人体测量指标、体重指数与胰腺癌：来自胰腺癌队列联盟（PanScan）的汇总分析
Anthropometric measures, body mass index, and pancreatic cancer: a pooled analysis from the Pancreatic Cancer Cohort Consortium (PanScan).
作者信息
Arslan Alan A, Helzlsouer Kathy J, Kooperberg Charles, Shu Xiao-Ou, Steplowski Emily, Bueno-de-Mesquita H Bas, Fuchs Charles S, Gross Myron D, Jacobs Eric J, Lacroix Andrea Z, Petersen Gloria M, Stolzenberg-Solomon Rachael Z, Zheng Wei, Albanes Demetrius, Amundadottir Laufey, Bamlet William R, Barricarte Aurelio, Bingham Sheila A, Boeing Heiner, Boutron-Ruault Marie-Christine, Buring Julie E, Chanock Stephen J, Clipp Sandra, Gaziano J Michael, Giovannucci Edward L, Hankinson Susan E, Hartge Patricia, Hoover Robert N, Hunter David J, Hutchinson Amy, Jacobs Kevin B, Kraft Peter, Lynch Shannon M, Manjer Jonas, Manson Joann E, McTiernan Anne, McWilliams Robert R, Mendelsohn Julie B, Michaud Dominique S, Palli Domenico, Rohan Thomas E, Slimani Nadia, Thomas Gilles, Tjønneland Anne, Tobias Geoffrey S, Trichopoulos Dimitrios, Virtamo Jarmo, Wolpin Brian M, Yu Kai, Zeleniuch-Jacquotte Anne, Patel Alpa V
机构信息
Department of Obstetrics and Gynecology, New York University School of Medicine, 550 First Ave, TH-528, New York, NY 10016, USA.
出版信息
Arch Intern Med. 2010 May 10;170(9):791-802. doi: 10.1001/archinternmed.2010.63.
BACKGROUND
Obesity has been proposed as a risk factor for pancreatic cancer.
METHODS
Pooled data were analyzed from the National Cancer Institute Pancreatic Cancer Cohort Consortium (PanScan) to study the association between prediagnostic anthropometric measures and risk of pancreatic cancer. PanScan applied a nested case-control study design and included 2170 cases and 2209 control subjects. Odds ratios (ORs) and 95% confidence intervals (CIs) were estimated using unconditional logistic regression for cohort-specific quartiles of body mass index (BMI [calculated as weight in kilograms divided by height in meters squared]), weight, height, waist circumference, and waist to hip ratio as well as conventional BMI categories (underweight, <18.5; normal weight, 18.5-24.9; overweight, 25.0-29.9; obese, 30.0-34.9; and severely obese, > or = 35.0). Models were adjusted for potential confounders.
RESULTS
In all of the participants, a positive association between increasing BMI and risk of pancreatic cancer was observed (adjusted OR for the highest vs lowest BMI quartile, 1.33; 95% CI, 1.12-1.58; P(trend) < .001). In men, the adjusted OR for pancreatic cancer for the highest vs lowest quartile of BMI was 1.33 (95% CI, 1.04-1.69; P(trend) < .03), and in women it was 1.34 (95% CI, 1.05-1.70; P(trend) = .01). Increased waist to hip ratio was associated with increased risk of pancreatic cancer in women (adjusted OR for the highest vs lowest quartile, 1.87; 95% CI, 1.31-2.69; P(trend) = .003) but less so in men.
CONCLUSIONS
These findings provide strong support for a positive association between BMI and pancreatic cancer risk. In addition, centralized fat distribution may increase pancreatic cancer risk, especially in women.
背景
肥胖已被认为是胰腺癌的一个风险因素。
方法
对来自美国国立癌症研究所胰腺癌队列联盟（PanScan）的汇总数据进行分析，以研究诊断前人体测量指标与胰腺癌风险之间的关联。PanScan采用巢式病例对照研究设计，纳入了2170例病例和2209例对照。使用无条件逻辑回归对体重指数（BMI [计算方法为体重（千克）除以身高（米）的平方]）、体重、身高、腰围和腰臀比的队列特定四分位数以及传统BMI类别（体重过轻，<18.5；正常体重，18.5 - 24.9；超重，25.0 - 29.9；肥胖，30.0 - 34.9；严重肥胖，≥35.0）估计比值比（OR）和95%置信区间（CI）。模型针对潜在混杂因素进行了调整。
结果
在所有参与者中，观察到BMI升高与胰腺癌风险之间存在正相关（最高BMI四分位数与最低BMI四分位数相比的调整后OR为1.33；95% CI，1.12 - 1.58；P趋势<.001）。在男性中，BMI最高四分位数与最低四分位数相比的胰腺癌调整后OR为1.33（95% CI，1.04 - 1.69；P趋势<.03），在女性中为1.34（95% CI，1.05 - 1.70；P趋势 =.01）。腰臀比增加与女性胰腺癌风险增加相关（最高四分位数与最低四分位数相比的调整后OR为1.87；95% CI，1.31 - 2.69；P趋势 =.003），但在男性中相关性较弱。
结论
这些发现为BMI与胰腺癌风险之间的正相关提供了有力支持。此外，脂肪集中分布可能会增加胰腺癌风险，尤其是在女性中。
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