Division of Epidemiology and Prevention, Aichi Cancer Center Research Institute, Nagoya, Japan.
J Epidemiol. 2011;21(6):466-73. doi: 10.2188/jea.je20110020. Epub 2011 Oct 8.
Current obesity is an established risk factor for endometrial cancer; however, the roles of weight gain during adulthood and obesity in early adulthood on endometrial cancer have not been elucidated. Here, we conducted a case-control study comprising 222 histologically diagnosed incident endometrial cancer cases and 2162 age- and menstrual-status matched non-cancer controls.
Information on current body weight, weight and height at age 20 years, and lifestyle/environmental factors was obtained from a self-administered questionnaire. Subjects were classified into 3 groups according to change in body mass index (BMI, kg/m(2)) from age 20 years to enrollment (≤0 [reference], 0-3, and >3 kg/m(2)). The effects of adult BMI change and obesity in early adulthood were evaluated using an unconditional logistic regression model adjusted for potential confounders.
A high BMI at age 20 (BMI ≥25, BMI <25 as reference) was significantly positively associated with endometrial cancer risk (P = 0.005), as was a BMI increase during adulthood (0-3 BMI change, multivariate odds ratio [OR] = 1.28, 95% confidence interval [CI] = 0.88-1.87; >3 BMI change, OR = 2.02, 95% CI = 1.38-2.96; P-trend < 0.001). Parity and BMI at age 20 appeared to modify the effect of weight gain on cancer risk, albeit without statistical significance. This positive association of weight gain with risk was observed only for endometrioid adenocarcinoma.
The results show that endometrial cancer is positively associated with obesity at age 20 and weight gain during adulthood among Japanese women.
目前肥胖是子宫内膜癌的既定危险因素;然而,成年后体重增加和成年早期肥胖对子宫内膜癌的作用尚未阐明。在这里,我们进行了一项病例对照研究,包括 222 例组织学诊断为子宫内膜癌的病例和 2162 例年龄和月经状况匹配的非癌症对照。
从自我管理的问卷中获得了当前体重、20 岁时的体重和身高以及生活方式/环境因素的信息。根据从 20 岁到入组时体重指数(BMI,kg/m²)的变化,将受试者分为 3 组(≤0[参考]、0-3 和>3kg/m²)。使用非条件逻辑回归模型调整潜在混杂因素后,评估成人 BMI 变化和成年早期肥胖的影响。
20 岁时 BMI 较高(BMI≥25,BMI<25 为参考)与子宫内膜癌风险显著正相关(P=0.005),成年期 BMI 增加也是如此(0-3 BMI 变化,多变量比值比[OR]为 1.28,95%置信区间[CI]为 0.88-1.87;>3 BMI 变化,OR 为 2.02,95%CI 为 1.38-2.96;P 趋势<0.001)。尽管没有统计学意义,但产次和 20 岁时的 BMI 似乎改变了体重增加对癌症风险的影响。这种体重增加与风险的正相关仅见于子宫内膜样腺癌。
研究结果表明,日本女性子宫内膜癌与 20 岁时肥胖和成年后体重增加呈正相关。