Division of Nutritional Epidemiology, Institute of Environmental Medicine, Karolinska Institutet, Box 210, 171 77, Stockholm, Sweden.
Br J Cancer. 2011 Sep 27;105(7):1061-8. doi: 10.1038/bjc.2011.319. Epub 2011 Aug 16.
The relationships between body mass index (BMI) during early and middle-late adulthood and incidence of prostate cancer (PCa) by subtype of the disease (localised, advanced) and fatal PCa is unclear.
A population-based cohort of 36,959 Swedish men aged 45-79 years was followed up from January 1998 through December 2008 for incidence of PCa (1530 localised and 554 advanced cases were diagnosed) and through December 2007 for PCa mortality (225 fatal cases).
From a competing-risks analysis, incidence of localised PCa was observed to be inversely associated with BMI at baseline (middle-late adulthood; rate ratio (RR) for 35 kg m(-2) when compared with 22 kg m(-2) was 0.69 (95% CI 0.52-0.92)), but not at age 30. For fatal PCa, BMI at baseline was associated with a nonstatistically significant increased risk (RR for every five-unit increase: 1.12 (0.88-1.43)) and BMI at age 30 with a decreased risk (RR for every five-unit increase: 0.72 (0.51-1.01)).
Our results indicate an inverse association between obesity during middle-late, but not early adulthood, and localised PCa. They also suggest a dual association between BMI and fatal PCa--a decreased risk among men who were obese during early adulthood and an increased risk among those who were obese during middle-late adulthood.
体重指数(BMI)在成年早期和中晚期与前列腺癌(PCa)的发病风险(局部、晚期)和致命性 PCa 的关系尚不清楚。
对 36959 名年龄在 45-79 岁的瑞典男性进行了一项基于人群的队列研究,从 1998 年 1 月至 2008 年 12 月期间随访 PCa 的发病情况(诊断出 1530 例局部和 554 例晚期病例),并于 2007 年 12 月之前随访 PCa 死亡率(诊断出 225 例致命病例)。
从竞争风险分析中可以看出,局部 PCa 的发病风险与基线时的 BMI 呈负相关(中晚期;与 22kg/m2 相比,35kg/m2 的发病率比为 0.69(95%CI 0.52-0.92)),但与 30 岁时的 BMI 无关。对于致命性 PCa,基线时的 BMI 与风险呈正相关(每增加五个单位的 RR:1.12(0.88-1.43)),而 30 岁时的 BMI 与风险呈负相关(每增加五个单位的 RR:0.72(0.51-1.01))。
我们的研究结果表明,肥胖与中晚期而非早期成年期的局部 PCa 呈负相关。它们还表明 BMI 与致命性 PCa 之间存在双重关联-早期成年期肥胖的男性风险降低,而中晚期成年期肥胖的男性风险增加。