Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, P.O. Box 281, SE-171 77, Stockholm, Sweden,
Cancer Causes Control. 2013 Dec;24(12):2143-55. doi: 10.1007/s10552-013-0291-0. Epub 2013 Sep 19.
The role of body size in prostate cancer etiology is unclear and potentially varies by age and disease subtype. We investigated whether body size in childhood and adulthood, including adult weight change, is related to total, low-intermediate-risk, high-risk, and fatal prostate cancer.
We used data on 1,499 incident prostate cancer cases and 1,118 population controls in Sweden. Body figure at age 10 was assessed by silhouette drawings. Adult body mass index (BMI) and weight change were based on self-reported height and weight between ages 20 and 70. We estimated odds ratios (ORs) with 95 % confidence intervals (CIs) by unconditional logistic regression.
Height was positively associated with prostate cancer. Overweight/obesity in childhood was associated with a 54 % increased risk of dying from prostate cancer compared to normal weight, whereas a 27 % lower risk was seen in men who were moderately thin (drawing 2) in childhood (P trend = 0.01). Using BMI <22.5 as a reference, we observed inverse associations between BMI 22.5 to <25 at age 20 and all prostate cancer subtypes (ORs in the range 0.72-0.82), and between mean adult BMI 25 to <27.5 and low-intermediate-risk disease (OR 0.75, 95 % CI 0.55-1.02). Moderate adult weight gain increased the risk of disease in men with low BMI at start and in short men.
Our comprehensive life-course approach revealed no convincing associations between anthropometric measures and prostate cancer risk. However, we found some leads that deserve further investigation, particularly for early-life body size. Our study highlights the importance of the time window of exposure in prostate cancer development.
体型在前列腺癌病因学中的作用尚不清楚，并且可能因年龄和疾病亚型而异。我们研究了儿童期和成年期的体型，包括成年体重变化，与总前列腺癌、低中危前列腺癌、高危前列腺癌和致命性前列腺癌之间的关系。
我们使用了瑞典 1499 例前列腺癌病例和 1118 例人群对照的数据。10 岁时的体型通过剪影图进行评估。成年期体重指数（BMI）和体重变化基于 20 至 70 岁之间的自我报告身高和体重。我们通过非条件逻辑回归估计了比值比（OR）及其 95％置信区间（CI）。
身高与前列腺癌呈正相关。与正常体重相比，儿童期超重/肥胖与死于前列腺癌的风险增加 54％相关，而儿童期中度消瘦（图 2）的男性风险降低 27％（趋势 P = 0.01）。以 BMI <22.5 为参考，我们观察到 20 岁时 BMI 22.5-<25 与所有前列腺癌亚型之间呈负相关（OR 值在 0.72-0.82 之间），以及成人 BMI 25-<27.5 与低中危疾病之间呈负相关（OR 0.75，95％CI 0.55-1.02）。成人体重适度增加会增加低 BMI 起始和身材矮小男性的疾病风险。
我们全面的生命历程方法没有发现体型指标与前列腺癌风险之间有明显的关联。然而，我们发现了一些值得进一步研究的线索，特别是对于生命早期的体型。我们的研究强调了在前列腺癌发展过程中暴露时间窗的重要性。
