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人体测量因素与皮肤黑色素瘤:基于人群的扬努斯队列的前瞻性数据。

Anthropometric factors and cutaneous melanoma: Prospective data from the population-based Janus Cohort.

机构信息

Department of Research, Cancer Registry of Norway, Oslo, Norway.

Oslo Center for Biostatistics and Epidemiology, Department of Biostatistics, University of Oslo, Oslo, Norway.

出版信息

Int J Cancer. 2018 Feb 15;142(4):681-690. doi: 10.1002/ijc.31086. Epub 2017 Oct 17.

Abstract

The aim of the present study was to prospectively examine risk of cutaneous melanoma (CM) according to measured anthropometric factors, adjusted for exposure to ultraviolet radiation (UVR), in a large population-based cohort in Norway. The Janus Cohort, including 292,851 Norwegians recruited 1972-2003, was linked to the Cancer Registry of Norway and followed for CM through 2014. Cox regression was used to estimate hazard ratios (HRs) of CM with 95% confidence intervals (CIs). Restricted cubic splines were incorporated into the Cox models to assess possible non-linear relationships. All analyses were adjusted for attained age, indicators of UVR exposure, education, and smoking status. During a mean follow-up of 27 years, 3,000 incident CM cases were identified. In men, CM risk was positively associated with body mass index, body surface area (BSA), height and weight (all p  < 0.001), and the exposure-response curves indicated an exponential increase in risk for all anthropometric factors. Weight loss of more than 2 kg in men was associated with a 53% lower risk (HR 0.47, 95% CI: 0.39, 0.57). In women, CM risk increased with increasing BSA (p  = 0.002) and height (p  < 0.001). The shape of the height-CM risk curve indicated an exponential increase. Our study suggests that large body size, in general, is a CM risk factor in men, and is the first to report that weight loss may reduce the risk of CM among men.

摘要

本研究旨在前瞻性地检查在挪威的一个大型基于人群的队列中,根据测量的人体测量学因素,调整紫外线辐射(UVR)暴露后,患皮肤黑色素瘤(CM)的风险。Janus 队列包括 1972-2003 年招募的 292851 名挪威人,与挪威癌症登记处相关联,并通过 2014 年随访 CM。Cox 回归用于估计 CM 的风险比(HR)和 95%置信区间(CI)。受限立方样条被纳入 Cox 模型以评估可能的非线性关系。所有分析均根据获得的年龄、UVR 暴露指标、教育程度和吸烟状况进行调整。在平均 27 年的随访期间,确定了 3000 例新发 CM 病例。在男性中,CM 风险与体重指数、体表面积(BSA)、身高和体重呈正相关(均 p < 0.001),并且暴露反应曲线表明所有人体测量因素的风险呈指数增加。男性体重减轻超过 2 公斤与风险降低 53%相关(HR 0.47,95%CI:0.39,0.57)。在女性中,CM 风险随着 BSA(p = 0.002)和身高(p < 0.001)的增加而增加。身高与 CM 风险曲线的形状表明呈指数增加。我们的研究表明,一般来说,体型较大是男性 CM 的一个危险因素,并且是第一个报告体重减轻可能降低男性 CM 风险的研究。

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