Department of Epidemiology, Faculty of Health Medicine and Life Science, MaastrichtUniversity, Maastricht, the Netherlands.
Am J Epidemiol. 2011 Nov 15;174(10):1127-39. doi: 10.1093/aje/kwr247. Epub 2011 Oct 7.
A large body size may differentially influence risk of colorectal cancer (CRC) by anatomic location. The Netherlands Cohort Study includes 120,852 men and women aged 55-69 years who self-reported weight, height, and trouser/skirt size at baseline (1986), as well as weight at age 20 years. Derived variables included body mass index (BMI; weight (kg)/height (m)(2)), BMI at age 20 years, and BMI change. After 16.3 years of follow-up (1986-2002), 2,316 CRC cases were available for case-cohort analysis. In men, the highest risk estimates were observed for body fat (per 5-unit increase in BMI, hazard ratio (HR) = 1.25, 95% confidence interval (CI): 1.05, 1.46; for highest quintile of trouser size vs. lowest, HR = 1.63, 95% CI: 1.17, 2.29 (P-trend = 0.02)) and appeared more closely associated with distal colon tumors (for BMI (5-unit increase), HR = 1.42, 95% CI: 1.13, 1.79; for highest quintile of trouser size, HR = 2.56, 95% CI: 1.55, 4.24 (P-trend < 0.01)) than with proximal colon or rectal tumors. In women, body fat was not associated with CRC risk unless it was considered simultaneously with physical activity; a large trouser/skirt size and a low level of physical activity increased risk for all subtypes. Height was associated with risk of CRC, especially distal colon tumors (highest quintile vs. lowest: HR = 1.53, 95% CI: 1.03, 2.27; P-trend = 0.05), in women only.
大的体型可能会通过解剖位置不同地影响结直肠癌（CRC）的风险。荷兰队列研究包括 120852 名年龄在 55-69 岁的男性和女性，他们在基线（1986 年）时自我报告体重、身高和裤子/裙子尺寸，以及 20 岁时的体重。得出的变量包括体重指数（BMI；体重（kg）/身高（m）（2））、20 岁时的 BMI 和 BMI 变化。在 16.3 年的随访（1986-2002 年）后，可用于病例-队列分析的 CRC 病例为 2316 例。在男性中，观察到最高的风险估计值与体脂肪（BMI 每增加 5 个单位，风险比（HR）= 1.25，95%置信区间（CI）：1.05，1.46；裤子尺寸最高五分位与最低五分位相比，HR = 1.63，95% CI：1.17，2.29（P 趋势 = 0.02）），并且与远端结肠肿瘤的相关性更为密切（对于 BMI（增加 5 个单位），HR = 1.42，95% CI：1.13，1.79；对于裤子尺寸最高五分位，HR = 2.56，95% CI：1.55，4.24（P 趋势 < 0.01）），而与近端结肠或直肠肿瘤无关。在女性中，体脂肪与 CRC 风险无关，除非同时考虑体力活动；大的裤子/裙子尺寸和低水平的体力活动会增加所有亚型的风险。身高与 CRC 风险相关，尤其是与远端结肠肿瘤（最高五分位与最低五分位相比：HR = 1.53，95% CI：1.03，2.27；P 趋势 = 0.05）），仅在女性中。
