欧洲癌症与营养前瞻性调查中身体大小与前列腺癌风险

Body size and risk of prostate cancer in the European prospective investigation into cancer and nutrition.

作者信息

Pischon Tobias, Boeing Heiner, Weikert Steffen, Allen Naomi, Key Tim, Johnsen Nina Føns, Tjønneland Anne, Severinsen Marianne Tang, Overvad Kim, Rohrmann Sabine, Kaaks Rudolf, Trichopoulou Antonia, Zoi Gitaki, Trichopoulos Dimitrios, Pala Valeria, Palli Domenico, Tumino Rosario, Sacerdote Carlotta, Bueno-de-Mesquita H Bas, May Anne, Manjer Jonas, Wallström Peter, Stattin Pär, Hallmans Göran, Buckland Genevieve, Larrañaga Nerea, Chirlaque María Dolores, Martínez Carmen, Redondo Cornejo María L, Ardanaz Eva, Bingham Sheila, Khaw Kay-Tee, Rinaldi Sabina, Slimani Nadia, Jenab Mazda, Riboli Elio

机构信息

Department of Epidemiology, German Institute of Human Nutrition Potsdam-Rehbruecke, Nuthetal, Germany.

出版信息

Cancer Epidemiol Biomarkers Prev. 2008 Nov;17(11):3252-61. doi: 10.1158/1055-9965.EPI-08-0609.

DOI:10.1158/1055-9965.EPI-08-0609

PMID:18990768

Abstract

BACKGROUND

Body size has been hypothesized to influence the risk of prostate cancer; however, most epidemiologic studies have relied on body mass index (BMI) to assess adiposity, whereas only a few studies have examined whether body fat distribution predicts prostate cancer.

METHODS

We examined the association of height, BMI, waist and hip circumference, and waist-hip ratio with prostate cancer risk among 129,502 men without cancer at baseline from 8 countries of the European Prospective Investigation into Cancer and Nutrition (EPIC), using Cox regression, with age as time metric, stratifying by study center and age at recruitment, and adjusting for education, smoking status, alcohol consumption, and physical activity.

RESULTS

During a mean follow-up of 8.5 years, 2,446 men developed prostate cancer. Waist circumference and waist-hip ratio were positively associated with risk of advanced disease. The relative risk of advanced prostate cancer was 1.06 (95% confidence interval, 1.01-1.1) per 5-cm-higher waist circumference and 1.21 (95% confidence interval, 1.04-1.39) per 0.1-unit-higher waist-hip ratio. When stratified by BMI, waist circumference and waist-hip ratio were positively related to risk of total, advanced, and high-grade prostate cancer among men with lower but not among those with higher BMI (Pinteraction for waist with BMI, 0.25, 0.02, and 0.05, respectively; Pinteraction for waist-hip ratio with BMI, 0.27, 0.22, and 0.14; respectively).

CONCLUSIONS

These data suggest that abdominal adiposity may be associated with an increased risk of advanced prostate cancer. This association may be stronger among individuals with lower BMI; however, this finding needs confirmation in future studies.

摘要

背景

有假说认为体型会影响前列腺癌风险；然而，大多数流行病学研究依赖体重指数（BMI）来评估肥胖程度，而仅有少数研究探讨了体脂分布是否可预测前列腺癌。

方法

我们在欧洲癌症与营养前瞻性调查（EPIC）的8个国家的129,502名基线时无癌症的男性中，采用Cox回归分析身高、BMI、腰围和臀围以及腰臀比与前列腺癌风险的关联，以年龄作为时间指标，按研究中心和招募时的年龄进行分层，并对教育程度、吸烟状况、饮酒量和体力活动进行校正。

结果

在平均8.5年的随访期间，2446名男性患前列腺癌。腰围和腰臀比与晚期疾病风险呈正相关。腰围每增加5厘米，晚期前列腺癌的相对风险为1.06（95%置信区间，1.01 - 1.1）；腰臀比每增加0.1个单位，相对风险为1.21（95%置信区间，1.04 - 1.39）。按BMI分层时，腰围和腰臀比与BMI较低男性的总体前列腺癌、晚期前列腺癌和高级别前列腺癌风险呈正相关，而与BMI较高男性无关（腰围与BMI的交互P值分别为0.25、0.02和0.05；腰臀比与BMI的交互P值分别为0.27、0.22和0.14）。