Body mass index, abnormal glucose metabolism, and mortality from hematopoietic cancer
Body mass index, abnormal glucose metabolism, and mortality from hematopoietic cancer
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DOI：
10.1158/1055-9965.epi-06-0007
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发表时间：
2006-12-01
影响因子：
3.8
通讯作者：
Dyerl, Alan
中科院分区：
文献类型：
--
作者：
Chiu, Brian C-H.;Gapstur, Susan M.;Dyerl, Alan
背景：高体重指数(BMI)和糖尿病与非霍奇金淋巴瘤(NHL)的风险有关，但结果不一致，大多数研究使用自我报告的信息。还没有研究评估非霍奇金淋巴瘤与负荷后血糖(PLG)水平的相关性，而PLG水平与BMI呈正相关。我们分析了一项队列研究的数据，以调查采访者测量的BMI和PLG与非霍奇金淋巴瘤死亡风险的相关性，并探索与白血病和多发性骨髓瘤的相关性。方法：从1967年到1973年，对84个芝加哥地区组织的员工进行了筛查，基线平均年龄为40岁。身高和体重由实习护士测量。非糖尿病受试者口服葡萄糖负荷为50克。在35,420名男性和女性的高危队列中，129人死于NHL，151人死于白血病，66人死于多发性骨髓瘤，平均随访时间为31年。结果：在男性中，BMI与NHL(HR，2.57；95%CI，最高与最低四分位数的1.24~5.34；P趋势=0.01)和白血病(HR，1.98；1.07~3.69；P趋势=0.02)的死亡率呈剂量-反应关系。PLG与NHL死亡率呈正相关(HR，2.86；95%CI，1.35~6.06，P-趋势=0.004)。对于女性，较高的BMI与白血病死亡率呈正相关(HR，2.47；95%CI，0.96-6.36；P-趋势=0.02)，PLG水平最高与多发性骨髓瘤的死亡风险相关(HR，3.06；95%CI，1.05-8.93)。调整各因素后，BMI和PLG的风险估计值保持不变。结论：高BMI和/或PLG异常与女性死于非霍奇金淋巴瘤、白血病和骨髓瘤的风险高相关。这些发现可能具有公共卫生意义，因为BMI和血糖水平是可以修改的。
Background: High body mass index (BMI) and diabetes have been linked to risk of non-Hodgkin's lymphoma (NHL), but results are inconsistent and most studies use self-reported information. No study has evaluated the association of NHL with postload plasma glucose (PLG) levels, which are positively associated with BMI. We analyzed data from a cohort study to investigate associations of interviewer-measured BMI and PLG with risk of NHL mortality and to explore associations with leukemia and multiple myeloma.Methods: Employees of 84 Chicago-area organizations, with an average age of 40 years at baseline, were screened from 1967 to 1973. Height and weight were measured by study nurses. A 50-g oral glucose load was administered to nondiabetic participants. Of the at-risk cohort of 35,420 men and women, 129 died of NHL, 151 died of leukemia, and 66 died of multiple myeloma during an average of 31 years of follow-up. Hazard Ratios (HR) and 95% confidence intervals (95% CI) were derived from Cox proportional hazards regression models.Results: Among men, there were positive dose-response relations of BMI with mortality from NHL (HR, 2.57; 95% Cl, 1.24-5.34 for the highest versus lowest quartile; P-trend=0.01) and leukemia (HR, 1.98; 1.07-3.69; P-trend=0.02). PLG also was positively related to NHL mortality (HR, 2.86; 95% Cl, 1.35-6.06 for the highest versus lowest category; P-trend=0.004). For women, a higher BMI was positively associated with leukemia mortality (HR, 2.47; 95% Cl, 0.96-6.36; P-trend=0.02) and the highest level of PLG was associated with-risk of mortality from multiple myeloma (HR, 3.06; 95% Cl, 1.05-8.93). The risk estimates for BMI and PLG remained unchanged after adjustment for each factor.Conclusions: High BMI and/or abnormal PLG is associated with higher risk of mortality from NHL and possibly leukemia and from myeloma in women. These findings might have public health significance because BMI and glucose levels are amenable to modification.