AIM To identify the factors influencing cecal insertion time(CIT) and to evaluate the effect of obesity indices on CIT. METHODS We retrospectively reviewed the data for participants who received both colonoscopy and a...AIM To identify the factors influencing cecal insertion time(CIT) and to evaluate the effect of obesity indices on CIT. METHODS We retrospectively reviewed the data for participants who received both colonoscopy and abdominal computed tomography(CT) from February 2008 to May 2008 as part of a comprehensive health screening program. Age, gender, obesity indices [body mass index(BMI), waist-to-hip circumference ratio(WHR), waist circumference(WC), visceral adipose tissue(VAT)volume and subcutaneous adipose tissue(SAT) volume on abdominal CT], history of prior abdominal surgery, constipation, experience of the colonoscopist, quality of bowel preparation, diverticulosis and time required to reach the cecum were analyzed. CIT was categorized as longer than 10 min(prolonged CIT) and shorter than or equal to 10 min, and then the factors that required a CIT longer than 10 min were examined.RESULTS A total of 1678 participants were enrolled. The mean age was 50.42 ± 9.931 years and 60.3% were men. The mean BMI, WHR, WC, VAT volume and SAT volume were 23.92 ± 2.964 kg/m2, 0.90 ± 0.076, 86.95 ± 8.030 cm, 905.29 ± 475.220 cm3 and 1707.72 ± 576.550 cm3, respectively. The number of patients who underwent abdominal surgery was 268(16.0%). Colonoscopy was performed by an attending physician alone in 61.9% of cases and with the involvement of a fellow in 38.1% of cases. The median CIT was 7 min(range 2-56 min, IQR 5-10 min), and mean CIT was 8.58 ± 5.291 min. Being female, BMI, VAT volume and involvement of fellow were significantly associated with a prolonged CIT in univariable analysis. In multivariable analysis, being female(OR = 1.29, P = 0.047), lower BMI(< 23 kg/m2)(OR = 1.62, P = 0.004) or higher BMI(≥ 25 kg/m2)(OR = 1.80, P < 0.001), low VAT volume(< 500 cm3)(OR = 1.50, P = 0.013) and fellow involvement(OR = 1.73, P < 0.001) were significant predictors of prolonged CIT. In subgroup analyses for gender, lower BMI or higher BMI and fellow involvement were predictors for prolonged CIT in both genders. However, low V展开更多
Background There are several surrogate indicators of abdominal fat deposition,including tri-ponderal mass index(TMI),lipid accumulation product(LAP),and the Chinese visceral adiposity index(CVAI).In spite of this,it r...Background There are several surrogate indicators of abdominal fat deposition,including tri-ponderal mass index(TMI),lipid accumulation product(LAP),and the Chinese visceral adiposity index(CVAI).In spite of this,it remains unclear whether these indices have a longitudinal relationship with the prevalence of cardiometabolic multimorbidity(CM),a pressing global health issue.This research investigated the association between CVAI and CM compared to other indicators of visceral obesity.Methods 6638 participants(aged>45)from the China Health and Retirement Longitudinal Study(CHARLS)were analyzed for incident CM.Cox proportional models were adopted to explore whether the level of CVAI was correlated with the risk of CM.Harrell's concordance statistic(C-statistic)was applied to compare predictive values.Sensitivity and subgroup analyses were implemented for the steadiness of the results.Results Over 4 years,266(4.01%)participants developed CM.A 1-standard deviation(SD)increase in the levels of CVAI,body mass index(BMI),LAP,and TMI was associated with greater CM risk after adjusting for confounders[hazard ratios(HRs):2.20,95%confidence interval(CI):1.88-2.57,1.92(95%CI:1.55-2.38),1.20(95%CI:1.12-1.27),and 1.50(95%CI:1.35-1.66),respectively].CVAI outperformed other indices in predictive performance.Subgroup analysis revealed younger participants or those living alone were more prone to developing CM.Results were potent after finishing all sensitivity analyses.Conclusions The study highlighted a positive correlation between the level of CVAI and CM risk.CVAI's superior predictive performance positions it as a reliable indicator for identifying individuals at heightened CM risk.展开更多
