BMI of colorectal cancer patients will affect preoperative medical and surgical complications: A real world study based on DACCA_CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Authors：

LIU Yong ¹ , YANG Lielong ^1,2 ,  WANG Xiaodong ¹ , LI Li ¹ , ZHOU Zongguang ¹

1. Department of Gastrointestinal Surgery, West China Hospital, Sichuan University, Chengdu 610041, P. R. China;
2. West China School of Clinical Medicine, Sichuan University, Chengdu 610041, P. R. China;

Corresponding?author：

WANG Xiaodong, Email: wangxiaodong@wchscu.cn

Keywords：

colorectal cancer; body mass index; database from colorectal cancer; surgical complication; surgical history; medical complication

DOI：

10.7507/1007-9424.202111021

Video：

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objective To analyze the impact of body mass index (BMI) on medical and surgical complications of colorectal cancer patients served by West China Hospital, based on the current version of Database from Colorectal Cancer (DACCA). Methods The data of DACCA was updated on September 27, 2021. The data included BMI, surgical complications, liver nodules, liver function, renal nodules, renal function, operation history, medical complications, diabetes, hypertension, pneumonia, pulmonary nodules, pulmonary function, heart disease, thrombosis, and cardiac function. Results After scanning, 5 305 data rows were included. BMI was divided by Chinese four classification methods. The analysis results showed that in terms of surgical complications, obese patients were more likely to be complicated with surgical complications of digestive system (χ²= 43.883, P<0.001) and reproductive system (χ²=13.139, P=0.004). Lean patients were more likely to have surgical complications of urinary system (χ²=223.415, P<0.001), and obese patients had liver function (H=61.521, P<0.001) and renal function (H=9.994, P=0.019) might be even worse. In terms of operation history, BMI in colorectal cancer patients had nothing to do with the number of times of operation (H=6.262, P=0.100), and operation history of each system or department (P>0.05). Regarding to medical complications, with the increase of BMI, the risk of colorectal cancer patients with diabetes mellitus (χ²=118.597, P<0.001), or hypertension (χ²= 163.334, P< 0.001) increased. Patients with low BMI were more likely to have pneumonia (H=7.899, P= 0.048) and worse pulmonary function (H=40.673, P<0.001). Conclusions The analysis results of DACCA database show that BMI is not related to the occurrence of any special surgical history included in the research. Because the internal and external complications of patients are closely related to the treatment plan and prognosis, we should pay more attention to the obese patients in the process of clinical treatment, and they are more likely to have multisystemic abnormalities and various abnormal indicators than other patients. For thin patients, we should pay more attention to their lung function and inflammatory lesions, so as to improve the clinical therapeutic effect.

Citation： LIU Yong, YANG Lielong, WANG Xiaodong, LI Li, ZHOU Zongguang. BMI of colorectal cancer patients will affect preoperative medical and surgical complications: A real world study based on DACCA. CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY, 2021, 28(12): 1637-1644. doi: 10.7507/1007-9424.202111021 Copy

