Hernandez Brenda Y, Park Song-Yi, Wilkens Lynne R, Henderson Brian E, Kolonel Laurence N
Epidemiology Department, Cancer Research Center of Hawaii, University of Hawaii, Honolulu, Hawaii, USA.
Cancer Epidemiol Biomarkers Prev. 2009 Sep;18(9):2413-21. doi: 10.1158/1055-9965.EPI-09-0293. Epub 2009 Sep 1.
We investigated the relationship of body size and prostate cancer risk in the Multiethnic Cohort, a longitudinal study of individuals ages 45 to 75 in Hawaii and in California. Self-reported measures of height and weight were obtained at baseline. Of 83,879 men enrolled from 1993 to 1996, a total of 5,554 were diagnosed with prostate cancer during an average of 9.6 years of follow-up. The influence of baseline weight and weight change since age 21 varied by ethnic group. Whites gaining more than 10 lbs had a nonlinear, increased risk of advanced and high-grade prostate cancer [relative risks (RR), 2.12; 95% confidence intervals (CI), 1.19-3.78 for 25-39.9 lbs; P trend 0.43; and RR, 1.49; 95% CI, 1.04-2.14, for >or=40 lbs; P trend 0.20, respectively]. African American men gaining 40 lbs or more (relative to <10 lbs) had a nonmonotonic, increased risk of localized prostate cancers (RR, 1.26; 95% CI, 1.02-1.54; P trend 0.09) and those who gained 25 lbs or more were at increased risk of low-grade disease (RR, 1.28; 95% CI, 1.03-1.58, for >or=40 versus 10 lbs, respectively; P trend 0.07). Japanese men had a statistically significant, inverse association of weight gain and localized disease (RR, 0.80; 95% CI, 0.65-0.99 for >or=40 versus 10 lbs; P trend 0.05). Our findings provide evidence that adiposity and changes in adiposity between younger and older adulthood influence the development of prostate cancer. Ethnic differences in risk may be explained by variation in the distribution of accumulated body fat that could differentially affect prostate carcinogenesis.
我们在多民族队列研究中调查了体型与前列腺癌风险之间的关系，该研究对夏威夷和加利福尼亚州45至75岁的个体进行了纵向跟踪。在基线时获取了自我报告的身高和体重数据。在1993年至1996年招募的83879名男性中，共有5554人在平均9.6年的随访期间被诊断出患有前列腺癌。自21岁以来的基线体重和体重变化的影响因种族而异。体重增加超过10磅的白人患晚期和高级别前列腺癌的风险呈非线性增加[相对风险（RR）为2.12；25至39.9磅时95%置信区间（CI）为1.19 - 3.78；P趋势为0.43；体重增加≥40磅时RR为1.49；95%CI为1.04 - 2.14；P趋势为0.20]。体重增加40磅或更多（相对于增加不足10磅）的非裔美国男性患局限性前列腺癌的风险呈非单调增加（RR为1.26；95%CI为1.02 - 1.54；P趋势为0.09），而体重增加25磅或更多的男性患低级别疾病的风险增加（体重增加≥40磅与增加10磅相比，RR分别为1.28；95%CI为1.03 - 1.58；P趋势为0.07）。日本男性体重增加与局限性疾病之间存在统计学上显著的负相关（体重增加≥40磅与增加10磅相比，RR为0.80；95%CI为0.65 - 0.99；P趋势为0.05）。我们的研究结果表明，肥胖以及成年早期和成年晚期之间的肥胖变化会影响前列腺癌的发生。风险的种族差异可能由累积体脂分布的变化来解释，这种变化可能对前列腺癌发生有不同影响。
