Epidemiology Program, Division of Public Health Sciences, Fred Hutchinson Cancer Research Center, Seattle, WA 98109-1024, USA.
Cancer Causes Control. 2010 Feb;21(2):223-36. doi: 10.1007/s10552-009-9453-5. Epub 2009 Oct 23.
We hypothesized that intentional weight loss may be associated with development of lymphohematopoietic cancers, based on observations of immune suppression following weight loss in short-term studies.
At the baseline of the Women's Health Initiative Observational Study (1994-1998), participants reported information about intentional weight loss episodes in the past 20 years. We estimated hazard ratios (HRs) and 95% confidence intervals (CIs) among 81,219 women for associations between past intentional weight loss and risk of developing non-Hodgkin lymphoma (NHL), leukemia, and multiple myeloma during an average 9.9 years of follow-up.
The risk of NHL was associated with having lost a large maximum amount of weight (> or =50 pounds, HR = 1.68, 95% CI 1.13-2.50). NHL risk also varied by the frequency of intentional weight loss; women had increased risk if they lost 50 pounds or more > or =3 times (HR = 1.97, 95% CI 0.93-4.16; p trend by frequency = 0.09) or 20-49 pounds > or =3 times (HR = 1.55, 95% CI 1.00-2.40; p trend = 0.05), but there was no risk associated with smaller amounts of weight loss (10-19 pounds > or =3 times, HR = 0.78, 95% CI 0.46-1.33). These associations persisted with adjustment for body mass index at different ages. We observed non-significant associations of similar magnitude for multiple myeloma, but past intentional weight loss episodes were not associated with leukemia.
Further assessment of intentional weight loss as a possible risk factor for lymphomas may provide insight into the etiology of these cancers.
我们假设,根据短期研究中体重减轻后免疫抑制的观察结果,有目的的体重减轻可能与淋巴血液系统癌症的发展有关。
在妇女健康倡议观察研究(1994-1998 年)的基线时,参与者报告了过去 20 年中有意减轻体重的情况。我们估计了 81219 名女性中过去有意减轻体重与非霍奇金淋巴瘤(NHL)、白血病和多发性骨髓瘤发展风险之间的关联的风险比(HR)和 95%置信区间(CI),平均随访 9.9 年。
NHL 的风险与失去大量最大体重(>或=50 磅,HR=1.68,95%CI 1.13-2.50)有关。NHL 风险也因有意减轻体重的频率而异;如果女性失去 50 磅或更多体重>或=3 次(HR=1.97,95%CI 0.93-4.16;p 趋势频率=0.09)或 20-49 磅>或=3 次(HR=1.55,95%CI 1.00-2.40;p 趋势=0.05),则风险增加,但与较小量的体重减轻无关(10-19 磅>或=3 次,HR=0.78,95%CI 0.46-1.33)。这些关联在调整不同年龄的体重指数后仍然存在。我们观察到多发性骨髓瘤的类似幅度的非显著关联,但过去有意减轻体重的事件与白血病无关。
进一步评估有意减轻体重作为淋巴瘤的一个可能危险因素可能有助于深入了解这些癌症的病因。