Campbell Peter T, Newton Christina C, Kitahara Cari M, Patel Alpa V, Hartge Patricia, Koshiol Jill, McGlynn Katherine A, Adami Hans-Olov, Berrington de González Amy, Beane Freeman Laura E, Bernstein Leslie, Buring Julie E, Freedman Neal D, Gao Yu-Tang, Giles Graham G, Gunter Marc J, Jenab Mazda, Liao Linda M, Milne Roger L, Robien Kim, Sandler Dale P, Schairer Catherine, Sesso Howard D, Shu Xiao-Ou, Weiderpass Elisabete, Wolk Alicja, Xiang Yong-Bing, Zeleniuch-Jacquotte Anne, Zheng Wei, Gapstur Susan M
Epidemiology Research Program, American Cancer Society, Atlanta, Georgia.
Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, Maryland.
Cancer Epidemiol Biomarkers Prev. 2017 Apr;26(4):597-606. doi: 10.1158/1055-9965.EPI-16-0796. Epub 2017 Mar 17.
There are few established risk factors for gallbladder cancer beyond gallstones. Recent studies suggest a higher risk with high body mass index (BMI), an indicator of general heaviness, but evidence from other body size measures is lacking. Associations of adult BMI, young adult BMI, height, adult weight gain, waist circumference (WC), waist-height ratio (WHtR), hip circumference (HC), and waist-hip ratio (WHR) with gallbladder cancer risk were evaluated. Individual-level data from 1,878,801 participants in 19 prospective cohort studies (14 studies had circumference measures) were harmonized and included in this analysis. Multivariable Cox proportional hazards regression estimated hazard ratios (HR) and 95% confidence intervals (CI). After enrollment, 567 gallbladder cancer cases were identified during 20.1 million person-years of observation, including 361 cases with WC measures. Higher adult BMI (per 5 kg/m, HR: 1.24; 95% CI, 1.13-1.35), young adult BMI (per 5 kg/m, HR: 1.12; 95% CI, 1.00-1.26), adult weight gain (per 5 kg, HR: 1.07; 95% CI, 1.02-1.12), height (per 5 cm, HR: 1.10; 95% CI, 1.03-1.17), WC (per 5 cm, HR: 1.09; 95% CI, 1.02-1.17), WHtR (per 0.1 unit, HR: 1.24; 95% CI, 1.00-1.54), and HC (per 5 cm, HR: 1.13; 95% CI, 1.04-1.22), but not WHR (per 0.1 unit, HR: 1.03; 95% CI, 0.87-1.22), were associated with higher risks of gallbladder cancer, and results did not differ meaningfully by sex or other demographic/lifestyle factors. These findings indicate that measures of overall and central excess body weight are associated with higher gallbladder cancer risks. Excess body weight is an important, and potentially preventable, gallbladder cancer risk factor. .
除胆结石外,胆囊癌的确立风险因素较少。近期研究表明,高体重指数(BMI),即总体超重的一个指标,会增加患癌风险,但缺乏其他身体尺寸测量指标的相关证据。本研究评估了成人BMI、青年成人BMI、身高、成人体重增加、腰围(WC)、腰高比(WHtR)、臀围(HC)和腰臀比(WHR)与胆囊癌风险的关联。对19项前瞻性队列研究(其中14项研究有周长测量数据)中1,878,801名参与者的个体水平数据进行了整合,并纳入本分析。采用多变量Cox比例风险回归估计风险比(HR)和95%置信区间(CI)。入组后,在2010万人年的观察期内共确诊567例胆囊癌病例,其中361例有WC测量数据。较高的成人BMI(每增加5kg/m²,HR:1.24;95%CI,1.13 - 1.35)、青年成人BMI(每增加5kg/m²,HR:1.12;95%CI,1.00 - 1.26)、成人体重增加(每增加5kg,HR:1.07;95%CI,1.02 - 1.12)、身高(每增加5cm,HR:1.10;95%CI,1.03 - 1.17)、WC(每增加5cm,HR:1.09;95%CI,1.02 - 1.17)、WHtR(每增加0.1单位,HR:1.24;95%CI,1.00 - 1.54)和HC(每增加5cm,HR:1.13;95%CI,1.04 - 1.22)与胆囊癌风险较高相关,但WHR(每增加0.1单位,HR:1.03;95%CI,0.87 - 1.22)与胆囊癌风险无关,且结果在性别或其他人口统计学/生活方式因素方面无显著差异。这些发现表明,总体和中心性超重指标与胆囊癌风险较高相关。超重是一个重要的、且可能可预防的胆囊癌风险因素。