Public Health, Department of Social and Environmental Medicine, Osaka University Graduate School of Medicine, Suita, Osaka 565-0871, Japan.
J Epidemiol. 2013;23(3):219-26. doi: 10.2188/jea.je20120199. Epub 2013 Apr 20.
We investigated the association of baseline body mass index (BMI) and weight change since age 20 years with liver cancer mortality among Japanese.
The data were obtained from the Japan Collaborative Cohort Study for Evaluation of Cancer Risk (JACC Study). A total of 31 018 Japanese men and 41 455 Japanese women aged 40 to 79 years who had no history of cancer were followed from 1988 through 2009.
During a median 19-year follow-up, 527 deaths from liver cancer (338 men, 189 women) were documented. There was no association between baseline BMI and liver cancer mortality among men or men with history of liver disease. Men without history of liver disease had multivariable hazard ratios (HR) of 1.95 (95%CI, 1.07-3.54) for BMI less than 18.5 kg/m(2) and 1.65 (1.05-2.60) for BMI of 25 kg/m(2) or higher, as compared with a BMI of 21.0 to 22.9 kg/m(2). BMI was positively associated with liver cancer mortality among women and women with history of liver disease. Weight change since age 20 years was positively associated with liver cancer mortality among women regardless of history of liver disease. Women with history of liver disease had a multivariable HRs of 1.96 (1.05-3.66) for weight gain of 5.0 to 9.9 kg and 2.31 (1.18-4.49) for weight gain of 10 kg or more, as compared with weight change of -4.9 to 4.9 kg.
Both underweight (BMI <18.5 kg/m(2)) and overweight (BMI ≥25 kg/m(2)) among men without history of liver disease, and weight gain after age 20 (weight change ≥5 kg) among women with history of liver disease, were associated with increased mortality from liver cancer.
我们研究了日本人群基线体重指数(BMI)和 20 岁以后体重变化与肝癌死亡率之间的关系。
数据来自日本癌症风险评估合作队列研究(JACC 研究)。共有 31018 名 40 至 79 岁无癌症病史的日本男性和 41455 名日本女性参与了这项研究,随访时间从 1988 年持续到 2009 年。
在中位 19 年的随访期间,共记录了 527 例肝癌死亡病例(338 例男性,189 例女性)。在无肝病病史的男性中,基线 BMI 与肝癌死亡率之间没有关联。无肝病病史的男性 BMI 低于 18.5kg/m2 时,多变量风险比(HR)为 1.95(95%CI,1.07-3.54),BMI 为 25kg/m2 或更高时,HR 为 1.65(1.05-2.60),而 BMI 为 21.0 至 22.9kg/m2 时为参考值。BMI 与有肝病病史的女性和女性肝癌死亡率呈正相关。20 岁以后的体重变化与无论是否有肝病病史的女性肝癌死亡率均呈正相关。有肝病病史的女性体重增加 5.0 至 9.9kg 时,多变量 HR 为 1.96(1.05-3.66),体重增加 10kg 或更多时,HR 为 2.31(1.18-4.49),而体重变化为-4.9 至 4.9kg 时为参考值。
无肝病病史的男性中体重过轻(BMI<18.5kg/m2)和超重(BMI≥25kg/m2),以及有肝病病史的女性 20 岁以后体重增加(体重变化≥5kg),均与肝癌死亡率的增加相关。