Mediation role of body mass index in the relationship between food-specific serum immunoglobulin G reactivity and colorectal adenomas in a Chinese population: a cross-sectional study

Guanchao Sun; Xiaona Ma; Shiping Xu; Binbin Su; Qianqian Chen; Xiaoyu Dong; Lihui Wang; Jun Wan; Hui Shi

doi:10.1177/17562848241307601

Mediation role of body mass index in the relationship between food-specific serum immunoglobulin G reactivity and colorectal adenomas in a Chinese population: a cross-sectional study

Therap Adv Gastroenterol. 2024 Dec 23:17:17562848241307601. doi: 10.1177/17562848241307601. eCollection 2024.

Authors

Guanchao Sun^{1

2}, Xiaona Ma², Shiping Xu^{2

3}, Binbin Su^{2

3}, Qianqian Chen⁴, Xiaoyu Dong², Lihui Wang^{1

2}, Jun Wan⁵, Hui Shi^{6

7}

Affiliations

¹ Medical School of Chinese PLA, Beijing, China.
² Department of Gastroenterology, Second Medical Center of Chinese PLA General Hospital, Beijing, China.
³ National Clinical Research Center for Geriatrics Diseases, Beijing, China.
⁴ Department of Gastroenterology, First Medical Center of Chinese PLA General Hospital, Beijing, China.
⁵ Department of Gastroenterology, Second Medical Center of Chinese PLA General Hospital, Beijing 100853, China National Clinical Research Center for Geriatrics Diseases, 28 Fuxing Road, Haidian District, Beijing 100853, China.
⁶ Department of Gastroenterology, Second Medical Center of Chinese PLA General Hospital, Beijing 100853, China.
⁷ National Clinical Research Center for Geriatrics Diseases, 28 Fuxing Road, Haidian District, Beijing 100853, China.

Abstract

Background: Colorectal adenomas (CAs) represent a significant global health issue, particularly in China, where lifestyle modifications have contributed to their increased prevalence. These adenomas are precursors to colorectal cancer. While high-fiber diets have been shown to decrease risk, the implications of food-specific serum immunoglobulin G reactivity (FSsIgGR) on CAs remain uncertain and warrant further investigation.

Objectives: To investigate the association between FSsIgGR and the occurrence of CAs in the Chinese population, assess the mediating influence of body mass index (BMI), and offer insights into potential prevention strategies.

Design: A retrospective cross-sectional study.

Methods: This study is based on 8796 individuals who underwent colonoscopy at the Second Medical Center of Chinese PLA General Hospital from 2017 to 2021. We examined the relationship between FSsIgGR and CAs using logistic regression, controlling for various confounders. Interaction effects were explored through subgroup analysis. We addressed missing data using multiple imputation and confirmed the robustness of our findings through sensitivity analysis. The role of BMI as a mediator was quantified using structural equation modeling.

Results: The cohort comprised 2703 patients diagnosed with CAs and 6093 polyp-free controls, with an average age of 50.1 years, of whom 70.1% were male. The analysis revealed a significant inverse association between FSsIgGR and the incidence of CAs (adjusted odds ratio = 0.97; 95% confidence interval: 0.95-0.99; p < 0.001). Dose-response analysis indicated a linear reduction in CAs risk correlating with an increased number of IgG-positive food items. Structural equation modeling showed that BMI mediated 6.02% of the effect on CAs risk (p = 0.038).

Conclusion: Our findings suggest that FSsIgGR correlates with a reduced risk of developing CAs, with BMI partially mediating this effect. These results add a novel dimension to CAs risk assessment and prevention, highlighting potential dietary interventions.

Keywords: Chinese population; body mass index; colorectal adenomas; cross-sectional study; food-specific serum IgG reactivity; mediation analysis.