基金Supported by National Cancer Center,South Korea,No.NCC-1610250,No.NCC-1410250,and No.NCC 0810200-1
文摘AIM To identify the factors influencing cecal insertion time(CIT) and to evaluate the effect of obesity indices on CIT. METHODS We retrospectively reviewed the data for participants who received both colonoscopy and abdominal computed tomography(CT) from February 2008 to May 2008 as part of a comprehensive health screening program. Age, gender, obesity indices [body mass index(BMI), waist-to-hip circumference ratio(WHR), waist circumference(WC), visceral adipose tissue(VAT)volume and subcutaneous adipose tissue(SAT) volume on abdominal CT], history of prior abdominal surgery, constipation, experience of the colonoscopist, quality of bowel preparation, diverticulosis and time required to reach the cecum were analyzed. CIT was categorized as longer than 10 min(prolonged CIT) and shorter than or equal to 10 min, and then the factors that required a CIT longer than 10 min were examined.RESULTS A total of 1678 participants were enrolled. The mean age was 50.42 ± 9.931 years and 60.3% were men. The mean BMI, WHR, WC, VAT volume and SAT volume were 23.92 ± 2.964 kg/m2, 0.90 ± 0.076, 86.95 ± 8.030 cm, 905.29 ± 475.220 cm3 and 1707.72 ± 576.550 cm3, respectively. The number of patients who underwent abdominal surgery was 268(16.0%). Colonoscopy was performed by an attending physician alone in 61.9% of cases and with the involvement of a fellow in 38.1% of cases. The median CIT was 7 min(range 2-56 min, IQR 5-10 min), and mean CIT was 8.58 ± 5.291 min. Being female, BMI, VAT volume and involvement of fellow were significantly associated with a prolonged CIT in univariable analysis. In multivariable analysis, being female(OR = 1.29, P = 0.047), lower BMI(< 23 kg/m2)(OR = 1.62, P = 0.004) or higher BMI(≥ 25 kg/m2)(OR = 1.80, P < 0.001), low VAT volume(< 500 cm3)(OR = 1.50, P = 0.013) and fellow involvement(OR = 1.73, P < 0.001) were significant predictors of prolonged CIT. In subgroup analyses for gender, lower BMI or higher BMI and fellow involvement were predictors for prolonged CIT in both genders. However, low V
基金supported by the National Natural Science Foundation of China(No.82074295)the Science and Technology Program of Tibet Grant(No.XZ202201ZY0051G)。
文摘Background There are several surrogate indicators of abdominal fat deposition,including tri-ponderal mass index(TMI),lipid accumulation product(LAP),and the Chinese visceral adiposity index(CVAI).In spite of this,it remains unclear whether these indices have a longitudinal relationship with the prevalence of cardiometabolic multimorbidity(CM),a pressing global health issue.This research investigated the association between CVAI and CM compared to other indicators of visceral obesity.Methods 6638 participants(aged>45)from the China Health and Retirement Longitudinal Study(CHARLS)were analyzed for incident CM.Cox proportional models were adopted to explore whether the level of CVAI was correlated with the risk of CM.Harrell's concordance statistic(C-statistic)was applied to compare predictive values.Sensitivity and subgroup analyses were implemented for the steadiness of the results.Results Over 4 years,266(4.01%)participants developed CM.A 1-standard deviation(SD)increase in the levels of CVAI,body mass index(BMI),LAP,and TMI was associated with greater CM risk after adjusting for confounders[hazard ratios(HRs):2.20,95%confidence interval(CI):1.88-2.57,1.92(95%CI:1.55-2.38),1.20(95%CI:1.12-1.27),and 1.50(95%CI:1.35-1.66),respectively].CVAI outperformed other indices in predictive performance.Subgroup analysis revealed younger participants or those living alone were more prone to developing CM.Results were potent after finishing all sensitivity analyses.Conclusions The study highlighted a positive correlation between the level of CVAI and CM risk.CVAI's superior predictive performance positions it as a reliable indicator for identifying individuals at heightened CM risk.