1.	汪曉東, 劉健博, 張詩, 等. 數據庫研究第三部分: 結直腸癌的內外科合并癥及術前體質狀態. 中國普外基礎與臨床雜志, 2019, 26(8): 985-991.
2.	Elangovan A, Skeans J, Landsman M, et al. Colorectal cancer, age, and obesity-related comorbidities: A large database study. Dig Dis Sci, 2021, 66(9): 3156-3163.
3.	Boakye D, Rillmann B, Walter V, et al. Impact of comorbidity and frailty on prognosis in colorectal cancer patients: A systematic review and meta-analysis. Cancer Treat Rev, 2018, 64: 30-39.
4.	劉勇, 劉桂娜, 龔佳祺, 等. 結直腸癌患者的 BMI 會影響術后住院時間—基于 DACCA 的真實世界數據研究. 中國普外基礎與臨床雜志, 2021, 28(11): 1486-1493.
5.	汪曉東, 劉健博, 李立. 數據庫建設第三部分: 結直腸癌內外科合并癥及術前體質狀態的標簽與結構化. 中國普外基礎與臨床雜志, 2019, 26(9): 1110-1115.
6.	Li W, Homer K, Hull S, et al. Obesity predicts liver function testing and abnormal liver results. Obesity (Silver Spring), 2020, 28(1): 132-138.
7.	Gray B, Steyn F, Davies PS, et al. Liver function parameters, cholesterol, and phospholipid α-linoleic acid are associated with adipokine levels in overweight and obese adults. Nutr Res, 2014, 34(5): 375-382.
8.	Wang J, Cheng R, Luo Y, et al. High-fat diet induces metabolic syndrome in mice and its influence on intestinal development, liver function and intestinal microbiota. Wei Sheng Yan Jiu, 2021, 50(1): 93-99.
9.	Correia-Costa L, Afonso AC, Schaefer F, et al. Decreased renal function in overweight and obese prepubertal children. Pediatr Res, 2015, 78(4): 436-444.
10.	Falakaflaki B, Mazloomzadeh S, Moradzade A. Comparison of renal function between normal-weight and overweight b children. Indian J Nephrol, 2012, 22(3): 193-195.
11.	Viazzi F, Russo E, Mirijello A, et al. Long-term blood pressure variability, incidence of hypertension and changes in renal function in type 2 diabetes. J Hypertens, 2020, 38(11): 2279-2286.
12.	Ruilope LM, Bakris GL. Renal function and target organ damage in hypertension. Eur Heart J, 2011, 32(13): 1599-1604.
13.	Fan W, Xu Y, Liu Y, et al. Obesity or overweight, a chronic inflammatory status in male reproductive system, leads to mice and human subfertility. Front Physiol, 2018, 8: 1117.
14.	Keskin MZ, Budak S, Aksoy EE, et al. Investigation of the effect of body mass index (BMI) on semen parameters and male reproductive system hormones. Arch Ital Urol Androl, 2017, 89(3): 219-221.
15.	Khullar V, Sexton CC, Thompson CL, et al. The relationship between BMI and urinary incontinence subgroups: results from EpiLUTS. Neurourol Urodyn, 2014, 33(4): 392-399.
16.	Saadia Z. Effect of age, educational status, parity and bmi on development of urinary incontinence— a Cross Sectional Study in Saudi Population. Mater Sociomed, 2015, 27(4): 251-254.
17.	McIntyre HD, Catalano P, Zhang C, et al. Gestational diabetes mellitus. Nat Rev Dis Primers, 2019, 5(1): 47.
18.	Plows JF, Stanley JL, Baker PN, et al. The pathophysiology of gestational diabetes mellitus. Int J Mol Sci, 2018, 19(11): 3342.
19.	Grassi G, Seravalle G, Dell'Oro R, et al. Adrenergic and reflex abnormalities in obesity-related hypertension. Hypertension, 2000, 36(4): 538-542.
20.	Hall JE, do Carmo JM, da Silva AA, et al. Obesity, kidney dysfunction and hypertension: mechanistic links. Nat Rev Nephrol, 2019, 15(6): 367-385.
21.	Hartley BF, Barnes NC, Lettis S, et al. Risk factors for exacerbations and pneumonia in patients with chronic obstructive pulmonary disease: a pooled analysis. Respir Res, 2020, 21(1): 5.
22.	Peters U, Suratt BT, Bates JHT, et al. Beyond BMI: obesity and lung disease. Chest, 2018, 153(3): 702-709.
23.	Duran M, Ziyrek M. Effect of obesity on pulmonary vascular hemodynamics. J Cardiovasc Echogr, Apr-Jun 2020, 30(2): 75-81.

