Adolescent body mass index and erythrocyte sedimentation rate in relation to colorectal cancer risk.
Adolescent body mass index and erythrocyte sedimentation rate in relation to colorectal cancer risk.
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DOI：
10.1136/gutjnl-2014-309007
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发表时间：
2016-08
期刊：
影响因子：
24.5
通讯作者：
Fall K
中科院分区：
文献类型：
--
作者：
Kantor ED;Udumyan R;Signorello LB;Giovannucci EL;Montgomery S;Fall K
成人肥胖和炎症与结直肠癌（CRC）风险相关；然而，对于青少年体重指数（BMI）和以红细胞沉降率（ESR）衡量的炎症与CRC风险的关系知之甚少。我们试图在一组239,658名瑞典男性中评估这些关联，这些男性在青春期后期（16 - 20岁）接受了义务兵役入伍检查。
在征兵评估时（1969 - 1976年），测量了身高和体重，并检测了红细胞沉降率。通过与国家癌症登记处的关联，对这些应征者进行CRC随访直至2010年1月1日。在平均35年的随访中，发生了885例CRC，包括501例结肠癌和384例直肠癌。使用Cox回归来估计调整后的风险比（HRs）和相应的95%置信区间（95% CIs）。
与青春期后期正常体重（BMI：18.5 - <25kg/m²）相比，超重上限（BMI：27.5 - <30kg/m²）与CRC风险高2.08倍相关（95% CI：1.40，3.07），肥胖（BMI：30 + kg/m²）与CRC风险高2.38倍相关（95% CI：1.51，3.76）（趋势p值：<0.001）。红细胞沉降率（15 + mm/hr）的男性青少年与低红细胞沉降率（<10mm/hr）的相比，CRC风险高63%（HR：1.63；95% CI：1.08，2.45）（趋势p值：0.006）。这些关联在解剖部位上没有显著差异。
青春期后期的BMI和以红细胞沉降率衡量的炎症可能与未来的CRC风险独立相关。需要进一步的研究来更好地理解早期生活暴露与CRC的关系。
Adult obesity and inflammation have been associated with risk of colorectal cancer (CRC); however, less is known about how adolescent body mass index (BMI) and inflammation, as measured by erythrocyte sedimentation rate (ESR), relate to CRC risk. We sought to evaluate these associations in a cohort of 239,658 Swedish men who underwent compulsory military enlistment examinations in late adolescence (ages 16–20 years). At the time of the conscription assessment (1969–1976), height and weight were measured and erythrocyte sedimentation rate was assayed. By linkage to the national cancer registry, these conscripts were followed for CRC through January 1, 2010. Over an average of 35 years of follow-up, 885 cases of CRC occurred, including 501 colon cancers and 384 rectal cancers. Cox regression was used to estimate adjusted hazard ratios (HRs) and corresponding 95% confidence intervals (95% CIs). Compared with normal weight (BMI: 18.5-<25kg/m2) in late adolescence, upper overweight (BMI: 27.5-<30 kg/m2) was associated with a 2.08-fold higher risk of CRC (95% CI: 1.40, 3.07) and obesity (BMI: 30+ kg/m2) was associated with a 2.38-fold higher risk of CRC (95% CI: 1.51, 3.76) (p-trend:<0.001). Male adolescents with ESR(15+ mm/hr) had a 63% higher risk of CRC (HR: 1.63; 95% CI: 1.08, 2.45) than those with low ESR (<10 mm/hr) (p-trend:0.006). Associations did not significantly differ by anatomic site. Late-adolescent BMI and inflammation, as measured by ESR, may be independently associated with future CRC risk. Further research is needed to better understand how early-life exposures relate to CRC.