P2975 - Association of Obesity and Metabolic Determinants with Colonic Neoplasia in Latinx Populations: A Highlight of Sex-Based Differences

Robert Tamai, MD¹, Lillian Dawit, MD¹, Patrick Lee, MD, MS², Okeefe Simmons, MD³, Li Ding, MD, MPH², Liyun Yuan, MD^2
1Keck School of Medicine of the University of Southern California, Los Angeles, CA; ²University of Southern California, Los Angeles, CA; ³New York-Presbyterian/Weill Cornell Medical Center, New York, NY

Introduction: Obesity is a risk factor for colonic neoplasia. However, there are few data on the impact of sex and ethnicity on the association of metabolic determinants and risk of colonic neoplasia. The aim of this study was to investigate sex-based differences in metabolic determinants of advanced adenoma (AA) detection in Latinx patients after a positive fecal blood test (FBT).

Methods: We retrospectively reviewed data from a single safety-net hospital of asymptomatic Latinx patients at least 45 years of age who underwent colonoscopy after positive screening FBT from December 2016 to December 2020. Stratified by sex, patients without adenoma were compared to patients with AA. Patient demographics, metabolic characteristics, as well as colon polyp size and histology were recorded. Relative risk for AA (size>10mm, high-grade dysplasia, villous or tubulovillous histology) was assessed by multivariate logistical regression analyses, adjusted for covariates.

Results: Our cohort (N=672) had a mean age of 58.9 years and BMI of 31.2 kg/m², was 41% male, 64% with hypertension, 45% with diabetes, and had a mean LDL of 93.1 mg/dL. Colonoscopy identified AA in 16% (105/672) of patients. Females have a lower risk of AA than males [RR 0.475 (95% CI 0.322 – 0.701); p < 0.001]. BMI >34.9 [RR 1.835 (95% CI 1.148 – 2.935); p=0.01] and triglyceride level [per 10 unit increase, [RR 1.002 (95% CI 1.000 – 1.003); p=0.02] were associated with increased risk of AA. In males, BMI >34.9 [RR 1.833 (95% CI 1.140 – 2.946); p=0.01] was an independent risk factor for AA. In females, increased triglyceride level [RR 1.004 (95% CI 1.001 – 1.007); p=0.02] was an independent risk factor for AA.

Discussion: Latinx patients with a positive FBT were observed to have high incidences of obesity, diabetes, hypertension, dyslipidemia, and advanced adenoma. In our study, class II obesity (BMI ≥35) is a risk factor for AA in males, while elevated triglyceride level is a strong risk factors in females. Overall, females have a much lower risk for AA. Our data is based on the experience of our safety-net hospital in Los Angeles. Further studies are needed to assess and validate these findings in Latinx populations.

Table: Table 1. Multivariate logistical regression analyses of BMI and metabolic determinants on the risk of advanced colorectal adenoma on screening colonoscopy in Latinx patients with a positive FBT.


Disclosures:
Robert Tamai indicated no relevant financial relationships.
Lillian Dawit indicated no relevant financial relationships.
Patrick Lee indicated no relevant financial relationships.
Okeefe Simmons indicated no relevant financial relationships.
Li Ding: NIH – Grant/Research Support.
Liyun Yuan indicated no relevant financial relationships.


Robert Tamai, MD¹, Lillian Dawit, MD¹, Patrick Lee, MD, MS², Okeefe Simmons, MD³, Li Ding, MD, MPH², Liyun Yuan, MD². P2975 - Association of Obesity and Metabolic Determinants with Colonic Neoplasia in Latinx Populations: A Highlight of Sex-Based Differences, ACG 2021 Annual Scientific Meeting Abstracts. Las Vegas, Nevada: American College of Gastroenterology.