Zhang D, Chen J, Wang J, Gong S, Jin H, Sheng P, Qi X, Lv L, Dong Y, Hou L
Department of Neurosurgery, Shanghai Institute of Neurosurgery, PLA Institute of Neurosurgery, Changzheng Hospital, Second Military Medical University, Shanghai, China.
Department of Neurosurgery, Neuroscience Center, Changzheng Hospital, Second Military Medical University, Shanghai, China.
Eur J Clin Nutr. 2016 Jul;70(7):757-65. doi: 10.1038/ejcn.2016.4. Epub 2016 Feb 24.
BACKGROUND/OBJECTIVES: Data regarding the relationships between body mass index (BMI) and brain tumors are inconsistent, especially for the commonly seen gliomas and meningiomas. Therefore, we conducted a dose-response meta-analysis to unravel the issue.
SUBJECTS/METHODS: Cochrane Library, PubMed and Embase were searched for pertinent case-control and cohort studies updated to November 2014. Dose-response and quantitative analysis were conducted with random-effect model.
Sixteen studies were included, containing 3 887 156 participants and 11 614 cases. In categorical analysis for the relationships between abnormal weight and BMI, the summary risk ratio (RR) of brain tumors was 1.34 (95% confidential interval (CI), 1.15-1.56) for obesity, 1.12 (95% CI, 1.05-1.19) for overweight and 0.77 (95% CI, 0.64-0.93) for underweight; the summary RR of gliomas was 1.13 (95% CI, 1.02-1.26) for overweight and 0.71 (95% CI, 0.58-0.88) for underweight; the summary RR of meningiomas was 1.48 (95% CI, 1.30-1.69) for obesity and 1.18 (95% CI, 1.07-1.31) for overweight. In dose-response analysis, for every 5 kg/m(2) increment of BMI, the summary RR was 1.13 (95% CI, 1.07-1.20) for overall brain tumors, 1.07 (95% CI, 0.97-1.19) for gliomas and 1.19 (95% CI, 1.14-1.25) for meningiomas.
Excess weight was associated with increased risk of brain tumors and meningiomas but not with gliomas. Selective screening for brain tumors among obesity, especially for the females, might be more instructive.
背景/目的：关于体重指数（BMI）与脑肿瘤之间关系的数据并不一致，尤其是对于常见的胶质瘤和脑膜瘤。因此，我们进行了一项剂量反应荟萃分析以阐明该问题。
受试者/方法：检索Cochrane图书馆、PubMed和Embase中截至2014年11月更新的相关病例对照研究和队列研究。采用随机效应模型进行剂量反应和定量分析。
纳入16项研究，共3887156名参与者和11614例病例。在体重异常与BMI关系的分类分析中，肥胖者患脑肿瘤的汇总风险比（RR）为1.34（95%置信区间（CI），1.15 - 1.56），超重者为1.12（95%CI，1.05 - 1.19），体重过轻者为0.77（95%CI，0.64 - 0.93）；超重者患胶质瘤的汇总RR为1.13（95%CI，1.02 - 1.26），体重过轻者为0.71（95%CI，0.58 - 0.88）；肥胖者患脑膜瘤的汇总RR为1.48（95%CI，1.30 - 1.69），超重者为1.18（95%CI，1.07 - 1.31）。在剂量反应分析中，BMI每增加5kg/m²，总体脑肿瘤的汇总RR为1.13（95%CI，1.07 - 1.20），胶质瘤为1.07（95%CI，0.97 - 1.19），脑膜瘤为1.19（95%CI，1.14 - 1.25）。
体重超标与脑肿瘤和脑膜瘤风险增加相关，但与胶质瘤无关。对肥胖人群，尤其是女性进行脑肿瘤的选择性筛查可能更具指导意义。
