Obesity and thyroid cancer risk among U.S. men and women: a pooled analysis of five prospective studies.
Obesity and thyroid cancer risk among U.S. men and women: a pooled analysis of five prospective studies.
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DOI：
10.1158/1055-9965.epi-10-1220
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发表时间：
2011-03
期刊：
影响因子：
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通讯作者：
Berrington de González A
中科院分区：
文献类型：
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作者：
Kitahara CM;Platz EA;Freeman LE;Hsing AW;Linet MS;Park Y;Schairer C;Schatzkin A;Shikany JM;Berrington de González A
自20世纪80年代初以来，美国的甲状腺癌发病率急剧上升。尽管肥胖症的患病率在这段时间内翻了一番，但肥胖症和甲状腺癌之间的关系尚不确定。我们对美国五项前瞻性研究进行了综合分析，其中包括413,979名女性和434,953名男性，研究了身体质量指数(BMI)与甲状腺癌风险之间的关系。以达到的年龄为时间指标的比例风险模型根据教育、种族、婚姻状况、吸烟、饮酒以及(适当时)队列和性别进行了调整。在随访期间(平均10.3年)，768名女性和388名男性被诊断为甲状腺癌。患甲状腺癌的风险随着BMI的增加而增加(每5公斤/平方米：女性的危险比为1.16[95%可信区间(CI)，1.08-1.24]；男性的HR为1.21[95%CI，0.97-1.49])。两项研究之间没有显著的异质性(P>；0.05)。男女合计，超重(2 5.0~2 9.9 kg/m2)和肥胖(≥30 kg/m2)与正常体重(18.5~2 4.9 kg/m2)的相对危险度分别为1.2 0(95%可信区间1.0 4~1.38)和1.5 3(95%可信区间1.31~1.79)。我们没有发现其他因素的显著影响，结果在组织学类型上也没有显著差异。青壮年(18-20岁)的BMI与甲状腺癌风险呈显著正相关(每增加5公斤/平方米：HR，1.18[95%CI，1.03-1.35])。BMI与男性和女性患甲状腺癌的风险呈正相关。我们的研究提供了强有力的证据，表明肥胖是甲状腺癌的一个独立危险因素。
Thyroid cancer incidence has risen dramatically in the U.S. since the early 1980s. Although the prevalence of obesity has doubled during this time period, the relationship between obesity and thyroid cancer is uncertain. We examined the association between body mass index (BMI) and thyroid cancer risk in a pooled analysis of five prospective U.S. studies, including 413,979 women and 434,953 men. Proportional hazards models with attained age as the time metric were adjusted for education, race, marital status, smoking, alcohol intake, and (where appropriate) cohort and sex. Over follow-up (mean=10.3 years), 768 women and 388 men were diagnosed with thyroid cancer. The risk of thyroid cancer was greater with increasing BMI (per 5 kg/m2: hazard ratio [HR] in women, 1.16 [95% confidence interval (CI), 1.08–1.24]; HR in men, 1.21 [95% CI, 0.97–1.49]). There was no significant heterogeneity between studies (both P>0.05). For women and men combined, the HRs for overweight (25.0–29.9 kg/m2) and obesity (≥30 kg/m2) compared to normal-weight (18.5–24.9 kg/m2) were 1.20 (95% CI, 1.04–1.38) and 1.53 (95% CI, 1.31–1.79), respectively. We found no significant effect modification by other factors, and the results did not differ significantly by histologic type. A significant positive association for BMI in young adulthood (ages 18–20) with thyroid cancer risk was also observed (per 5-kg/m2 increase: HR, 1.18 [95% CI, 1.03–1.35]). BMI was positively associated with thyroid cancer risk in both men and women. Our study provides strong evidence that obesity is an independent risk factor for thyroid cancer.