Visceral obesity is associated with an increased risk of developing esophago-gastric junctional adenocarcinoma in Japan: a population-based case?control study in Akita Prefecture
Visceral obesity is associated with an increased risk of developing esophago-gastric junctional adenocarcinoma in Japan: a population-based case?control study in Akita Prefecture
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在日本，内脏肥胖与食管胃交界处腺癌的风险增加相关：秋田县的一项基于人群的病例对照研究
DOI：
10.1007/s10388-021-00906-1
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发表时间：
2022
期刊：
影响因子：
2.4
通讯作者：
Matsuhas
中科院分区：
文献类型：
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作者：
Watanabe Kenta;Koizumi Shigeto;Shirane Kenji;Tsuda Hidehiko;Watanabe Hiroyuki;Tsuji Tsuyotoshi;Onochi Kengo;Yamai Kiyonori;Kusano Chika;Dohmen Takahiro;Horikawa Yohei;Ajimine Takuma;Saito Masahiro;Koike Tomoyuki;Masamune Atsushi;Shimodaira Yosuke;Matsuhas
背景虽然在西方国家，食管-胃结合部腺癌（EGJAC）和肥胖，特别是内脏肥胖之间的联系已经被提出，但在亚洲，包括日本，这种联系仍然不清楚。在这项以人群为基础的病例对照研究中，我们调查了EGJAC和obesity.MethodsTo执行近人口为基础的数据收集所有早期EGJAC发生在秋田县2014年至2019年，临床数据，包括内窥镜和计算机断层扫描（CT）的结果，收集了11个癌症治疗基地医院在该地区。年龄和性别匹配的对照组以1：2的病例对照比从在同一地区接受健康检查的健康受试者中提取。利用CT图像计算内脏脂肪面积（VFA）。Logistic回归分析进行调查EGJACs和肥胖相关的parameters.ResultsIn总，74 EGJAC例（62名男性，中位年龄为70岁）和148个对照组之间的关联提取。多变量分析显示，BMI与EGJAC之间存在显著负相关，VFA与EGJAC之间存在显著正相关，比值比（OR）（95%置信区间[CI]）分别为0.65（0.53-0.80）和1.01（1.01-1.02）。这些发现在另一个数据集（40个EGJAC和80个对照）中得到证实。此外，作为一个分类变量，VFA ≥ 100 cm 2与EGJAC呈显著正相关（OR [95%CI] 1.96 [1.02-3.76]）。结论我们发现在日本人群中EGJAC和肥胖相关参数（BMI与VFA）之间存在矛盾的关联，这表明VFA而不是BMI作为EGJAC的危险因素可能具有关键作用。
BackgroundWhile an association between esophago-gastric junctional adenocarcinomas (EGJACs) and obesity, especially visceral obesity, has been suggested in Western countries, the association remains unclear in Asia, including Japan. In this population-based case–control study, we investigated the association between EGJACs and obesity.MethodsTo perform near-population-based data collection for all early-stage EGJACs occurring in Akita Prefecture from 2014 to 2019, clinical data, including endoscopic and computed tomography (CT) findings, were collected from 11 cancer treatment base hospitals in the area. Age- and gender-matched controls were extracted at a case-to-control ratio of 1:2 from healthy subjects who received health checkups in the same area. The visceral fat area (VFA) was calculated using CT images. Logistic regression analyses were performed to investigate the associations between EGJACs and obesity-related parameters.ResultsIn total, 74 EGJAC cases (62 males, median age of 70 years old) and 148 controls were extracted. Multivariable analyses showed a significantly negative association between the BMI and EGJACs and a significantly positive association between the VFA and EGJACs with odds ratios (ORs) (95% confidence intervals [CIs]) of 0.65 (0.53–0.80) and 1.01 (1.01–1.02), respectively. These findings were confirmed in another dataset (40 EGJACs and 80 controls). In addition, as a categorical variable, VFA ≥ 100 cm2showed a significantly positive association with EGJACs (OR [95% CI] 1.96 [1.02–3.76]).ConclusionsWe found paradoxical associations between EGJACs and obesity-related parameters (BMI vs. VFA) in a Japanese population, suggesting a potentially pivotal role of the VFA rather than the BMI as a risk factor for EGJACs.