Chang Ellen T, Hjalgrim Henrik, Smedby Karin Ekström, Akerman Måns, Tani Edneia, Johnsen Hans E, Glimelius Bengt, Adami Hans-Olov, Melbye Mads
Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Box 281, SE-171 77 Stockholm, Sweden.
J Natl Cancer Inst. 2005 Feb 2;97(3):210-8. doi: 10.1093/jnci/dji012.
The incidence of non-Hodgkin lymphoma and prevalence of obesity are increasing globally. A suggested positive association between obesity and risk of non-Hodgkin lymphoma has prompted us to investigate the relationship between body mass index (BMI) and risk of malignant lymphoma subtypes in a population-based case-control study.
Telephone interviews were conducted with 3055 case patients with non-Hodgkin lymphoma and 618 case patients with Hodgkin lymphoma diagnosed between October 1, 1999, and August 30, 2002, and 3187 population-based control subjects. The interviews assessed current height, normal adult weight, and other possible risk factors. Multivariable odds ratios (ORs) and corresponding 95% confidence intervals (CIs) for risk of lymphoma were estimated by unconditional logistic regression. All statistical tests were two-sided.
BMI was not associated with risk of overall non-Hodgkin lymphoma or of Hodgkin lymphoma (for example, comparing the highly obese group [BMI > or =35.0 kg/m2] with the normal-weight group [BMI = 18.5-24.9 kg/m2], OR for risk of non-Hodgkin lymphoma = 0.9, 95% CI = 0.6 to 1.3; P(trend) across all categories of BMI = .27). BMI was also not associated with risk of any non-Hodgkin lymphoma subtype evaluated, although there was some evidence of a positive association with risk of diffuse large B-cell lymphoma (for example, comparing the highly obese group with the normal-weight group, OR for diffuse large B-cell lymphoma = 1.5, 95% CI = 0.9 to 2.4; P(trend) =.05).
Excess weight does not appear to be associated with an increased risk of malignant lymphoma in general, or with a risk of most major lymphoma subtypes. Hence, the growing incidence of obesity is unlikely to be an important contributor to the increasing incidence of non-Hodgkin lymphoma worldwide.
全球范围内,非霍奇金淋巴瘤的发病率和肥胖患病率都在上升。肥胖与非霍奇金淋巴瘤风险之间可能存在的正相关关系促使我们在一项基于人群的病例对照研究中,调查体重指数(BMI)与恶性淋巴瘤亚型风险之间的关系。
对1999年10月1日至2002年8月30日期间确诊的3055例非霍奇金淋巴瘤患者、618例霍奇金淋巴瘤患者以及3187例基于人群的对照对象进行了电话访谈。访谈评估了当前身高、正常成人体重以及其他可能的风险因素。通过无条件逻辑回归估计淋巴瘤风险的多变量优势比(OR)和相应的95%置信区间(CI)。所有统计检验均为双侧检验。
BMI与总体非霍奇金淋巴瘤或霍奇金淋巴瘤的风险无关(例如,将高度肥胖组[BMI≥35.0kg/m²]与正常体重组[BMI=18.5-24.9kg/m²]进行比较,非霍奇金淋巴瘤风险的OR=0.9,95%CI=0.6至1.3;所有BMI类别之间的P(趋势)=.27)。BMI与所评估的任何非霍奇金淋巴瘤亚型的风险也无关,尽管有一些证据表明与弥漫性大B细胞淋巴瘤的风险呈正相关(例如,将高度肥胖组与正常体重组进行比较,弥漫性大B细胞淋巴瘤的OR=1.5,95%CI=0.9至2.4;P(趋势)=.05)。
总体而言,超重似乎与恶性淋巴瘤风险增加无关,也与大多数主要淋巴瘤亚型的风险无关。因此,肥胖发生率的上升不太可能是全球非霍奇金淋巴瘤发病率上升的重要原因。