1. 汪曉東, 劉健博, 張詩, 等. 數據庫研究第三部分: 結直腸癌的內外科合并癥及術前體質狀態. 中國普外基礎與臨床雜志, 2019, 26(8): 985-991.
2. Elangovan A, Skeans J, Landsman M, et al. Colorectal cancer, age, and obesity-related comorbidities: A large database study. Dig Dis Sci, 2021, 66(9): 3156-3163.
3. Boakye D, Rillmann B, Walter V, et al. Impact of comorbidity and frailty on prognosis in colorectal cancer patients: A systematic review and meta-analysis. Cancer Treat Rev, 2018, 64: 30-39.
4. 劉勇, 劉桂娜, 龔佳祺, 等. 結直腸癌患者的 BMI 會影響術后住院時間—基于 DACCA 的真實世界數據研究. 中國普外基礎與臨床雜志, 2021, 28(11): 1486-1493.
5. 汪曉東, 劉健博, 李立. 數據庫建設第三部分: 結直腸癌內外科合并癥及術前體質狀態的標簽與結構化. 中國普外基礎與臨床雜志, 2019, 26(9): 1110-1115.
6. Li W, Homer K, Hull S, et al. Obesity predicts liver function testing and abnormal liver results. Obesity (Silver Spring), 2020, 28(1): 132-138.
7. Gray B, Steyn F, Davies PS, et al. Liver function parameters, cholesterol, and phospholipid α-linoleic acid are associated with adipokine levels in overweight and obese adults. Nutr Res, 2014, 34(5): 375-382.
8. Wang J, Cheng R, Luo Y, et al. High-fat diet induces metabolic syndrome in mice and its influence on intestinal development, liver function and intestinal microbiota. Wei Sheng Yan Jiu, 2021, 50(1): 93-99.
9. Correia-Costa L, Afonso AC, Schaefer F, et al. Decreased renal function in overweight and obese prepubertal children. Pediatr Res, 2015, 78(4): 436-444.
10. Falakaflaki B, Mazloomzadeh S, Moradzade A. Comparison of renal function between normal-weight and overweight b children. Indian J Nephrol, 2012, 22(3): 193-195.
11. Viazzi F, Russo E, Mirijello A, et al. Long-term blood pressure variability, incidence of hypertension and changes in renal function in type 2 diabetes. J Hypertens, 2020, 38(11): 2279-2286.
12. Ruilope LM, Bakris GL. Renal function and target organ damage in hypertension. Eur Heart J, 2011, 32(13): 1599-1604.
13. Fan W, Xu Y, Liu Y, et al. Obesity or overweight, a chronic inflammatory status in male reproductive system, leads to mice and human subfertility. Front Physiol, 2018, 8: 1117.
14. Keskin MZ, Budak S, Aksoy EE, et al. Investigation of the effect of body mass index (BMI) on semen parameters and male reproductive system hormones. Arch Ital Urol Androl, 2017, 89(3): 219-221.
15. Khullar V, Sexton CC, Thompson CL, et al. The relationship between BMI and urinary incontinence subgroups: results from EpiLUTS. Neurourol Urodyn, 2014, 33(4): 392-399.
16. Saadia Z. Effect of age, educational status, parity and bmi on development of urinary incontinence— a Cross Sectional Study in Saudi Population. Mater Sociomed, 2015, 27(4): 251-254.
17. McIntyre HD, Catalano P, Zhang C, et al. Gestational diabetes mellitus. Nat Rev Dis Primers, 2019, 5(1): 47.
18. Plows JF, Stanley JL, Baker PN, et al. The pathophysiology of gestational diabetes mellitus. Int J Mol Sci, 2018, 19(11): 3342.
19. Grassi G, Seravalle G, Dell'Oro R, et al. Adrenergic and reflex abnormalities in obesity-related hypertension. Hypertension, 2000, 36(4): 538-542.
20. Hall JE, do Carmo JM, da Silva AA, et al. Obesity, kidney dysfunction and hypertension: mechanistic links. Nat Rev Nephrol, 2019, 15(6): 367-385.
21. Hartley BF, Barnes NC, Lettis S, et al. Risk factors for exacerbations and pneumonia in patients with chronic obstructive pulmonary disease: a pooled analysis. Respir Res, 2020, 21(1): 5.
22. Peters U, Suratt BT, Bates JHT, et al. Beyond BMI: obesity and lung disease. Chest, 2018, 153(3): 702-709.
23. Duran M, Ziyrek M. Effect of obesity on pulmonary vascular hemodynamics. J Cardiovasc Echogr, Apr-Jun 2020, 30(2): 75-81.

CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

BMI of colorectal cancer patients will affect preoperative medical and surgical complications: A real world study based on DACCA

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