Prospective study of adiposity and weight change in relation to prostate cancer incidence and mortality
Prospective study of adiposity and weight change in relation to prostate cancer incidence and mortality
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DOI：
10.1002/cncr.22443
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发表时间：
2007-02-15
期刊：
影响因子：
6.2
通讯作者：
Leitzmann, Michael F.
中科院分区：
文献类型：
--
作者：
Wright, Margaret E.;Chang, Shih-Chen;Leitzmann, Michael F.
背景肥胖与前列腺癌的联系并不一致，很少有研究评估这种联系是否因疾病的侵袭性而异。作者前瞻性研究了美国国立卫生研究院-美国退休人员协会饮食与健康研究中287,760名年龄在50 - 71岁的男性（1995-1996年）的体重指数（BMI）和成人体重变化与前列腺癌发病率和死亡率的关系。在基线时，参与者完成了关于身高，体重和癌症筛查实践的问卷调查，包括直肠指检和前列腺特异性抗原检测。采用考克斯回归分析计算相对危险度（RR）和95%置信区间（95% CI）。在5年的随访中，总共确定了9986例前列腺癌，在6年的随访中确定了173例前列腺癌死亡。在多变量模型中，较高的基线BMI与前列腺癌总发病率显著降低相关，主要是因为与局部肿瘤的关系（对于最高BMI类别[>= 40 kg/m2]的男性与最低BMI类别[< 25 kg/m2]的男性：RR，0.67; 95% CI，0.50-0.89;P= 0.0006）。相反，在较高BMI水平下观察到前列腺癌死亡率显著升高（BMI < 25 kg/m2：RR，1.0 [参考组]; BMI 25-29.9 kg/m2：RR，1.25; 95% CI，0.871.80; BMI 30-34）。9 kg/m（2）：RR，1.46; 95% CI，0.92-2.33; BMI ≥ 35 kg/m（2）：RR，2.12; 95% CI，1.08-4.15; P=.02）。从18岁到基线的成人体重增加也与致死性前列腺癌呈正相关（P= 0.009），但与偶发疾病无关。虽然肥胖与前列腺癌发病率没有正相关，但较高的BMI和成人体重增加会增加死于前列腺癌的风险。
BACKGROUND. Adiposity has been linked inconsistently with prostate cancer, and few Studies have evaluated whether such associations vary by disease aggressiveness.METHODS. The authors prospectively examined body mass index (BMI) and adult weight change in relation to prostate cancer incidence and mortality in 287,760 men ages 50 years to 71 years at enrollment (1995-1996) in the National Institutes of Health-AARP Diet and Health Study. At baseline, participants completed questionnaires regarding height, weight, and cancer screening practices, including digital rectal examinations and prostate-specific antigen tests. Cox regression analysis was used to calculate relative risks (RR) and 95% confidence intervals (95% CIs).RESULTS. in total, 9986 incident prostate cancers were identified during 5 years of follow-up, and 173 prostate cancer deaths were ascertained during 6 years of follow-up. In multivariate models, higher baseline BMI was associated with significantly reduced total prostate cancer incidence, largely because of the relationship with localized tumors (for men in the highest BMI category [>= 40 kg/m(2)] vs men in the lowest BMI category [< 25 kg/m(2)]: RR, 0.67; 95% CI, 0.50-0.89;P=.0006). Conversely, a significant elevation in prostate cancer mortality was observed at higher BMI levels (BMI < 25 kg/m(2) : RR, 1.0 [referent group]; BMI 25-29.9 kg/m(2) : RR, 1.25; 95% CI, 0.871.80; BMI 30-34. 9 kg/m(2) : RR, 1.46; 95% CI, 0.92-2.33; and BMI >= 35 kg/m(2) : RR, 2.12; 95% CI, 1.08-4.15; P=.02). Adult weight gain from age 18 years to baseline also was associated positively with fatal prostate cancer (P=.009), but not with incident disease.CONCLUSIONS. Although adiposity was not related positively to prostate cancer incidence, higher BMI and adult weight gain increased the risk of dying from prostate cancer.