Department of Neurosurgery, Oslo University Hospital, Oslo, Norway; Oslo Centre for Biostatistics and Epidemiology, Research Support Services, Oslo University Hospital, Oslo, Norway; Neurosurgery Unit, Faculty of Medicine and Health Sciences, Macquarie University, Sydney,Australia; Crown Princess Mary Cancer Care Centre, Westmead Hospital, Sydney,Australia; NHMRC Clinical Trials Centre, Sydney,Australia; Department of Gynecological Cancer, Oslo University Hospital (Norwegian Radium Hospital), Oslo, Norway; The Cancer Registry of Norway, Oslo, Norway; Department of Public Health, Norwegian University of Science and Technology, Trondheim, Norway; FORMI and Department of Neurology, Oslo University Hospital (Ulleval),Oslo, Norway; Faculty of Medicine, University of Oslo, Oslo, Norway.
Neuro Oncol. 2017 Jul 1;19(7):976-985. doi: 10.1093/neuonc/now272.
Glioma comprises a heterogeneous group of mostly malignant brain tumors, whereof glioblastoma (GBM) represents the largest and most lethal subgroup. Body height and body mass index (BMI) are risk factors for other cancers, but no previous study has examined anthropometric data in relation to different glioma subgroups.
This prospective cohort study includes 1.8 million Norwegian women and men between ages 14 and 80 years at baseline. Body weight and height were measured, and incident cases of glioma were identified by linkage to the National Cancer Registry. Cox regression analyses were performed to evaluate risk for different glioma subgroups in relation to anthropometric measures.
During 54 million person-years of follow-up, 4,382 gliomas were identified. Overweight and obesity were not associated with risk for any glioma subgroup. Height was positively associated with risk for GBM and all other gliomas (hazard ratio [HR] per 10 cm increase: 1.24; 95% confidence interval [CI], 1.17-1.31 and 1.18; 95% CI, 1.09-1.29) but not with the proxy for isocitrate dehydrogenase (IDH)-mutant glioma (HR, 1.09; 95% CI, 0.98-1.21). In further subgroup analyses, the effect of height on glioma risk varied significantly with positive associations for oligoastrocytoma (HR, 1.74; 95% CI, 1.20-2.53) and malignant glioma not otherwise specified (NOS) (HR, 1.42; 95% CI, 1.16-1.76, but not with diffuse astrocytoma (WHO grades II and III) or oligodendroglioma.
This epidemiologic study consolidates height as a risk factor for GBM and other gliomas. It further indicates that this association is not universal for gliomas but may differ between different glioma subgroups.
神经胶质瘤包含一组异质性的大多数恶性脑肿瘤，其中胶质母细胞瘤（GBM）代表最大和最致命的亚组。身高和体重指数（BMI）是其他癌症的危险因素，但以前没有研究检查过与不同神经胶质瘤亚组相关的人体测量数据。
本前瞻性队列研究包括 180 万 14 至 80 岁基线期的挪威男女。测量体重和身高，并通过与国家癌症登记处的链接确定神经胶质瘤的发病情况。进行 Cox 回归分析，以评估与人体测量指标相关的不同神经胶质瘤亚组的风险。
在 5400 万人年的随访期间，共发现 4382 例神经胶质瘤。超重和肥胖与任何神经胶质瘤亚组的风险无关。身高与 GBM 和所有其他神经胶质瘤的风险呈正相关（每增加 10 厘米的风险比 [HR]：1.24；95%置信区间 [CI]，1.17-1.31 和 1.18；95%CI，1.09-1.29），但与异柠檬酸脱氢酶（IDH）突变型神经胶质瘤（HR，1.09；95%CI，0.98-1.21）的代表无关。在进一步的亚组分析中，身高对神经胶质瘤风险的影响差异显著，与少突星形细胞瘤（HR，1.74；95%CI，1.20-2.53）和未特指的恶性神经胶质瘤（HR，1.42；95%CI，1.16-1.76）呈正相关，但与弥漫性星形细胞瘤（WHO 分级 II 和 III）或少突胶质细胞瘤无关。
这项流行病学研究证实身高是 GBM 和其他神经胶质瘤的危险因素。它进一步表明，这种关联不是普遍适用于神经胶质瘤，而是可能因不同的神经胶质瘤亚组而异。
