Department of Epidemiology, UCLA School of Public Health, Los Angeles, CA, USA.
Int J Cancer. 2011 Mar 15;128(6):1449-61. doi: 10.1002/ijc.25468.
Previous studies reported an inverse relationship between body mass index (BMI) and upper aerodigestive tract (UADT) cancers. Examining change in BMI over time may clarify these previous observations. We used data from 2,048 cases and 2,173 hospital- and population-based controls from ten European countries (alcohol-related cancers and genetic susceptibility in Europe study) to investigate the relationship with BMI and adult change in BMI on UADT cancer risk. Odds ratios (ORs) and 95% confidence intervals (CIs) were estimated for associations between BMI at three time intervals and BMI change on UADT cancer development, adjusting for center, age, sex, education, fruit and vegetable intake, smoking and alcohol consumption. We found an inverse relationship between UADT cancers and BMI at time of interview and 2 years before interview. No association was found with BMI at 30 years of age. Regarding BMI change between age 30 and 2 years before interview, BMI decrease (BMI change <-5%) vs. BMI stability (-5% ≤ BMI change <5%) showed no overall association with UADT cancers (OR = 1.15; 95% CI = 0.89, 1.49). An increase in BMI (BMI change ≥+5%) was inversely associated with UADT cancers (OR = 0.74; 95% CI = 0.62, 0.89). BMI gain remained inversely associated across all subsites except for esophageal cancer. When stratified by smoking or by drinking, association with BMI gain was detected only in drinkers and smokers. In conclusion, BMI gain is inversely associated with UADT cancers. These findings may be influenced by smoking and/or drinking behaviors and/or the development of preclinical UADT cancers and should be corroborated in studies of a prospective nature.
先前的研究报告称，体重指数（BMI）与上呼吸道-消化道（UADT）癌症之间呈负相关。通过观察 BMI 随时间的变化，或许可以澄清这些先前的观察结果。我们利用来自十个欧洲国家的 2048 例病例和 2173 例医院和人群对照的数据（欧洲与酒精相关癌症和遗传易感性研究），研究了 BMI 与 UADT 癌症风险之间的关系，以及 BMI 随时间的变化与 UADT 癌症发展之间的关系。通过调整中心、年龄、性别、教育、水果和蔬菜摄入量、吸烟和饮酒情况，对 BMI 与 UADT 癌症发展之间的关联进行了比值比（OR）和 95%置信区间（CI）的估计。我们发现，UADT 癌症与访谈时和访谈前 2 年的 BMI 呈负相关，与 30 岁时的 BMI 无关。关于 30 岁与访谈前 2 年之间 BMI 的变化，与 UADT 癌症之间无关联的是 BMI 减少（BMI 变化<-5%）与 BMI 稳定（-5%≤BMI 变化<5%）。BMI 增加（BMI 变化≥+5%）与 UADT 癌症呈负相关（OR=0.74；95%CI=0.62，0.89）。除了食管癌之外，所有亚部位的 BMI 增加都与癌症呈负相关。在按吸烟或饮酒分层时，仅在饮酒者和吸烟者中发现与 BMI 增加有关联。综上所述，BMI 增加与 UADT 癌症呈负相关。这些发现可能受到吸烟和/或饮酒行为以及临床前 UADT 癌症发展的影响，应在前瞻性研究中得到证实。
