Aarestrup J, Gamborg M, Cook M B, Baker J L
Institute of Preventive Medicine, Bispebjerg and Frederiksberg Hospitals, The Capital Region, Nordre Fasanvej 57, 2000 Frederiksberg, Denmark.
Division of Cancer Epidemiology and Genetics, National Cancer Institute, NIH, DHHS, 9609 Medical Center Drive, MSC 9774, Bethesda, MD 20892-9774, USA.
Eur J Cancer. 2015 Jul;51(10):1340-5. doi: 10.1016/j.ejca.2015.03.022. Epub 2015 Apr 17.
Adult body size is positively associated with aggressive and fatal prostate cancers. It is unknown whether these associations originate in early life. Therefore, we investigated if childhood height, body mass index (BMI; kg/m(2)) and growth are associated with prostate cancer-specific mortality and survival.
Subjects were 125,208 men from the Copenhagen School Health Records Register, born 1930-1969 with height and weight measurements at ages 7-13years. Linkage to the Danish Cancer Registry and the Register of Causes of Death enabled identification of incident and fatal prostate cancers. Cox proportional hazards regressions were performed.
630 men had prostate cancer recorded as the underlying cause of death. Childhood height at age 13years was positively associated with prostate cancer-specific mortality (hazard ratio [HR]per z-score=1.2, 95% confidence interval [CI]: 1.1-1.3). Associations were significant at all other childhood ages. Growth analyses showed that height at age 13years had a stronger association with prostate cancer-specific mortality than height at age 7, suggesting the association at age 7 is largely mediated through later childhood height. The tallest boys at age 13years had a significantly worse survival, but only when restricted to a diagnosis at <60years of age (HRz-score of 1=1.7, 95% CI: 1.3-2.4). These associations were significant at all other childhood ages. Childhood BMI was not associated with prostate cancer mortality or survival.
Childhood height was positively associated with the hard end-point of prostate cancer-specific mortality, which strengthens prior epidemiologic observations of a positive association with prostate cancer incidence.
成年人体型与侵袭性及致命性前列腺癌呈正相关。这些关联是否源于生命早期尚不清楚。因此,我们调查了儿童期身高、体重指数(BMI;千克/平方米)和生长情况是否与前列腺癌特异性死亡率及生存率相关。
研究对象为来自哥本哈根学校健康记录登记处的125208名男性,他们出生于1930年至1969年,在7至13岁时测量了身高和体重。与丹麦癌症登记处及死亡原因登记处的关联使得能够识别前列腺癌的发病和死亡情况。进行了Cox比例风险回归分析。
630名男性的死亡原因记录为前列腺癌。13岁时的儿童期身高与前列腺癌特异性死亡率呈正相关(每z评分的风险比[HR]=1.2,95%置信区间[CI]:1.1-1.3)。在所有其他儿童期年龄,这种关联均显著。生长分析表明,13岁时的身高与前列腺癌特异性死亡率的关联比7岁时更强,这表明7岁时的关联很大程度上是通过儿童后期身高介导的。13岁时最高的男孩生存率显著更差,但仅限于60岁之前确诊的情况(z评分为1时的HR=1.7,95%CI:1.3-2.4)。在所有其他儿童期年龄,这些关联均显著。儿童期BMI与前列腺癌死亡率或生存率无关。
儿童期身高与前列腺癌特异性死亡率这一硬性终点呈正相关,这强化了先前关于前列腺癌发病率正相关的流行病学观察。