体重指数、血清总胆固醇与胃高级别上皮内瘤变风险：一项中国成年人病例对照研究
Body mass index, serum total cholesterol, and risk of gastric high-grade dysplasia: A case-control study among Chinese adults.
作者信息
Huang Ya-Kai, Kang Wei-Ming, Ma Zhi-Qiang, Liu Yu-Qin, Zhou Li, Yu Jian-Chun
机构信息
Department of General Surgery, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College Cell Culture Center, Institute of Basic Medical Sciences, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China.
出版信息
Medicine (Baltimore). 2016 Aug;95(35):e4730. doi: 10.1097/MD.0000000000004730.
Obesity is related to an increased risk of gastric cardia cancer. However, the influences of excess body weight and serum total cholesterol on the risk of gastric high-grade dysplasia have not been fully characterized.A case-control study was conducted to explore the relationships between body mass index (BMI), serum total cholesterol level, and the risk of gastric high-grade dysplasia in Chinese adults. A total of 893 consecutive patients with gastric high-grade dysplasia (537 men and 356 women) and 902 controls (543 men and 359 women) were enrolled from January 2000 to October 2015. Odds ratios (ORs) with 95% confidence intervals (CIs) were estimated, and a multivariate analysis was conducted.After adjusting for age, alcohol consumption, smoking status, family history of gastric cancer or esophageal cancer, and serum total cholesterol level, a BMI ranging from 27.5 to 29.9 was significantly related to an increased risk of gastric high-grade dysplasia in both men (adjusted OR = 1.87, 95% CI = 1.24-2.81) and women (adjusted OR = 2.72, 95% CI = 1.44-5.16). The 2 highest BMI categories (27.5-29.9 and ≥30.0) were identified as risk factors for gastric cardia high-grade dysplasia in both men (BMI = 27.5-29.9: adjusted OR = 1.78, 95% CI = 1.02-3.10; BMI ≥ 30.0: adjusted OR = 2.54, 95% CI = 1.27-5.08) and women (BMI = 27.5-29.9: adjusted OR = 2.88, 95% CI = 1.27-6.55; BMI ≥ 30.0: adjusted OR = 2.77, 95% CI = 1.36-5.64), whereas only a BMI ranging from 27.5 to 29.9 was a risk factor for gastric noncardia high-grade dysplasia in both men (adjusted OR = 1.98, 95% CI = 1.25-3.14) and women (adjusted OR = 2.88, 95% CI = 1.43-5.81). In addition, higher serum total cholesterol was associated with an increased risk of gastric noncardia high-grade dysplasia (adjusted OR = 1.83, 95% CI = 1.25-2.69) in women.Increased BMI was associated with an increased risk of gastric high-grade dysplasia in both men and women, and higher serum total cholesterol increased the risk of gastric noncardia high-grade dysplasia in women.
肥胖与贲门癌风险增加有关。然而，超重和血清总胆固醇对胃高级别上皮内瘤变风险的影响尚未完全明确。开展了一项病例对照研究，以探讨中国成年人的体重指数（BMI）、血清总胆固醇水平与胃高级别上皮内瘤变风险之间的关系。2000年1月至2015年10月期间，共纳入了893例连续的胃高级别上皮内瘤变患者（男性537例，女性356例）和902例对照（男性543例，女性359例）。估计了比值比（OR）及95%置信区间（CI），并进行了多因素分析。在调整年龄、饮酒、吸烟状况、胃癌或食管癌家族史以及血清总胆固醇水平后，BMI在27.5至29.9之间与男性（调整后OR = 1.87，95% CI = 1.24 - 2.81）和女性（调整后OR = 2.72，95% CI = 1.44 - 5.16）胃高级别上皮内瘤变风险增加显著相关。BMI最高的两个类别（27.5 - 29.9和≥30.0）被确定为男性（BMI = 27.5 - 29.9：调整后OR = 1.78，95% CI = 1.02 - 3.10；BMI≥30.0：调整后OR = 2.54，95% CI = 1.27 - 5.08）和女性（BMI = 27.5 - 29.9：调整后OR = 2.88，95% CI = 1.27 - 6.55；BMI≥30.0：调整后OR = 2.77，95% CI = 1.36 - 5.64）贲门高级别上皮内瘤变的危险因素，而仅BMI在27.5至29.9之间是男性（调整后OR = 1.98，95% CI = 1.25 - 3.14）和女性（调整后OR = 2.88，95% CI = 1.43 - 5.81）非贲门胃高级别上皮内瘤变的危险因素。此外，较高的血清总胆固醇与女性非贲门胃高级别上皮内瘤变风险增加相关（调整后OR = 1.83，95% CI = 1.25 - 2.69）。BMI增加与男性和女性胃高级别上皮内瘤变风险增加相关，而较高的血清总胆固醇增加女性非贲门胃高级别上皮内瘤变的风险。
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