Prospective study of body size throughout the life-course and the incidence of endometrial cancer among premenopausal and postmenopausal women.
Prospective study of body size throughout the life-course and the incidence of endometrial cancer among premenopausal and postmenopausal women.
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DOI：
10.1002/ijc.29427
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发表时间：
2015-08-01
影响因子：
6.4
通讯作者：
Michels KB
中科院分区：
文献类型：
--
作者：
Dougan MM;Hankinson SE;Vivo ID;Tworoger SS;Glynn RJ;Michels KB
虽然成人肥胖已知会增加子宫内膜癌的风险，但儿童肥胖的证据有限。我们前瞻性地研究了终生肥胖与子宫内膜癌风险之间的关系。47，289名护士健康研究（NHS）和105，386名护士健康研究II（NHS II）的成员使用象形图回忆了他们在5岁，10岁和20岁时的身体脂肪。儿童和青少年的身体肥胖分别是5岁和10岁以及10岁和20岁时的平均值。我们从同期问卷中获得成人体重。我们使用考克斯比例风险模型计算子宫内膜癌的风险比（HR）。在随访期间，诊断出757例子宫内膜癌。儿童期、10岁、青春期和20岁时的身体肥胖与子宫内膜癌风险呈正相关（青春期≥ 5级与≤ 2级的HR：1.83（95% CI 1.41-2.37））。在调整了最近的BMI后，没有任何相关性持续存在。自18岁以来的体重变化与子宫内膜癌风险呈正相关[增加≥ 25 kg vs稳定的HR：2.54（95% CI 1.80-3.59）。成人BMI与子宫内膜癌风险密切相关[HR BMI ≥ 35 kg/m2 vs BMI ≤ 25 kg/m2：4.13（95% CI 3.29-5.16）]。在绝经后妇女中，非激素治疗者与BMI的相关性明显更强。总之，终生肥胖与子宫内膜癌风险呈正相关，成人肥胖是最强的风险因素之一。在整个生命中保持健康的体重仍然很重要。
Although adult obesity is known to increase endometrial cancer risk, evidence for childhood obesity is limited. We prospectively examined the association between body fatness throughout life and endometrial cancer risk. 47,289 members of the Nurses’ Health Study (NHS) and 105,386 of the Nurses’ Health Study II (NHS II) recalled their body fatness at ages 5, 10, and 20 using a pictogram. Childhood and adolescent body fatness were derived as the average at ages 5 and 10, and ages 10 and 20, respectively. We obtained adult weight from concurrent questionnaires. We calculated hazard ratios (HR) of endometrial cancer using Cox proportional hazards models. During follow-up, 757 incident cases of endometrial cancer were diagnosed. Body fatness in childhood, at age 10, in adolescence, and at age 20 were positively associated with endometrial cancer risk (HR for ≥ Level 5 versus ≤ Level 2 in adolescence: 1.83 (95% CI 1.41-2.37). After adjusting for most recent BMI, none of the associations persisted. Weight change since age 18 was positively associated with endometrial cancer risk [HR for ≥ 25 kg gain versus stable: 2.54 (95% CI 1.80-3.59). Adult BMI was strongly associated with endometrial cancer risk [HR BMI ≥ 35 kg/m2 versus BMI ≤ 25 kg/m2: 4.13 (95% CI 3.29-5.16)]. In postmenopausal women, the association with BMI was significantly stronger among non-users of hormone therapy. In conclusion, obesity throughout life is positively associated with endometrial cancer risk, with adult obesity one of the strongest risk factors. Maintaining a healthy weight throughout life remains important.