Body size and composition and the risk of gastric and oesophageal adenocarcinoma
Body size and composition and the risk of gastric and oesophageal adenocarcinoma
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DOI：
10.1002/ijc.21638
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发表时间：
2006-05-15
影响因子：
6.4
通讯作者：
Giles, GG
中科院分区：
文献类型：
--
作者：
MacInnis, RJ;English, DR;Giles, GG
虽然越来越多的证据表明肥胖可能与食管和贲门恶性肿瘤的发病率增加有关，但这些报告（主要是病例对照研究）依赖于不完善的肥胖指标，如体重指数（BMI），并且通常没有明确区分食管和胃内的解剖亚部位。在一项针对27-75岁人群的前瞻性研究中，我们直接测量了脂肪质量和无脂肪质量（使用生物电阻抗分析）、身高、体重、腰围和臀围。在平均随访11.3年的41,295人中，通过人群癌症登记确定了30例贲门或食管下1/3癌和68例非贲门胃腺癌。下食管和贲门腺癌的风险与BMI呈正相关，风险比（HR）和BMI >= 30 kg/m2的人与BMI < 25 kg/m2的人相比，95%置信区间为3.7（1.1-12.4），腰围每增加10 cm的HR为1.46（1.05-2.04），无脂体重每增加10 kg的HR为2.06（1.15-3.69）。非贲门部胃腺癌与体型关系不大。我们观察到食管下段和贲门腺癌的风险增加与BMI增加、中心性肥胖和体重的非脂肪成分相关，但与非贲门胃腺癌无关。肥胖症患病率的增加可能与在许多人群中观察到的胃食管癌发病率的增加有关。(c)2005 Wiley-Liss，Inc.
Although evidence has been mounting that obesity may be related to the increased incidence of oesophageal and gastric cardia malignancies, these reports (mainly case-control studies) have relied on imperfect measures of obesity such as body mass index (BMI), and generally have not clearly distinguished between anatomical subsites within the oesophagus and stomach. In a prospective study of people aged 27-75 years, we directly measured fat mass and fat-free mass (using bioelectrical impedance analysis), height, weight and waist and hip circumferences. Among 41,295 people followed on average for 11.3 years, 30 cases with cancers in the gastric cardia or lower third of the oesophagus and 68 cases with noncardia gastric adenocarcinomas were ascertained via the population cancer registry. The risk of adenocarcinoma of the lower oesophagus and gastric cardia was positively associated with BMI with a hazards ratio (HR) and (95% confidence interval) for people with BMI >= 30 kg/m(2) compared with those < 25 kg/m(2) of 3.7 (1.1-12.4), an HR per 10 cm increase in waist circumference of 1.46 (1.05-2.04), and a HR per 10 kg increase on fat-free mass of 2.06 (1.15-3.69). Noncardia gastric adenocarcinoma showed little relationship with body size. We observed an increased risk of adenocarcinoma of the lower oesophagus and gastric cardia associated with increased BMI, central adiposity and the nonfat component of weight, but found no association with noncardia gastric adenocarcinoma. An increasing prevalence of obesity may be associated with the increasing incidence of gastro-oesophageal cancer observed in many populations. (c) 2005 Wiley-Liss, Inc.