Patel Alpa V, Rodriguez Carmen, Bernstein Leslie, Chao Ann, Thun Michael J, Calle Eugenia E
Department of Epidemiology and Surveillance Research, American Cancer Society, National Home Office, 1599 Clifton Road Northeast, Atlanta, GA 30329-4251, USA.
Cancer Epidemiol Biomarkers Prev. 2005 Feb;14(2):459-66. doi: 10.1158/1055-9965.EPI-04-0583.
Obesity and physical activity, in part through their effects on insulin sensitivity, may be modifiable risk factors for pancreatic cancer.
The authors analyzed data from the American Cancer Society Cancer Prevention Study II Nutrition Cohort to examine the association between measures of adiposity, recreational physical activity, and pancreatic cancer risk. Information on current weight and weight at age 18, location of weight gain, and recreational physical activity were obtained at baseline in 1992 via a self-administered questionnaire for 145,627 men and women who were cancer-free at enrollment. During the 7 years of follow-up, 242 incident pancreatic cancer cases were identified among these participants. Cox proportional hazards modeling was used to compute hazard rate ratios (RR) and to adjust for potential confounding factors including personal history of diabetes and smoking.
We observed an increased risk of pancreatic cancer among obese [body mass index (BMI) >/= 30] men and women compared with men and women of normal BMI [<25; RR, 2.08; 95% confidence interval (95% CI), 1.48-2.93, P(trend) = 0.0001]. After adjustment for between BMI, risk of pancreatic cancer was independently increased among men and women who reported a tendency for central weight gain compared with men and women reporting a tendency for peripheral weight gain (RR, 1.45; 95% CI, 1.02-2.07). We observed no difference in pancreatic cancer incidence rates between men and women who were most active (>31.5 metabolic equivalent hours per week) at baseline compared with men and women who reported no recreational physical activity (RR, 1.20; 95% CI, 0.63-2.27).
This study, along with several recent studies, supports the hypothesis that obesity and central adiposity are associated with pancreatic cancer risk.
肥胖和身体活动，部分通过对胰岛素敏感性的影响，可能是胰腺癌可改变的风险因素。
作者分析了美国癌症协会癌症预防研究II营养队列的数据，以研究肥胖指标、休闲体育活动与胰腺癌风险之间的关联。1992年通过自填问卷，收集了145,627名入组时无癌症的男性和女性的当前体重、18岁时的体重、体重增加部位以及休闲体育活动等信息。在7年的随访期间，这些参与者中确诊了242例胰腺癌新发病例。采用Cox比例风险模型计算风险率比（RR），并对包括糖尿病和吸烟个人史等潜在混杂因素进行调整。
我们观察到，与体重指数（BMI）正常（<25）的男性和女性相比，肥胖（BMI≥30）的男性和女性患胰腺癌的风险增加[RR，2.08；95%置信区间（95%CI），1.48 - 2.93，P（趋势）=0.0001]。在调整BMI差异后，与报告有外周性体重增加倾向的男性和女性相比，报告有中心性体重增加倾向的男性和女性患胰腺癌的风险独立增加（RR，1.45；95%CI，1.02 - 2.07）。我们观察到，与报告无休闲体育活动的男性和女性相比，基线时最活跃（每周代谢当量小时数>31.5）的男性和女性之间胰腺癌发病率无差异（RR，1.20；95%CI，0.63 - 2.27）。
本研究以及最近的几项研究支持肥胖和中心性肥胖与胰腺癌风险相关的假说。
