Lifetime weight history and endometrial cancer risk by type of menopausal hormone use in the NIH-AARP diet and health study
Lifetime weight history and endometrial cancer risk by type of menopausal hormone use in the NIH-AARP diet and health study
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DOI：
10.1158/1055-9965.epi-06-0675
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发表时间：
2007-04-01
影响因子：
3.8
通讯作者：
Leitzmann, Michael F.
中科院分区：
文献类型：
--
作者：
Chang, Shih-Chen;Lacey, James V., Jr.;Leitzmann, Michael F.
肥胖和绝经期雌激素治疗是子宫内膜癌的既定危险因素。然而，肥胖和绝经期激素治疗对子宫内膜癌风险的联合作用尚不完全清楚。我们在1995年至1996年基线时对103，882名年龄在50至71岁之间的女性进行了研究。在中位数为4.6年的时间里，到2000年，总共有455，304人-年的随访，确定了677例子宫内膜癌。基线体重指数（BMI）和成人体重增加均与子宫内膜癌风险增加相关。肥胖与正常体重女性（BMI > 30 vs < 25 kg/m2）比较的多变量相对危险度（RR）为3.03 [95%可信区间（95%CI），2.50-3.68]。与18岁和基线之间体重稳定（增加或减少< 5 kg）的女性相比，体重增加>= 20 kg的女性的RR为2.75（95% CI，1.96-3.86）。激素治疗显著改变了BMI（P交互作用< 0.001）和成人体重增加（P交互作用= 0.004）与子宫内膜癌风险的关系。与正常体重相比，从未使用过绝经期激素治疗的妇女肥胖的RR为5.41（95%CI，4.01-7.29），曾使用过绝经期激素治疗的妇女肥胖的RR为2.53（95%CI，1.21-5.30），目前使用激素治疗的妇女肥胖的RR为1.44（95%CI，1.00-2.05）。与18岁和基线之间的稳定体重相比，体重增加的RR！20 kg体重的绝经期激素治疗者和未使用者的平均体重分别为5.35（95% CI，3.01-9.52）和1.43（95% CI，0.96-2.15）。我们的结论是，目前的肥胖和成年体重增加与子宫内膜癌的风险大幅增加，与关系尤其明显，在从未使用绝经激素治疗。
Obesity and menopausal estrogen therapy are established risk factors for endometrial cancer. However, the joint effects of obesity and menopausal hormone therapy on endometrial cancer risk are incompletely understood. We addressed this issue in a cohort of 103,882 women ages 50 to 71 years at baseline in 1995 to 1996. During a median of 4.6 years, which contributed to a total of 455,304 person-years of follow-up through 2000, 677 cases of endometrial cancer were ascertained. Both baseline body mass index (BMI) and adult weight gain were associated with increased endometrial cancer risk. The multivariate relative risk (RR) comparing obese with normal weight women (BMI > 30 versus < 25 kg/m(2)) was 3.03 [95% confidence interval (95% CI), 2.50-3.68]. Compared with women with stable weight (gained or lost < 5 kg) between age 18 and baseline, women who gained >= 20 kg had a RR of 2.75 (95% Cl, 1.96-3.86). Menopausal Introduction hormone therapy significantly modified the relations of BMI (Pinteraction < 0.001) and adult weight gain (P-interaction = 0.004) to endometrial cancer risk. Compared with normal weight, the RRs for obesity were 5.41 (95% Cl, 4.01-7.29) among women who never used menopausal hormone therapy, 2.53 (95% Cl, 1.21-5.30) among former menopausal hormone therapy users, and 1.44 (95% Cl, 1.00-2.05) among current users. Compared with a stable weight between age 18 and baseline, the RRs for weight gain of !20 kg among never users and ever users of menopausal hormone therapy were 5.35 (95% Cl, 3.01-9.52) and 1.43 (95% Cl, 0.96-2.15), respectively. We conclude that both current adiposity and adult weight gain are associated with substantial increases in the risk of endometrial cancer, with relations particularly evident among never users of menopausal hormone therapy.