Pischon Tobias, Lahmann Petra H, Boeing Heiner, Tjønneland Anne, Halkjaer Jytte, Overvad Kim, Klipstein-Grobusch Kerstin, Linseisen Jakob, Becker Nikolaus, Trichopoulou Antonia, Benetou Vassiliki, Trichopoulos Dimitrios, Sieri Sabina, Palli Domenico, Tumino Rosario, Vineis Paolo, Panico Salvatore, Monninkhof Evelyn, Peeters Petra H M, Bueno-de-Mesquita H Bas, Büchner Frederike L, Ljungberg Börje, Hallmans Göran, Berglund Göran, Gonzalez Carlos Alberto, Dorronsoro Miren, Gurrea Aurelio Barricarte, Navarro Carmen, Martinez Carmen, Quirós J Ramón, Roddam Andrew, Allen Naomi, Bingham Sheila, Khaw Kay-Tee, Kaaks Rudolf, Norat Teresa, Slimani Nadia, Riboli Elio
Department of Epidemiology, German Institute of Human Nutrition, Potsdam-Rehbruecke, Germany.
Int J Cancer. 2006 Feb 1;118(3):728-38. doi: 10.1002/ijc.21398.
Previous studies suggest that obesity is related to increased risk of renal cell carcinoma (RCC); however, only a few studies report on measures of central vs. peripheral adiposity. We examined the association between anthropometric measures, including waist and hip circumference and RCC risk among 348,550 men and women free of cancer at baseline from 8 countries of the European Prospective Investigation into Cancer and Nutrition (EPIC). During 6.0 years of follow-up we identified 287 incident cases of RCC. Relative risks were calculated using Cox regression, stratified by age and study center and adjusted for smoking status, education, alcohol consumption, physical activity, menopausal status, and hormone replacement therapy use. Among women, an increased risk of RCC was conferred by body weight (relative risk [RR] in highest vs. lowest quintile = 2.13; 95% confidence interval [CI] = 1.16-3.90; p-trend = 0.003), body mass index (BMI) (RR = 2.25; 95% CI = 1.14-4.44; p-trend = 0.009), and waist (RR = 1.67; 95% CI = 0.94-2.98; p-trend = 0.003) and hip circumference (RR = 2.30; 95% CI = 1.22-4.34; p-trend = 0.01); however, waist and hip circumference were no longer significant after controlling for body weight. Among men, hip circumference (RR = 0.44; 95% CI = 0.20-0.98; p-trend = 0.03) was related significantly to decreased RCC risk only after accounting for body weight. Height was not related significantly to RCC risk. Our findings suggest that obesity is related to increased risk of RCC irrespective of fat distribution among women, whereas low hip circumference is related to increased RCC risk among men. Our data give further credence to public health efforts aiming to reduce the prevalence of obesity to prevent RCC, in addition to other chronic diseases.
先前的研究表明，肥胖与肾细胞癌（RCC）风险增加有关；然而，只有少数研究报告了中心性肥胖与外周性肥胖的测量指标。我们在欧洲癌症与营养前瞻性调查（EPIC）的8个国家中，对348,550名基线时无癌症的男性和女性进行了研究，考察了包括腰围和臀围在内的人体测量指标与RCC风险之间的关联。在6.0年的随访期间，我们确定了287例RCC新发病例。使用Cox回归计算相对风险，按年龄和研究中心分层，并对吸烟状况、教育程度、饮酒量、身体活动、绝经状态和激素替代疗法的使用进行了调整。在女性中，体重（最高五分位数与最低五分位数的相对风险[RR]=2.13；95%置信区间[CI]=1.16 - 3.90；p趋势=0.003）、体重指数（BMI）（RR = 2.25；95% CI = 1.14 - 4.44；p趋势=0.009）、腰围（RR = 1.67；95% CI = 0.94 - 2.98；p趋势=0.003）和臀围（RR = 2.30；95% CI = 1.22 - 4.34；p趋势=0.01）与RCC风险增加有关；然而，在控制体重后，腰围和臀围不再具有显著性。在男性中，仅在考虑体重后，臀围（RR = 0.44；95% CI = 0.20 - 0.98；p趋势=0.03）与RCC风险降低显著相关。身高与RCC风险无显著关联。我们的研究结果表明，无论女性的脂肪分布如何，肥胖都与RCC风险增加有关，而低臀围与男性RCC风险增加有关。我们的数据进一步支持了旨在降低肥胖患病率以预防RCC及其他慢性疾病的公共卫生努力。
