Body mass index, weight change, and risk of prostate cancer in the Cancer Prevention Study II Nutrition Cohort
Body mass index, weight change, and risk of prostate cancer in the Cancer Prevention Study II Nutrition Cohort
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DOI：
10.1158/1055-9965.epi-06-0754
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发表时间：
2007-01-01
影响因子：
3.8
通讯作者：
Calle, Eugenia E.
中科院分区：
文献类型：
--
作者：
Rodriguez, Carmen;Freedland, Stephen J.;Calle, Eugenia E.
背景：肥胖与侵袭性前列腺癌相关。这种关联因分期和分级而异，其程度仍不明确。近期体重变化的作用此前尚未被研究。
方法：我们在癌症预防研究II营养队列的69991名男性中，根据诊断时的疾病分期和分级，研究了体重指数（BMI）和体重变化与前列腺癌发病的关系。参与者在1982年提供了身高和体重信息，并在1992年再次提供。在截至2003年6月30日的随访期间（不包括最初2年的随访），我们记录了5252例前列腺癌发病病例。使用考克斯比例风险模型来估计风险比（RR）和95%置信区间（95%CI）。
结果：1992年的BMI与前列腺癌风险之间的关联因诊断时的分期和分级而异。BMI与非转移性低级别前列腺癌风险呈负相关（RR，0.84；95%CI，0.66 - 1.06），但BMI与非转移性高级别前列腺癌风险（RR，1.22；95%CI，0.96 - 1.55）以及转移性或致命性前列腺癌风险（RR，1.54；95%CI，1.06 - 2.23）呈正相关。与体重保持稳定相比，1982年至1992年间体重减轻>11磅的男性患非转移性高级别前列腺癌的风险降低（RR，0.58；95%CI，0.42 - 0.79）。
结论：肥胖增加了更具侵袭性的前列腺癌的风险，并可能减少侵袭性较弱肿瘤的发生或诊断可能性。男性减肥可能会降低患前列腺癌的风险。
Background: Obesity has been associated with aggressive prostate cancer. The extent of this association, which varies by stage and grade, remains unclear. The role of recent weight change had not been previously examined.Methods: We examined body mass index (BMI) and weight change in relation to incident prostate cancer by disease stage and grade at diagnosis among 69,991 men in the Cancer Prevention Study II Nutrition Cohort. Participants provided information on height and weight in 1982, and again at enrollment in 1992. During follow-up through June 30, 2003 (excluding the first 2 years of follow-up), we documented 5,252 incident prostate cancers. Cox proportional hazards models were used to estimate rate ratios (RR) and 95% confidence intervals (95% CI).Results: The association between BMI in 1992 and risk of prostate cancer differed by stage and grade at diagnosis. BMI was inversely associated with risk of nonmetastatic low-grade prostate cancer (RR, 0.84, 95% CI, 0.66-1.06), but BMI was positively associated with risk of nonmetastatic high-grade prostate cancer (RR, 1.22; 95% CI, 0.96-1.55) and risk of metastatic or fatal prostate cancer (RR, 1.54; 95% CI, 1.06-2.23). Compared with weight maintenance, men who lost > 11 pounds between 1982 and 1992 were at a decreased risk of nonmetastatic high-grade prostate cancer (RR, 0.58; 95% CI, 0.42-0.79).Conclusion: Obesity increases the risk of more aggressive prostate cancer and may decrease either the occurrence or the likelihood of diagnosis of less-aggressive tumors. Men who lose weight may reduce their risk of prostate cancer.