SOC Epidemiologia e Biostatistica, Centro di Riferimento Oncologico, 33081 Aviano (PN), Italy.
Br J Cancer. 2011 Mar 29;104(7):1207-13. doi: 10.1038/bjc.2011.63. Epub 2011 Mar 8.
Endometrial cancer is strongly associated with body mass index (BMI), but the influence of BMI history and of different types of obesity is uncertain.
A case-control study was carried out in Italy including 454 cases and 908 controls admitted to hospital for acute non-hormone-related conditions. Odds ratios (ORs) and 95% confidence intervals (CIs) were computed using multivariate logistic and spline regression models.
The OR for BMI >30 at diagnosis compared with 20 to <25 kg m(-2) was 4.08 (95% CI: 2.90-5.74). The association for BMI was monotonic with a possible steeper increase for BMI above 28. Conversely, waist-to-hip ratio (WHR) showed a bell shaped curve with increased OR (2.10; 95% CI: 1.43-3.09) in the intermediate tertile only. After stratification by BMI at diagnosis, history of weight loss and BMI at age 30 did not influence endometrial cancer risk. History of obesity in middle age had a weak and not significant adverse effect among obese women (OR=1.60; 95% CI: 0.52-4.96).
The predominant importance of recent weight compared to lifetime history, justifies encouraging weight reduction in women at any age.
子宫内膜癌与体重指数（BMI）密切相关，但 BMI 变化史和不同类型肥胖的影响尚不确定。
意大利进行了一项病例对照研究，共纳入 454 例病例和 908 例因急性非激素相关疾病住院的对照。使用多变量逻辑回归和样条回归模型计算比值比（OR）和 95%置信区间（CI）。
与 BMI 20-<25 kg/m2 相比，诊断时 BMI>30 的 OR 为 4.08（95%CI：2.90-5.74）。BMI 与患病风险呈单调递增关系，BMI 超过 28 后可能会急剧上升。相反，腰围-臀围比（WHR）呈钟形曲线，仅在中间 tertile 时 OR 增加（2.10；95%CI：1.43-3.09）。按诊断时 BMI 分层后，减肥史和 30 岁时 BMI 对子宫内膜癌风险没有影响。中年肥胖史对肥胖女性的不良影响较弱且不显著（OR=1.60；95%CI：0.52-4.96）。
与终生史相比，近期体重的重要性更为突出，因此应鼓励任何年龄段的女性减轻体重。
