shortcomings of available studies and proposing a multidimensional exploration. This review aims to provide patients with more comprehensive, safe, and effective therapeutic regimens and improve the quality of survival and prognosis of patients. In addition, in-depth research on TCM should be promoted to reveal the potential mechanism for treating CIRI, providing new ideas and directions for the development of novel therapeutic drugs and methods.
6.Analysis of food poisoning event by type F Clostridium perfringens in a school
Chinese Journal of School Health 2025;46(10):1493-1497
Objective:
To understand the epidemiological and etiological characteristics of food poisoning event occurred in a school in Hangzhou, Zhejiang, so as to provide reference for the scientific management of related emergencies.
Methods:
By determining the nature of the event through epidemiological investigation, a case control study was carried out to spot suspicious food in May 2024. The hygienic investigation was conducted to find out possible pollution links and factors, patients and canteen practitioners anal swab, canteen retention samples, catering link daub and other specimens were collected ,for rapid pathogen screening. And the suspected pathogen Clostridium perfringens (CP) were isolated and identified according to the screening results, and toxin gene detection and whole genome sequencing and cluster analysis of CP isolated strains were carried out.
Results:
The incident resulted in 45 people experiencing gastrointestinal symptoms, such as diarrhea and abdominal pain. The suspicious food was tomato scrambled eggs and corn ribs provided by the student canteen for lunch on May 29. A hygiene investigation found that there was a risk of contamination in the food processing, preparation and storage. A total of 46 anal swabs and 10 canteen retention samples were positive for CP 16 S, 59 strains of CP were isolated from 27 samples, 10 cases and 1 practitioner isolate were positive for CPE ( cpe ) (F mode), and their whole genome evolution analysis was conducted based on the same source.
Conclusions
The food poisoning event is caused by CP infection carrying CPE ( cpe ) (F mode), and the possible sources of outbreak are the carriers of the CP by employees. It is recommended that cafeteria staff strengthen training on common foodborne diseases and conduct regular monitoring of pathogens.
7.Particulate matter exposure and end-stage renal disease risk in IgA nephropathy.
Yilin CHEN ; Huan ZHOU ; Siqing WANG ; Lingqiu DONG ; Yi TANG ; Wei QIN
Frontiers of Medicine 2025;19(5):855-864
Long-term exposure to particulate matter has been increasingly implicated in the progression of chronic kidney disease (CKD). However, its impact on IgA nephropathy (IgAN), a leading cause of end-stage renal disease (ESRD), remains unclear. A total of 1768 IgAN patients, confirmed by renal biopsy were included in this cohort study. Long-term exposure to PM2.5 and PM10 was assessed using high-resolution satellite-based data from the China High Air Pollutants (CHAP) dataset. Cox proportional hazards models were used to estimate the associations between PM2.5 or PM10 and ESRD risk, adjusting for demographic, clinical, and biochemical covariates. Over a median follow-up of 3.63 years, 209 participants progressed to ESRD. Higher exposure to both PM2.5 and PM10 was significantly associated with an increased risk, with hazard ratios of 1.62 and 1.36 per 10 µg/m3 increase, respectively. A nonlinear dose-response relationship was observed, with risk increasing markedly beyond threshold levels. Trajectory modeling of prebaseline exposure identified a subgroup with persistently high and fluctuating particulate matter exposure that showed the highest risk. This study provides strong evidence that prolonged exposure to ambient particulate matter contributes to renal disease progression in individuals with IgAN.
