Impact of Abdominal Adipose Depots and Race on Risk for Colorectal Cancer: A Case-Control Study

ABSTRACT

Visceral adipose tissue (VAT) but not subcutaneous adipose tissue (SAT) is associated with obesity-related diseases including colorectal cancer (CRC). Superficial SAT (SSAT) and deep SAT (DSAT), components of SAT, also appear to independently influence disease risk. These abdominal adipose tissues (AATs) are not extensively studied in connection with CRC and have not been explored in the United States despite known racial variations in body composition. We conducted a case-control study that compared associations between AAT with CRC risk and race of African-American (AA) and non-Hispanic white (NHW) men with incident CRC matched by age, body mass index, and race (N = 158, 79/group). Cross-sectional computed tomography images were used for assessment of AAT. Overall cases and controls had similar VAT areas (140 ± 192 vs 149 ± 152 cm², P-value = 0.93); however, cases had lower SSAT than controls (88 ± 39 vs 112 ± 65 cm², P < 0.01). Among controls, AA had significantly lower VAT (114 ± 168 vs 180 ± 167, P < 0.01) than NHW. Conditional logistic regression revealed that AA men with greater SSAT had lower odds for CRC (odds ratio [OR]: 0.24, 95% confidence interval [CI] 0.07–0.85). Our findings indicate that VAT does vary between cases and controls by race; however, this variation is not a risk factor for CRC. The negative association between CRC and SSAT in AA men warrants further investigation.

Declaration of Interest

The authors declare no conflicts of interest.

Author Contributions

SLGP and CB designed the study and data collection procedures. SLGP analyzed CT scans. SLGP and CB drafted article and had primary responsibility for final content. GF, WM, VC, and SF contributed to study methodology and scientific integrity. SF provided biostatistical supervision. VC, WM, and BP supervised data collection and computed tomography extraction at each of the participating medical centers. CB, GF, VC, WM, and SF approved research design and shared the responsibility of final content. All authors read, provided feedback, and approved the final manuscript.

Acknowledgments

The authors would like to thank Kristen Fleming, Andrew McLeod, and Caitlin Levy for their assistance with the electronic medical record review process and Julie Wang for helping with CT extractions. They also thank Liam McKeever for helping with the body composition analysis.

Funding

Research reported in this publication was supported by the national Cancer Institute of the National Institutes of Health under Award Number R25CA057699. The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health.