Song Mingyang, Hu Frank B, Spiegelman Donna, Chan Andrew T, Wu Kana, Ogino Shuji, Fuchs Charles S, Willett Walter C, Giovannucci Edward L
Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, Massachusetts. Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, Massachusetts.
Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, Massachusetts. Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, Massachusetts. Channing Division of Network Medicine, Department of Medicine, Harvard Medical School, Boston, Massachusetts.
Cancer Prev Res (Phila). 2015 Jul;8(7):620-7. doi: 10.1158/1940-6207.CAPR-15-0061. Epub 2015 Apr 30.
We investigated the association between adulthood weight change and colorectal cancer risk in a prospective study with 24 to 34 years of follow-up among 90,988 women and 46,679 men. The primary exposures included weight change from early adulthood (age = 18 years for women, 21 years for men) to baseline enrollment (median age = 43 years for women, 52 years for men), and from baseline to present. In the secondary analyses, we also assessed 4-year weight change during follow-up, and during premenopausal (from age 18 years to menopause) and postmenopausal (from menopause to present) periods in women. Compared to men maintaining their weight from age 21 to baseline, those who gained 20 kg or more were at a higher risk of colorectal cancer (relative risk [RR], 1.64; 95% confidence interval [CI], 1.15-2.35, Ptrend < 0.001), whereas those who lost 8 kg or more had a lower risk (RR, 0.61; 95% CI, 0.30-1.22, Ptrend = 0.003). Similar but weaker associations were found in women and the corresponding RRs were 1.38 (95% CI, 1.13-1.69, Ptrend < 0.001) and 0.80 (95% CI, 0.58-1.09, Ptrend = 0.21). Weight change from baseline to present was not associated with colorectal cancer risk. Four-year weight change during follow-up was positively associated with colorectal cancer risk in men (Ptrend = 0.03) but not in women (Ptrend = 0.42). In addition, in women, weight change before, but not after, menopause was associated with colorectal cancer risk. Our findings provide further scientific rationale for recommendations to maintain a healthy body weight during adulthood. A potential differential association according to sex and timing of weight change warrants further investigation.
在一项对90988名女性和46679名男性进行了24至34年随访的前瞻性研究中,我们调查了成年期体重变化与结直肠癌风险之间的关联。主要暴露因素包括从成年早期(女性为18岁,男性为21岁)到基线入组(女性中位年龄为43岁,男性为52岁)以及从基线到目前的体重变化。在二次分析中,我们还评估了随访期间、女性绝经前(从18岁到绝经)和绝经后(从绝经到目前)期间的4年体重变化。与从21岁到基线体重保持不变的男性相比,体重增加20千克或更多的男性患结直肠癌的风险更高(相对风险[RR]为1.64;95%置信区间[CI]为1.15 - 2.35,Ptrend < 0.001),而体重减轻8千克或更多的男性风险较低(RR为0.61;95%CI为0.30 - 1.22,Ptrend = 0.003)。在女性中发现了类似但较弱的关联,相应的RR分别为1.38(95%CI为1.13 - 1.69,Ptrend < 0.001)和0.80(95%CI为0.58 - 1.09,Ptrend = 0.21)。从基线到目前的体重变化与结直肠癌风险无关。随访期间的4年体重变化与男性的结直肠癌风险呈正相关(Ptrend = 0.03),但与女性无关(Ptrend = 0.42)。此外,在女性中,绝经前而非绝经后的体重变化与结直肠癌风险相关。我们的研究结果为成年期保持健康体重的建议提供了进一步的科学依据。根据性别和体重变化时间的潜在差异关联值得进一步研究。