Obesity and colorectal cancer risk: A meta-analysis of cohort studies
Obesity and colorectal cancer risk: A meta-analysis of cohort studies
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DOI：
10.3748/wjg.v13.i31.4199
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发表时间：
2007-08-21
影响因子：
4.3
通讯作者：
Niu, Li
中科院分区：
文献类型：
--
作者：
Dai, Zhe;Xu, Yan-Cheng;Niu, Li
目的：为了评估肥胖和结直肠癌风险之间的关系，我们检索了PubMed、EMBASE和科克伦图书馆，截止到2007年1月1日。队列研究允许评估肥胖和结直肠癌之间的因果关系，明确定义肥胖和结直肠癌的明确结果是合格的。提取研究设计、基线样本量、平均随访时间、共激活因子和研究结果。结果：以体重指数（BMI）测量，超重和肥胖男性患结直肠癌的合并相对危险度（RR）为1.37（95%CI：1.21-1.56），女性为1.07（95%CI：0.97-1.18）。BMI最高分位数与最低分位数的合并RR为1.59（95% CI：1.35-1.86）男性和1.22（95% CI：1.08-1.39），男性为1.16（95% CI：0.93-1.46），女性为1.23（95% CI：0.98-1.54）。腰围最高分位数与最低分位数的合并RR为1.68（95% CI：1.36-2.08）男性和1.48（95% CI：1.19-1.84），男性为1.26（95% CI：0.90-1.77），女性为1.23（95% CI：0.81-1.86）。腰臀比最高分位数与最低分位数的合并RR为1.91（95% CI：1.46-2.49）男性和1.49（95% CI：1.23-1.81），男性为1.93（95% CI：1.19-3.13），女性为1.20（95% CI：0.81-1.78）。与“正常范围”相比，超重组近端结肠癌的合并RR为1.14（95%CI：0.88-1.47），肥胖组为1.41（95%CI：0.66-3.01）。最高分位数与最低分位数的合并RR分别为2.05（95% CI：1.23-3.41）（腰围）和1.66（95% CI：0.69-3.99）（腰臀比）。与“正常范围”相比，超重组远端结肠癌的合并RR为1.38（95%CI：1.02-1.87），肥胖组为1.23（95%CI：0.80-1.90）。最高分位数与最低分位数的合并RR分别为1.86（95%CI：1.05-3.30）与腰围，1.79（95%CI：0.82-3.90）与腰臀比.CONCLUSION：肥胖是结直肠癌的一个有统计学意义的危险因素，并且在不同的癌症子网站之间的关系是男性比女性更显着。腹型肥胖指标较整体肥胖指标敏感。(c)2007年WJG。All rights reserved.
AIM: To evaluate the association between obesity and colorectal cancer risk.METHODS: We searched PubMed, EMBASE, and the Cochrane Library up to January 1, 2007. Cohort studies permitting the assessment of causal association between obesity and colorectal cancer, with clear definition of obesity and well-defined outcome of colorectal cancer were eligible. Study design, sample size at baseline, mean follow-up time, co-activators and study results were extracted. Pooled standardized effect sizes were calculated.RESULTS: The pooled relative risk (RR) of colorectal cancer was 1.37 (95% CI: 1.21-1.56) for overweight and obese men, 1.07 (95% CI: 0.97-1.18) for women measured by body mass index (BMI). The pooled RR for the highest vs the lowest quantiles of BMI was 1.59 (95% CI: 1.35-1.86) for men and 1.22 (95% CI: 1.08-1.39) for women at risk of colon cancer, 1.16 (95% CI: 0.93-1.46) for men and 1.23 (95% CI: 0.98-1.54) for women at risk of rectal cancer. The pooled RR for the highest vs the lowest quantiles of waist circumference was 1.68 (95% CI: 1.36-2.08) for men and 1.48 (95% CI: 1.19-1.84) for women at risk of colon cancer, 1.26 (95% CI: 0.90-1.77) for men and 1.23 (95% CI: 0.81-1.86) for women at risk of rectal cancer. The pooled RR for the highest quantiles vs the lowest quantiles of waist-to-hip ratio was 1.91 (95% CI: 1.46-2.49) for men and 1.49 (95% CI 1.23-1.81) for women at risk of colon cancer, 1.93 (95% CI: 1.19-3.13) for men and 1.20 (95% CI: 0.81-1.78) for women at risk of rectal cancer. Compared with 'normal range', the pooled RR for proximal colon cancer was 1.14 (95% CI : 0.88-1.47) for the overweight and 1.41 (95% Cl: 0.66-3.01) for the obese. The pooled RR for the highest quantiles vs the lowest quantiles was 2.05 (95% CI: 1.23-3.41) with waist circumference, 1.66 (95% CI: 0.69-3.99) with waist-to-hip ratio. Compared with 'normal range', the pooled RR for distal colon cancer was 1.38 (95% CI: 1.02-1.87) for the overweight and 1.23 (95% CI: 0.80-1.90) for the obese. The pooled RR for the highest quantiles vs the lowest quantiles was 1.86 (95% CI: 1.05-3.30) with waist circumference, and 1.79 (95% CI: 0.82-3.90) with waist-to-hip ratio.CONCLUSION: Obesity is a statistically significant risk factor for colorectal cancer and the relationship is more significant in men than in women among different cancer subsites. Indexes of abdominal obesity are more sensitive than those of overall obesity. (c) 2007 WJG. All rights reserved.