Charneco Eileen, Ortiz Ana P, Venegas-Ríos Heidi L, Romaguera Josefina, Umpierre Sharee
Cancer Control and Population Sciences Program, University of Puerto Rico Comprehensive Cancer Center, San Juan, PR.
P R Health Sci J. 2010 Sep;29(3):272-8.
Obesity is an established risk factor for endometrial cancer (EC). This association, however, has not been studied in Puerto Rico, where overweight and obesity have reached epidemic levels (38% and 26%, respectively).
A hospital based case-control study was designed to evaluate the association between body mass index (BMI) and EC in women older than 21 years of age. Seventy-four prevalent EC cases diagnosed between January 2004 and August 2007 and a random sample of 88 healthy controls were recruited from gynecology clinics of the Medical Sciences Campus, University of Puerto Rico. Demographic, reproductive, lifestyle, and clinical information was obtained via structured telephone interviews and medical chart review. Unconditional logistic regression models were used to estimate adjusted odds ratios (OR) and 95% confidence intervals (CI).
A significant trend was observed between BMI and EC in bivariate analyses (p < 0.05). Results showed that overweight (25.0 > BMI < 29.9 kg/m2) (OR = 4.4, 95% CI = 1.6-12.3) and obese (BMI < or = 30 kg/m2) (OR = 9.9, 95% CI = 3.6-26.9) women were more likely to have EC when compared to non-obese women. In multivariate analysis, obese women had a 4-fold greater possibility of EC (OR = 4.1; 95% CI: 1.8-8.6) than nonobese women, after adjusting for age, education, employment status, hypertension and diabetes diagnosis, use of oral contraceptives and consumption of poultry.
Consistent with previous studies worldwide, adult obesity was a strong predictor for EC in this sample of Puerto Rican women. Thus, cancer control strategies should promote weight reduction strategies to reduce disease risk in this population.
肥胖是子宫内膜癌（EC）的既定风险因素。然而，在波多黎各尚未对这种关联进行研究，该地超重和肥胖已达到流行程度（分别为38%和26%）。
设计了一项基于医院的病例对照研究，以评估21岁以上女性体重指数（BMI）与子宫内膜癌之间的关联。从波多黎各大学医学科学园区的妇科诊所招募了2004年1月至2007年8月期间确诊的74例子宫内膜癌现患病例以及88例健康对照的随机样本。通过结构化电话访谈和病历审查获取人口统计学、生殖、生活方式和临床信息。使用无条件逻辑回归模型估计调整后的比值比（OR）和95%置信区间（CI）。
在双变量分析中观察到BMI与子宫内膜癌之间存在显著趋势（p < 0.05）。结果显示，与非肥胖女性相比，超重（25.0 > BMI < 29.9 kg/m²）（OR = 4.4，95% CI = 1.6 - 12.3）和肥胖（BMI ≤ 30 kg/m²）（OR = 9.9，95% CI = 3.6 - 26.9）女性患子宫内膜癌的可能性更高。在多变量分析中，在调整年龄、教育程度、就业状况、高血压和糖尿病诊断、口服避孕药使用情况以及家禽消费量后，肥胖女性患子宫内膜癌的可能性是非肥胖女性的4倍（OR = 4.1；95% CI：1.8 - 8.6）。
与全球先前的研究一致，在这个波多黎各女性样本中，成年肥胖是子宫内膜癌的有力预测因素。因此，癌症控制策略应推广减重策略以降低该人群的疾病风险。