Humans
;
Glomerulonephritis, IGA/pathology*
;
Particulate Matter/adverse effects*
;
Male
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Female
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Kidney Failure, Chronic/epidemiology*
;
Adult
;
China/epidemiology*
;
Disease Progression
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Environmental Exposure/adverse effects*
;
Middle Aged
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Proportional Hazards Models
;
Risk Factors
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Air Pollutants/adverse effects*
;
Cohort Studies
8.Effects of KCNQ1OT1 on lipopolysaccharide-induced proliferation and osteogenic differentiation of human periodontal ligament stem cells by targeting miR-218
Siqing WANG ; Maoqi ZHANG ; Tingting HU ; Fang YE
Journal of China Medical University 2025;54(6):559-564
Objective To investigate the effects of the long noncoding RNA(lncRNA),KCNQ1 overlapping transcript 1(KCNQ1OT1),on lipopolysaccharide(LPS)-induced proliferation and osteogenic differentiation of human periodontal ligament stem cells(hPDLSCs)by targeting miR-218.Methods HPDLSCs were cultured in vitro and randomly assigned into hPDLSC,LPS,pcDNA-KCNQ1OT1,pcDN A,miR-218,or miR-NC groups.Cell proliferation and alizarin red staining of the cells were observed.The activity of alkaline phos-phatase,the expression of KCNQ1OT1 and miR-218,the levels of interleukin-1 β(IL-1β),interleukin-6(IL-6),and tumor necrosis factorα(TNF-α),and the expression of osteopontin(OPN),osteocalcin(OCN),Runt-related transcription factor 2(RUNX2),and bone morpho-genetic protein 2(BMP2)in cells were detected.A dual luciferase assay was performed to verify the relationship between KCNQ1OT1 and miR-218.Results Compared with the hPDLSC group,the cell proliferation rate,the alkaline phosphatase activity,and the expression of KCNQ1OT1,OPN,OCN,RUNX2,and BMP2 were significantly decreased,while the expression of miR-218 and the levels of IL-1β,IL-6,and TNF-α were significantly increased in the LPS group(P<0.05).Compared with the pcDNA-KCNQ1OT1 group,all the above indicators had the same trend in the miR-218 group(P<0.05).Compared with the LPS group,the cell proliferation rate,the alkaline phos-phatase activity,and the expression of KCNQ1OT1,OPN,OCN,RUNX2,and BMP2 were significantly increased,while the expression of miR-218 and the levels of IL-1β,IL-6,and TNF-α were significantly decreased in the pcDNA-KCNQ1OT1 group(P<0.05).There was a targeting relationship between KCNQ1OT1 and miR-218.The luciferase activity in the KCNQ1OT1-WT+miR-218 group was significantly lower than that in the KCNQ1OT1-WT+miR-NC group(P<0.05).Conclusion KCNQ1OT1 can downregulate miR-218 and promote LPS-induced proliferation and osteogenic differentiation of hPDLSCs.
9.The influence of diabetes mellitus and high-sensitivity C-reactive protein on the risk of diges-tive system malignancy: a prospective cohort study
Kuan LIU ; Jiaxing LI ; Chao MA ; Wanchao WANG ; Yuan TIAN ; Zhigang DONG ; Wenqiang WEI ; Shuohua CHEN ; Shouling WU ; Siqing LIU
Chinese Journal of Digestive Surgery 2025;24(1):93-102
Objective:To investigate the influence of diabetes mellitus (DM) and high-sen-sitivity C-reactive protein (Hs-CRP) on the risk of digestive system malignancy.Methods:The pro-spective cohort study was conducted. The clinical data of 93 928 participants who participated health examination in 9 hospitals at Tangshan, including Kailuan General Hospital Affiliated to North China University of Science and Technology et al, in 2006 were selected. According to the presence or absence of DM and the level of Hs-CRP, all participants were divided into 4 groups, including the DM(-)CRP(-) group defined as absence of DM and Hs-CRP ≤3 mg/L, the DM(-)CRP(+) group defined as absence of DM and Hs-CRP>3 mg/L, the DM(+)CRP(-) group defined as presence of DM and Hs-CRP ≤3 mg/L, and the DM(+)CRP(+) group defined as presence of DM and Hs-CRP >3 mg/L. The data of participants were collected by a fixed team of physicians. The first physical examination in 2006 was taken as the starting point for follow-up. The end event of follow-up was defined as the occurrence of digestive system malignancy or death, and the follow-up was up to December 31, 2021. Observation indicators: (1) comparison of clinical data among the 4 groups of participants; (2) the incidence and cumulative incidence rate of digestive system malignancy in participants; (3) influence of DM and Hs-CRP level on the risk of digestive system malignancy; (4) the combined influence of DM and Hs-CRP level on the risk of digestive system malignancy; (5) sensitivity analysis. Comparison of measurement data with normal distribution among multiple groups was conducted using the one-way analysis of variance. For pairwise comparison, least significant difference test was used for homogeneity of variance, and