Ma HF, Qian JH, Chen YH, Wang Y, Wang YM, Li JN, Zhou ZY, Ma JX, Zhang XC. Targeting obesity and lipid metabolism profiles to prevent perianal abscesses: A case-control study and Mendelian randomization analysis. World J Gastrointest Surg 2026; 18(1): 113855 [DOI: 10.4240/wjgs.v18.i1.113855]
Corresponding Author of This Article
Xue-Cheng Zhang, MD, Department of Proctology, China-Japan Friendship Hospital, No. 2 Yinghua East Road, Chaoyang District, Beijing 100029, China. zhangxuecheng@zryhyy.com.cn
Research Domain of This Article
Gastroenterology & Hepatology
Article-Type of This Article
Case Control Study
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This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Jan 27, 2026 (publication date) through Jan 28, 2026
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Journal Information of This Article
Publication Name
World Journal of Gastrointestinal Surgery
ISSN
1948-9366
Publisher of This Article
Baishideng Publishing Group Inc, 7041 Koll Center Parkway, Suite 160, Pleasanton, CA 94566, USA
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Ma HF, Qian JH, Chen YH, Wang Y, Wang YM, Li JN, Zhou ZY, Ma JX, Zhang XC. Targeting obesity and lipid metabolism profiles to prevent perianal abscesses: A case-control study and Mendelian randomization analysis. World J Gastrointest Surg 2026; 18(1): 113855 [DOI: 10.4240/wjgs.v18.i1.113855]
Huang-Fu Ma, Yue Wang, Yan-Mei Wang, Jia-Nan Li, Xue-Cheng Zhang, Department of Proctology, China-Japan Friendship Hospital, Beijing 100029, China
Jia-Hua Qian, Jian-Xiong Ma, The First Clinical Medical College, Zhejiang Chinese Medical University, Hangzhou 310053, Zhejiang Province, China
Yi-Hao Chen, The Second Clinical Medical College, Zhejiang Chinese Medical University, Hangzhou 310053, Zhejiang Province, China
Zhang-Yun Zhou, Department of Gastrointestinal Surgery, Anhui Zhongke Gengjiu Hospital, Hefei 230051, Anhui Province, China
Author contributions: Ma HF and Wang YM conceived the study and contributed to the manuscript review; Ma HF and Ma JX drafted the manuscript; Qian JH and Chen YH performed the statistical analysis and created the figures; Wang Y, Li JN, and Zhang XC contributed to the manuscript review; all authors have read and approved the final manuscript.
Supported by National Natural Science Foundation of China, No. 81804092; Young Elite Scientists Sponsorship Program by CACM, No. CACM-2022-QNRC2-A01; China Postdoctoral Science Foundation, No. 2023M743146; Zhejiang Chinese Medical University Scientific Research Project for Talent, No. 2023RCZXZK47; National Postdoctoral Research Program, No. GZC20232373; and China-Japan Friendship Hospital Scientific Research Fund, No. 2024-ZF-12.
Institutional review board statement: The study was conducted in accordance with the Declaration of Helsinki. It was approved by the Medical Ethics Committee of China-Japan Friendship Hospital, Beijing (No. 2024-KY-101).
Informed consent statement: All participants provided informed consent.
Conflict-of-interest statement: The authors declare that they have no competing interests.
STROBE statement: The authors have read the STROBE Statement – checklist of items, and the manuscript was prepared and revised according to the STROBE Statement – checklist of items
Data sharing statement: Data are provided within the manuscript or Supplementary material. The datasets used and/or analyzed during the current study are available from the corresponding author on reasonable request (daxiong1990@zcmu.edu.cn).
Open Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Xue-Cheng Zhang, MD, Department of Proctology, China-Japan Friendship Hospital, No. 2 Yinghua East Road, Chaoyang District, Beijing 100029, China. zhangxuecheng@zryhyy.com.cn
Received: September 8, 2025 Revised: October 11, 2025 Accepted: November 19, 2025 Published online: January 27, 2026 Processing time: 137 Days and 21.8 Hours
Abstract
BACKGROUND
Perianal abscesses (PAs) are associated with significant complications, such as recurrent infections, pain, anal fistulas, rectovaginal fistulas, rectourethral fistulas, and rectovesical fistulas. However, established primary and secondary prevention strategies for PAs are lacking.
AIM
To explore the relationships between obesity and lipid metabolites, including perianal abscess onset.
METHODS
We conducted two independent studies under a unified research question. Case-control analysis was conducted at a single hospital between May 2023 and November 2023. Inpatients diagnosed with a perianal abscess and matched healthy controls were included. Body dimensions and serum metabolites were measured. Genome-wide association study data regarding genetic variants of PAs, obesity, and serum metabolites were obtained for the Mendelian randomization (MR) analysis. The study outcomes were perianal abscess onset and the number and location of PAs.
RESULTS
In the case-control study, higher body mass index (BMI), waist-to-hip ratio (WHR), waist-to-height ratio (WHtR), blood glucose levels, uric acid (UA) levels, total cholesterol levels, triglyceride levels, and low-density lipoprotein (LDL) levels were associated with increased risk of PAs. Higher high-density lipoprotein levels were associated with reduced risk of PAs. The BMI, WHR, WHtR, UA level, triglyceride level, and LDL level were associated with the number and severity of PAs. In MR analysis, the BMI, WHR, body fat percentage, whole body fat mass, limb fat percentage, limb fat mass, and various lipid profiles were significantly associated with the risk of PAs.
CONCLUSION
A hospital-based case-control study and an independent MR analysis consistently support obesity and lipid metabolism profiles are associated with an increased risk of perianal abscess. These findings provide a basis for developing primary and secondary prevention strategies for perianal abscess.
Core Tip: Our case-control study revealed that the risk of perianal abscesses (PAs) was significantly correlated with various obesity/metabolic markers, including higher body mass index (BMI), waist-to-hip ratio (WHR), waist-to-height ratio, glucose levels, uric acid levels, cholesterol levels, triglyceride levels, and low-density lipoprotein (LDL) cholesterol levels, as well as lower levels of high-density lipoprotein cholesterol. The mendelian randomization analysis further confirmed relationships between the PA risk and factors such as BMI, WHR, large and medium LDLs, and lipid ratios. These findings suggest that lipid levels, body fat distribution, and metabolic markers are crucial to the understanding of PA risk.
