RESUMO
INTRODUCTION: XSome authors have assessed the link between obesity and colon adenoma risk. Moreover, it has been reported that obesity could increase the risk of proximal adenoma development. Accordingly, obese patients may have a distinctive pattern of adenoma recurrence. AIM: To determine whether metachronous adenoma features differ between obese and non-obese subjects submitted to colonoscopy surveillance. MATERIALS AND METHODS: We prospectively evaluated all patients over 18 years old that underwent surveillance colonoscopy at our institution between June 2013 and June 2014. Date of prior colonoscopy was registered. A body mass index ≥ 30 was used to define obesity. Analysis looking for variables significantly associated with metachronous adenoma was performed. Metachronous adenoma rate was compared between obese and non-obese subjects, as well as size, location, morphological and histopathological characteristics. RESULTS: Overall, 825 subjects were enrolled. Median time of surveillance colonoscopy was 38.9 months. Obesity was statistically more frequent in those subjects with metachronous adenomas (40% vs 25.71%, p < 0.001). On multivariate analysis, obesity [OR 1.7 (1.01-2.9)] and age [OR 1.02 (1-1.05)] were independently associated with metachronous adenoma presence. Obesity was also significantly associated with a higher risk of right colon adenomas [OR 2.4 (1.76-3.26)] and advanced adenoma [OR 1.99 (1.29-3.06)]. The risk is significantly higher in men and in those with a family history of colorectal cancer/adenoma. CONCLUSION: Obesity was associated with a higher risk of metachronous adenomas on surveillance colonoscopy. A higher risk of right-sided lesions and advanced adenomas was also found in this population.
Assuntos
Adenoma/etiologia , Neoplasias do Colo/etiologia , Obesidade/complicações , Adulto , Idoso , Idoso de 80 Anos ou mais , Índice de Massa Corporal , Colonoscopia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Análise Multivariada , Estudos Prospectivos , Fatores de RiscoRESUMO
BACKGROUND: - Previous evidence trying to assess the risk of celiac disease among dyspeptic patients has been inconclusive, showing in some cases notorious discrepancies. OBJECTIVE: - To determine the prevalence of celiac disease in patients with dyspepsia compared to healthy controls without dyspepsia. METHODS: - Adult patients under evaluation for dyspepsia were invited to participate. These patients were offered an upper gastrointestinal endoscopy with duodenal biopsies. On the other hand, asymptomatic adult volunteers who performed a preventive visit to their primary care physician were invited to participate and agreed to undertake an upper gastrointestinal endoscopy with duodenal biopsies as well. Those patients with histologic signs of villous atrophy were furtherly evaluated and serological tests were performed in order to determine celiac disease diagnosis. Celiac disease prevalence was compared between groups. RESULTS: - Overall, 320 patients with dyspepsia and 320 healthy controls were recruited. There were no significant differences in terms of gender or age between groups. Celiac disease diagnosis was made in 1.25% (4/320) of patients in the dyspepsia group versus 0.62% (2/320) in the control group. CONCLUSION: - Patients with dyspepsia who underwent routine duodenal biopsies did not show an increased risk for celiac disease when compared to healthy individuals.
Assuntos
Doença Celíaca/diagnóstico , Dispepsia/complicações , Adulto , Estudos de Casos e Controles , Doença Celíaca/complicações , Duodenoscopia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Prevalência , Estudos ProspectivosRESUMO
ABSTRACT BACKGROUND Previous evidence trying to assess the risk of celiac disease among dyspeptic patients has been inconclusive, showing in some cases notorious discrepancies. OBJECTIVE To determine the prevalence of celiac disease in patients with dyspepsia compared to healthy controls without dyspepsia. METHODS Adult patients under evaluation for dyspepsia were invited to participate. These patients were offered an upper gastrointestinal endoscopy with duodenal biopsies. On the other hand, asymptomatic adult volunteers who performed a preventive visit to their primary care physician were invited to participate and agreed to undertake an upper gastrointestinal endoscopy with duodenal biopsies as well. Those patients with histologic signs of villous atrophy were furtherly evaluated and serological tests were performed in order to determine celiac disease diagnosis. Celiac disease prevalence was compared between groups. RESULTS Overall, 320 patients with dyspepsia and 320 healthy controls were recruited. There were no significant differences in terms of gender or age between groups. Celiac disease diagnosis was made in 1.25% (4/320) of patients in the dyspepsia group versus 0.62% (2/320) in the control group. CONCLUSION Patients with dyspepsia who underwent routine duodenal biopsies did not show an increased risk for celiac disease when compared to healthy individuals.
RESUMO CONTEXTO As evidências ao avaliar o risco da doença celíaca entre pacientes dispéptico têm sido inconclusivas, mostrando discrepâncias notórias em alguns casos. OBJETIVO Determinar a prevalência da doença celíaca em pacientes com dispepsia em comparação com controles saudáveis sem dispepsia. MÉTODOS Pacientes adultos sob avaliação para dispepsia foram convidados a participar. A estes pacientes foi oferecida uma endoscopia digestiva com biópsias duodenais. Por outro lado, voluntários adultos assintomáticos, que realizaram uma visita preventiva ao seu médico de atenção primária foram convidados a participar e concordaram em realizar endoscopia digestiva com biópsias duodenais também. Naqueles pacientes com sinais histológicos de atrofia das vilosidades foram melhor avaliados e foram realizados testes sorológicos para determinar o diagnóstico de doença celíaca. A prevalência de doença celíaca foi comparada entre os grupos. RESULTADOS No total, 320 pacientes com dispepsia e 320 controles saudáveis foram recrutados. Não houve nenhuma diferença significativa entre os grupos em termos de sexo ou idade. O diagnóstico de doença celíaca foi feito em 1,25% (4/320) dos pacientes no grupo de dispepsia, contra 0,62% (2/320) no grupo controle. CONCLUSÃO Pacientes com dispepsia submetidos a biópsias duodenais de rotina não têm risco aumentado para a doença celíaca quando comparados com indivíduos saudáveis.