Dunnett′s T3 test was used for heterogeneity of variance. Comparison of measurement data with skewed distribution among multiple groups was conducted using the Kruskal-Wallis rank sum test, and Dunn-Bonferroni test was used for pairwise comparison. Comparison of count data among multiple groups was conducted using the chi-square test, and Bonferroni test was used among multiple comparisons. The Kaplan-Meier method was used to plot cumulative incidence curve, and Log-rank test was used for cumulative incidence rate analysis. The Cox proportional risk model was used for multivariate analysis. All models were adjusted for relevant confounders. Results:(1) Comparison of clinical data among the 4 groups of participants. Of the 93 928 participants, there were 70 743 cases in the DM(-)CRP(-) group, 14 644 cases in the DM(-)CRP(+) group, 6 425 cases in the DM(+)CRP(-) group, and 2 116 cases in the DM(+)CRP(+) group. There were significant differences in gender, age, fasting blood glucose, Hs-CRP, triglyceride, alanine aminotransferase, body mass index, marrital status, smoking, drinking, high school degree or above, physical exercise, high salt diet, high fat diet, positive hepatitis B virus surface antigen, fatty liver, liver cirrhosis, gallstone, taking hypoglycemic drugs, taking lipid-lowering drugs among the 4 groups of participants ( P<0.05). (2) The incidence and cumulative incidence rate of digestive system malignancy in participants. At the end-up of follow-up, 2 008 cases developed digestive system malignancy in the 93 928 participants, including 717 cases of colorectal cancer, 456 cases of liver cancer, 396 cases of gastric cancer, 195 cases of esophageal cancer, 144 cases of pancreatic cancer, 65 cases of gallbladder cancer or extrahepatic cholangiocarcinoma, 35 cases of small bowel cancer. The cumulative incidence rates of digestive system malignancy were 2.19%, 2.42%, 2.86%, 3.59% in participants of the DM(-)CRP(-) group, DM(-)CRP(+) group, DM(+)CRP(-) group, DM(+)CRP(+) group, respectively, showing a significant difference among the 4 groups ( χ2=31.72, P<0.05). (3) Influence of DM and Hs-CRP level on the risk of digestive system malignancy. After adjusting for the confounding factors of the participants, results of multivariate analysis showed that DM and Hs-CRP >3 mg/L were independent influencing factors for the incidence of digestive system malignancy ( hazard ratio=1.32, 1.19, 95% confidence interval as 1.13-1.56, 1.06-1.33, P<0.05). Futher analysis showed that there was a significant difference in interaction between DM and Hs-CRP >3 mg/L ( P<0.05). (4) The combined influence of DM and Hs-CRP level on the risk of digestive system malign-ancy. After adjusting for confounding factors, results of multivariate analysis showed that using the DM(-)CRP(-) group as the control group, the risk of incidence of digestive system malignancy increased in the DM(-)CRP(+) group, DM(+)CRP(-) group, and DM(+)CRP(+) group, respectively ( hazard ratio=1.14, 1.23, 1.79, 95% confidence interval as 1.01-1.29, 1.02-1.48, 1.38-2.31, P<0.05). In the site-specific analysis of digestive system malignancy, using the DM(-)CRP(-) group as the control group, the risk of incidence of liver cancer increased in the DM(-)CRP(+) group ( hazard ratio=1.37, 95% confidence interval as 1.07-1.75, P<0.05), the risk of incidence of liver cancer and pancrea-tic cancer increased in the DM(+)CRP(-) group ( hazard ratio=1.60, 1.74, 95% confidence interval as 1.16-2.21, 1.00-3.02, P<0.05), the risk of incidence of small bowel cancer, pancreatic cancer and colorectal cancer increased in the DM(+)CRP(+) group ( hazard ratio=5.05, 2.31, 2.23, 95% confidence interval as 1.57-16.21, 1.00-5.31, 1.54-3.24, P<0.05). (5) Sensitivity analysis. After adjusting for confounding factors of excluding 3 types of participants (103 cases of digestive system malignancy within 1 year of follow-up, 2 370 cases of taking glucose-lowering drugs, and 915 cases of taking lipid-lowering drugs), results of multivariate analysis showed that using the DM(-)CRP(-) group as the control group, the risk of incidence of digestive system malignancy increased in the DM(+)CRP(-) group, and DM(+)CRP(+) group, respectively ( hazard ratioexcluding cases of digestive system malignancy within 1 year of follow-up=1.26, 1.66, 95% confidence interval as 1.04-1.52, 1.26-2.18, P<0.05; hazard ratioexcluding cases taking glucose-lowering drugs=1.23, 1.75, 95% confidence interval as 1.02-1.49, 1.31-2.33, P<0.05; hazard ratioexcluding cases taking lipid-lowering drugs=1.24, 1.80, 95% confidence interval as 1.03-1.49, 1.39-2.34, P<0.05). Conclusions:DM and Hs-CRP >3 mg/L are independent influencing factors for the incidence of digestive system malignancy. There is an interation and synergistic effect between DM and Hs-CRP to promote the incidence of digestive system malignancy.
