Metabolic health reduces risk of obesity-related cancer in framingham study adults.
Metabolic health reduces risk of obesity-related cancer in framingham study adults.
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代谢健康降低了弗雷明汉研究成年人中与肥胖相关癌症的风险。
DOI：
10.1158/1055-9965.epi-14-0240
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发表时间：
2014-10
期刊：
影响因子：
--
通讯作者：
Denis GV
中科院分区：
文献类型：
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作者：
Moore LL;Chadid S;Singer MR;Kreger BE;Denis GV
目前尚不清楚代谢不健康和健康的超重/肥胖成人之间肥胖相关癌症的风险是否存在差异。在心脏研究中，年龄在55-69岁的成年人（n=3763）的体重指数（BMI）、腰围（WC）、腰高比（WHtR）和随机血糖数据被用于评估肥胖相关癌症（n=385）的风险，包括绝经后乳腺癌、女性生殖系统癌、结肠癌、肝癌、胆囊癌、胰腺癌和肾癌以及食管腺癌。多变量校正的考克斯比例风险模型用于估计三个风险组（与正常体重/正常葡萄糖的参考组相比）受试者中与体脂和代谢健康（由葡萄糖水平定义）相关的肥胖相关癌症的风险：正常体重/葡萄糖升高;超重/正常葡萄糖;超重/葡萄糖升高。血糖升高（≥125 mg/dL）的超重成人（BMI≥25或WHtR≥0.51（男性）和≥0.57（女性））发生肥胖相关癌症的风险增加2倍，而血糖正常的超重成人发生肥胖相关癌症的风险增加50%。正常体重的成年人血糖升高没有额外的癌症风险。BMI和WHtR的影响相互独立。最后，血糖水平升高的超重女性患女性生殖系统（宫颈癌、子宫内膜癌、子宫癌）和绝经后乳腺癌的风险增加2.6倍（95% CI：1.4-4.9），而血糖水平正常的超重女性仅增加70%的风险（95% CI：1.1-2.5）。这些结果表明，代谢健康的超重/肥胖老年人患癌症的风险可能低于代谢功能障碍的超重/肥胖成年人。代谢功能障碍和肥胖协同作用，增加癌症风险。
It is unknown whether the risk for obesity-related cancers between metabolically unhealthy and healthy overweight/obese adults. Data on body mass index (BMI), waist circumference (WC), waist-to-height ratio (WHtR), and random blood glucose in Framingham Heart Study adults (n=3763) ages 55-69 were used to estimate risks of obesity-related cancers (n=385) including post-menopausal breast, female reproductive, colon, liver, gallbladder, pancreas, and kidney cancers, as well as esophageal adenocarcinomas. Multivariable-adjusted Cox proportional hazards models were used to estimate risk for obesity-related cancers associated with body fat and metabolic health (as defined by glucose levels) among subjects in three risk groups (vs. referent group with normal-weight/normal glucose): normal-weight/elevated glucose; overweight/normal glucose; and overweight/elevated glucose. Overweight adults (BMI≥25 or WHtR≥0.51 (men) and ≥0.57 (women)) with elevated glucose (≥125 mg/dL) had a statistically significant two-fold increased risk of developing obesity-related cancer while overweight adults with normal glucose had a 50% increased risk. Normal-weight adults with elevated glucose had no excess cancer risk. The effects of BMI and WHtR were independent of one another. Finally, overweight women with elevated blood glucose had a 2.6-fold increased risk (95% CI: 1.4-4.9) of female reproductive (cervical, endometrial, uterine cancers) and post-menopausal breast cancers while overweight women with normal glucose levels had only a 70% increased risk (95% CI: 1.1-2.5). These results suggest that cancer risk may be lower among metabolically-healthy overweight/obese older adults than among overweight/obese adults with metabolic dysfunction. Metabolic dysfunction and obesity act synergistically to increase cancer risk.