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Aspirin may be more effective in preventing colorectal adenomas in patients with higher BMI (United States)

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Abstract

Obesity is a risk factor for colon cancer, possibly due to elevated levels of circulating cytokines derived from adipose tissue. Aspirin, which may affect the levels of these cytokines, has been shown in randomized controlled trials to decrease the risk of colorectal adenomas. We hypothesized that the chemopreventive effect of aspirin might be greater in individuals with higher body mass index (BMI). Data were available from the Aspirin/Folate Polyp Prevention Study, a randomized controlled trial of aspirin and folic acid to prevent recurrent colorectal adenomas. Obesity was defined as BMI ≥ 30 (kg/m2), overweight as BMI of 25–29 (kg/m2) and normal weight as BMI <25 (kg/m2). For the analysis of the effect of aspirin on the recurrence of colorectal adenoma by BMI, we computed risk ratios for aspirin versus placebo within the three BMI strata using a modified Poisson model. Overall the risk reduction of adenomas with a daily dose of 325 mg aspirin was greater among subjects with higher BMI. Among obese subjects the risk ratio (RR) for advanced adenomas compared with placebo was 0.44 (95% CI 0.17–1.10), versus RR = 1.23 (95% CI 0.55–2.77) among those with normal weight. However, 81 mg aspirin daily did not interact with BMI to modify the risk of adenomas in such a fashion. The more pronounced effect of 325 mg aspirin in individuals with higher BMI suggests a possible protective role of anti-inflammatory aspirin against increased adipose-driven cytokines among obese subjects.

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Authors and Affiliations

  1. Department of Epidemiology, School of Public Health, University of North Carolina, Chapel Hill, NC, USA

    Sangmi Kim

  2. Department of Community and Family Medicine, Dartmouth Medical School, Lebanon, NH, USA

    John A. Baron, Leila A. Mott & Bernard F. Cole

  3. Department of Gastroenterology and Hepatology, Cleveland Clinic Foundation, Cleveland, OH, USA

    Carol A. Burke

  4. Health Studies, Division of Environmental Health Sciences, School of Public Health, University of Minnesota, Minneapolis, MN, USA

    Timothy R. Church

  5. Department of Public Health Sciences and Nutritional Sciences, University of Toronto, Toronto, Canada

    Gail E. McKeown-Eyssen

  6. Department of Preventive Medicine, University of Southern California, Los Angeles, CA, USA

    Robert W. Haile

  7. Center for Gastrointestinal Biology and Disease, University of North Carolina, CB#7555, 4111 Bioinformatics Building, Chapel Hill, NC, 27599-7555, USA

    Robert S. Sandler

Authors
  1. Sangmi Kim
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  2. John A. Baron
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  3. Leila A. Mott
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  4. Carol A. Burke
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  5. Timothy R. Church
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  6. Gail E. McKeown-Eyssen
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  7. Bernard F. Cole
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  8. Robert W. Haile
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  9. Robert S. Sandler
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Corresponding author

Correspondence to Robert S. Sandler.

Additional information

This work was supported in part by grants from the National Institutes of Health P30 DK34987, R01 CA59005, RR000046.

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Kim, S., Baron, J.A., Mott, L.A. et al. Aspirin may be more effective in preventing colorectal adenomas in patients with higher BMI (United States). Cancer Causes Control 17, 1299–1304 (2006). https://doi.org/10.1007/s10552-006-0075-x

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  • DOI: https://doi.org/10.1007/s10552-006-0075-x

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