Intentional Weight Loss and Endometrial Cancer Risk
Intentional Weight Loss and Endometrial Cancer Risk
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DOI：
10.1200/jco.2016.70.5822
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发表时间：
2017-04-10
影响因子：
45.3
通讯作者：
Margolis, Karen L.
中科院分区：
文献类型：
--
作者：
Luo, Juhua;Chlebowski, Rowan T.;Margolis, Karen L.
虽然肥胖是一个确定的子宫内膜癌危险因素，但关于体重减轻对绝经后妇女子宫内膜癌风险影响的信息有限。因此，我们评估的意向性与子宫内膜癌的妇女健康倡议（WHI）observational study.Patients和MethodsPostmenopausal妇女（N = 36,794）年龄在WHI招募年龄50至79岁的体重变化之间的关联测量和体重指数计算在基线和第3年。在此期间的体重变化分类如下：稳定（变化在+/- 5%内），减轻（变化>= 5%）和增加（变化>= 5%）。通过第3年的自我报告评估体重减轻的意向性;将变化描述为有意或无意。在随后的11.4年（平均）的随访中，566例子宫内膜癌事件经病历审查证实。多变量考克斯比例风险回归模型被用来评估体重变化和子宫内膜癌incidence.ResultsIn多变量分析之间的关系（风险比[HR]和95%CI），与妇女谁有稳定的体重（+/- 5%），体重减轻的妇女有一个显着降低子宫内膜癌的风险（HR，0.71; 95%CI，0.54至0.95）。这种关联在有意减肥的肥胖女性中最强（HR，0.44; 95%CI，0.25至0.78）。体重增加（>= 10磅）与子宫内膜癌的风险较高，比稳定的体重，特别是在妇女谁从来没有使用hormone.ConclusionIntentional体重减轻绝经后妇女子宫内膜癌的风险较低，特别是肥胖的妇女。这些发现应该激励肥胖绝经后妇女的减肥计划。(C)2017年美国临床肿瘤学会
PurposeAlthough obesity is an established endometrial cancer risk factor, information about the influence of weight loss on endometrial cancer risk in postmenopausal women is limited. Therefore, we evaluated associations among weight change by intentionality with endometrial cancer in the Women's Health Initiative (WHI) observational study.Patients and MethodsPostmenopausal women (N = 36,794) ages 50 to 79 years at WHI enrollment had their body weights measured and body mass indices calculated at baseline and at year 3. Weight change during that period was categorized as follows: stable (change within +/- 5%), loss (change >= 5%), and gain (change >= 5%). Weight loss intentionality was assessed via self-report at year 3; change was characterized as intentional or unintentional. During the subsequent 11.4 years (mean) of follow-up, 566 incident endometrial cancer occurrences were confirmed by medical record review. Multivariable Cox proportional hazards regression models were used to evaluate relationships (hazard ratios [HRs] and 95% CIs) between weight change and endometrial cancer incidence.ResultsIn multivariable analyses, compared with women who had stable weight (+/- 5%), women with weight loss had a significantly lower endometrial cancer risk (HR, 0.71; 95% CI, 0.54 to 0.95). The association was strongest among obese women with intentional weight loss (HR, 0.44; 95% CI, 0.25 to 0.78). Weight gain (>= 10 pounds) was associated with a higher endometrial cancer risk than was stable weight, especially among women who had never used hormones.ConclusionIntentional weight loss in postmenopausal women is associated with a lower endometrial cancer risk, especially among women with obesity. These findings should motivate programs for weight loss in obese postmenopausal women. (C) 2017 by American Society of Clinical Oncology