10.Predictive value of different obesity indicators for colorectal cancer in different sex populations
Chao MA ; Jiaxing LI ; Kuan LIU ; Wanchao WANG ; Yuan TIAN ; Taixian JIANG ; Zhigang DONG ; Wenqiang WEI ; Shouling WU ; Siqing LIU
Chinese Journal of Gastrointestinal Surgery 2025;28(1):75-80
Objective:To investigate the predictive value of different obesity indicators for colorectal cancer (CRC) risk in different gender populations.Methods:This observational study was conducted within the Kailuan Study (Registration Number: ChiCTR-TNC-11001489). From July 2006 to October 2007, a total of 101,510 employed and retired individuals underwent health examinations, including gastrointestinal disease screening, hematological tests, and questionnaires, at Kailuan General Hospital and its 10 affiliated hospitals. After excluding those with incomplete data, 93,606 participants were included in this study and divided into male (74 852) and female (18 754) groups. CRC incidence was collected through physical examinations and questionnaires every two years. Each participant's follow-up period began at the time of the questionnaire and ended upon CRC diagnosis, death, or December 31, 2021. Body Mass Index (BMI), waist circumference, waist-to-hip ratio (WHR), and waist-to-height ratio (WHtR) were quartiled (Q1, Q2, Q3, Q4), with Q1 serving as the control group. After adjusting for traditional risk factors such as age, total cholesterol, triglycerides, diabetes, hypertension, smoking status, alcohol consumption, and physical exercise, Cox regression models were used to calculate the correlations between BMI, waist circumference, WHR, WHtR, and CRC incidence in both male and female populations.Results:The age of all patients was (51±12) years, BMI was (25.06±3.49) kg/m 2, waist circumference was (86.94±9.97) cm, hip circumference was (97.30±8.81) cm, WHR was 0.89±0.07, and WHtR was 0.52±0.06.Female participants had significantly lower BMI, waist circumference, WHR, and WHtR compared to males, with statistically significant differences (all P<0.05). The mean follow-up duration for all participants was 15.01 (14.10±2.66) years, during which 718 CRC cases were identified, including 626 males (0.83%) and 92 females (0.49%). Cox proportional hazards models for males showed that CRC risk increased with waist circumference from Q3 (HR=1.43, 95%CI: 1.13-1.79, P=0.003) to Q4 (HR=1.45,95%CI: 1.14-1.82, P=0.002). Similarly, CRC risk increased with WHR from Q3 (HR=1.22, 95%CI: 1.01-1.53, P=0.007) to Q4 (HR=1.43, 95%CI: 1.14-1.79, P=0.002) and with WHtR from Q3 (HR=1.37, 95%CI: 1.08-1.74, P=0.009) to Q4 (HR=1.68, 95%CI: 1.33-2.12, P<0.001). For females, CRC risk increased with waist circumference from Q2 (HR=2.37, 95%CI: 1.20-4.67, P=0.012) to Q3 (HR=2.42, 95%CI: 1.21-4.84, P=0.013) but decreased in Q4 ( HR=2.08, 95%CI: 1.02-4.25, P=0.043). CRC risk increased significantly with WHR from Q2 (HR=2.20, 95%CI: 1.11-4.39, P=0.024) to Q3 (HR=2.89, 95%CI: 1.48-5.67, P=0.002) in females but was not statistically significant in Q4 ( P=0.074). Among females, CRC risk also increased significantly with WHtR in Q2 (HR=2.30, 95% CI: 1.16-4.56, P=0.017) and Q4 (HR=2.64, 95%CI: 1.32-5.29, P=0.006). There were no statistically significant differences in CRC risk associated with BMI in either male or female populations (both P>0.05). Conclusion:Waist circumference, WHR, and WHtR were better predictors of CRC risk than BMI in both male and female populations.


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