Body mass index and risk of head and neck cancer in a pooled analysis of case-control studies in the International Head and Neck Cancer Epidemiology (INHANCE) Consortium
Body mass index and risk of head and neck cancer in a pooled analysis of case-control studies in the International Head and Neck Cancer Epidemiology (INHANCE) Consortium
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DOI：
10.1093/ije/dyp380
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发表时间：
2010-08-01
影响因子：
7.7
通讯作者：
Hashibe, Mia
中科院分区：
文献类型：
--
作者：
Gaudet, Mia M.;Olshan, Andrew F.;Hashibe, Mia
方法收集17个病例对照研究的资料，包括12 716例病例和17 438例对照。估计不同年龄体重指数（BMI）与HNC风险之间关联的比值比（OR）和95%置信区间（CI），调整年龄、性别、中心、种族、教育程度，结果BMI与对照组相比，校正OR值（95%CI）升高（病例诊断日期和对照组选择日期）< 18.5 kg/m2（2）BMI > 25.0-30.0 kg/m2（0.52，0.44-0.60）和BMI >= 30 kg/m2（0.43，0.33-0.57）的患者与BMI > 18.5-25.0 kg/m2（0.43，0.33-0.57）的患者相比，体重指数降低。这些关联在年龄、性别、肿瘤部位或对照来源方面没有差异。尽管吸烟或饮酒并不能改变BMI < 18.5 kg/m2人群中HNC风险的增加，但BMI > 25 kg/m2人群中的HNC风险仅在吸烟者和饮酒者中呈负相关。结论在我们的大型汇总分析中，无论吸烟和饮酒状况如何，消瘦与HNC风险增加相关，尽管不能排除反向因果关系。超重或肥胖人群中的风险降低可能表明身体大小是与吸烟和饮酒相关的风险的修正因素。通过对前瞻性队列研究和机制研究的分析，可以提供进一步的澄清。
Methods We pooled data from 17 case-control studies including 12 716 cases and the 17 438 controls. Odds ratios (ORs) and 95% confidence intervals (CIs) were estimated for associations between body mass index (BMI) at different ages and HNC risk, adjusted for age, sex, centre, race, education, tobacco smoking and alcohol consumption.Results Adjusted ORs (95% CIs) were elevated for people with BMI at reference (date of diagnosis for cases and date of selection for controls) < 18.5 kg/m(2) (2.13, 1.75-2.58) and reduced for BMI > 25.0-30.0 kg/m(2) (0.52, 0.44-0.60) and BMI >= 30 kg/m(2) (0.43, 0.33-0.57), compared with BMI > 18.5-25.0 kg/m(2). These associations did not differ by age, sex, tumour site or control source. Although the increased risk among people with BMI < 18.5 kg/m(2) was not modified by tobacco smoking or alcohol drinking, the inverse association for people with BMI > 25 kg/m(2) was present only in smokers and drinkers.Conclusions In our large pooled analysis, leanness was associated with increased HNC risk regardless of smoking and drinking status, although reverse causality cannot be excluded. The reduced risk among overweight or obese people may indicate body size is a modifier of the risk associated with smoking and drinking. Further clarification may be provided by analyses of prospective cohort and mechanistic studies.