成人身体质量指数（BMI）和腰围的变化与晚期结直肠肿瘤风险增加相关。
Changes in Adult BMI and Waist Circumference Are Associated with Increased Risk of Advanced Colorectal Neoplasia.
作者信息
Gathirua-Mwangi Wambui G, Monahan Patrick, Song Yiqing, Zollinger Terrell W, Champion Victoria L, Stump Timothy E, Imperiale Thomas F
机构信息
Department of Epidemiology, Richard M. Fairbanks School of Public Health, Indiana University, Indianapolis, IN, USA.
Center for Nursing Research, School of Nursing, Indiana University, 600 Barnhill Dr. NU 317C, Indianapolis, IN, 46202, USA.
出版信息
Dig Dis Sci. 2017 Nov;62(11):3177-3185. doi: 10.1007/s10620-017-4778-5. Epub 2017 Oct 5.
BACKGROUND
Waist circumference (WC) is a stronger predictor of colon cancer (CRC) risk than body mass index (BMI). However, how well change in either WC or BMI predicts risk of advanced colorectal neoplasia (AN) is unclear.
AIMS
To determine the relationship between change in BMI and WC from early adulthood to later age and the risk of AN and which change measure is a stronger predictor.
METHODS
In 4500 adults, ages 50-80, with no previous neoplasia and undergoing screening colonoscopy, BMI and WC at age 21 and at time of screening were reported. Changes in BMI and WC were defined using universal risk cutoffs. Known CRC risk factors were controlled in the logistic models.
RESULTS
Overall, model statistics showed WC change (omnibus test χ = 10.15, 2 DF, p value = 0.006) was a statistically stronger predictor of AN than BMI change (omnibus test χ = 5.66, 5 DF, p value = 0.34). Independent of BMI change, participants who increased WC (OR 1.44; 95% CI 1.05-1.96) or maintained a high-risk WC (OR 2.50; 95% CI 1.38-4.53) at age 21 and at screening had an increased risk of AN compared to those with a low-risk WC. Study participants who were obese at age 21 and at screening had an increased risk of AN (OR 1.87; 95% CI 1.08-3.23) compared to those who maintained a healthy BMI. Maintaining an overweight BMI or increasing BMI was not associated with AN.
CONCLUSIONS
Maintaining an unhealthy BMI and WC throughout adult life may increase risk of AN. WC change may be a better predictor of AN than BMI change.
背景
腰围（WC）比体重指数（BMI）更能预测结肠癌（CRC）风险。然而，WC或BMI的变化对晚期结直肠肿瘤（AN）风险的预测效果如何尚不清楚。
目的
确定从成年早期到晚年BMI和WC的变化与AN风险之间的关系，以及哪种变化指标是更强的预测因素。
方法
在4500名年龄在50 - 80岁、无既往肿瘤病史且接受筛查结肠镜检查的成年人中，报告了其21岁时和筛查时的BMI及WC。使用通用风险临界值定义BMI和WC的变化。在逻辑模型中对已知的CRC风险因素进行了控制。
结果
总体而言，模型统计显示WC变化（综合检验χ² = 10.15，自由度为2，p值 = 0.006）在统计学上比BMI变化（综合检验χ² = 5.66，自由度为5，p值 = 0.34）更能预测AN。与低风险WC者相比，在21岁和筛查时WC增加（比值比[OR] 1.44；95%置信区间[CI] 1.05 - 1.96）或维持高风险WC（OR 2.50；95% CI 1.38 - 4.53）的参与者AN风险增加。与维持健康BMI者相比，在21岁和筛查时肥胖的研究参与者AN风险增加（OR 1.87；95% CI 1.08 - 3.23）。维持超重BMI或BMI增加与AN无关。
结论
成年期全程维持不健康的BMI和WC可能会增加AN风险。WC变化可能比BMI变化更能预测AN。
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