Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, NY 10032, USA.
Int J Cancer. 2011 Oct 1;129(7):1708-17. doi: 10.1002/ijc.25794. Epub 2011 Mar 4.
Epidemiologic studies of pancreatic cancer risk have reported null or nonsignificant positive associations for obesity, while associations for height have been null. Waist and hip circumference have been evaluated infrequently. A pooled analysis of 14 cohort studies on 846,340 individuals was conducted; 2,135 individuals were diagnosed with pancreatic cancer during follow-up. Study-specific relative risks (RRs) and 95% confidence intervals (CIs) were calculated by Cox proportional hazards models, and then pooled using a random effects model. Compared to individuals with a body mass index (BMI) at baseline between 21-22.9 kg/m(2) , pancreatic cancer risk was 47% higher (95%CI:23-75%) among obese (BMI ≥ 30 kg/m(2) ) individuals. A positive association was observed for BMI in early adulthood (pooled multivariate [MV]RR = 1.30, 95%CI = 1.09-1.56 comparing BMI ≥ 25 kg/m(2) to a BMI between 21 and 22.9 kg/m(2) ). Compared to individuals who were not overweight in early adulthood (BMI < 25 kg/m(2) ) and not obese at baseline (BMI < 30 kg/m(2) ), pancreatic cancer risk was 54% higher (95%CI = 24-93%) for those who were overweight in early adulthood and obese at baseline. We observed a 40% higher risk among individuals who had gained BMI ≥ 10 kg/m(2) between BMI at baseline and younger ages compared to individuals whose BMI remained stable. Results were either similar or slightly stronger among never smokers. A positive association was observed between waist to hip ratio (WHR) and pancreatic cancer risk (pooled MVRR = 1.35 comparing the highest versus lowest quartile, 95%CI = 1.03-1.78). BMI and WHR were positively associated with pancreatic cancer risk. Maintaining normal body weight may offer a feasible approach to reducing morbidity and mortality from pancreatic cancer.
胰腺癌风险的流行病学研究报告肥胖与胰腺癌风险呈零或无显著正相关,而身高与胰腺癌风险无关。腰围和臀围的评估则较为少见。对 14 项队列研究中 846340 名个体的资料进行了汇总分析,随访期间有 2135 名个体被诊断为胰腺癌。采用 Cox 比例风险模型计算研究特异性相对危险度(RR)及其 95%置信区间(CI),然后采用随机效应模型进行汇总。与基线时 BMI 处于 21-22.9kg/m(2)范围内的个体相比,BMI≥30kg/m(2)的个体发生胰腺癌的风险高出 47%(95%CI:23-75%)。在年轻时 BMI 较高(汇总多变量[MV]RR=1.30,95%CI:1.09-1.56,与 BMI≥25kg/m(2)相比 BMI 处于 21-22.9kg/m(2))与胰腺癌风险呈正相关。与年轻时不超重(BMI<25kg/m(2))且基线时不肥胖(BMI<30kg/m(2))的个体相比,年轻时超重且基线时肥胖的个体发生胰腺癌的风险高出 54%(95%CI:24-93%)。与 BMI 稳定的个体相比,BMI 在基线和年轻时增加≥10kg/m(2)的个体的风险增加 40%。在从不吸烟者中,结果相似或略强。腰围与臀围比值(WHR)与胰腺癌风险呈正相关(与最低四分位相比,最高四分位的汇总 MVRR=1.35,95%CI:1.03-1.78)。BMI 和 WHR 与胰腺癌风险呈正相关。保持正常体重可能是降低胰腺癌发病率和死亡率的可行方法。