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出生体重越大,墨西哥儿童患急性白血病的风险就越高——这是来自墨西哥多机构儿童白血病病因研究组(MIGICCL)的经验。

A greater birthweight increases the risk of acute leukemias in Mexican children-experience from the Mexican Interinstitutional Group for the Identification of the Causes of Childhood Leukemia (MIGICCL).

机构信息

Health Research Coordination, Instituto Mexicano del Seguro Social (IMSS), Mexico City, Mexico.

Pediatric Hematology Services, Hospital General "Gaudencio González Garza", CMN "La Raza", IMSS, Mexico City, Mexico.

出版信息

Cancer Med. 2018 Apr;7(4):1528-1536. doi: 10.1002/cam4.1414. Epub 2018 Mar 13.

Abstract

In Mexico, due to the high rates of diabetes, overweight, and obesity, there has also been noted an increased newborn weight, which may be contributing to the elevated incidence rate of childhood acute leukemia (AL). We conducted a case-control study in public hospitals of Mexico City aimed to know whether a greater weight at birth is associated with a higher risk of developing leukemia. We included incident cases with acute lymphoblastic leukemia (ALL) and acute myeloid leukemia (AML) diagnosed between 2010 and 2015. Controls were frequency-matched to the cases by age, sex, and health institution. Logistic regression analysis was performed adjusting risks by child's sex, overcrowding index, birth order, and mother's age at the time of pregnancy. Adjusted odds ratios (aORs) and 95% confidence intervals were calculated. A total of 1455 cases and 1455 controls were included. An evident association between ALL and child's birthweight ≥2500 g was found (aOR 2.06; 95% CI: 1.59, 2.66) and also, in those with birthweight ≥3500 g (aOR 1.19; 95% CI: 1.00, 1.41). In AML patients with birthweight ≥2500 g and ≥3500 g, an aOR of 1.77 (95% CI: 1.07, 2.94) and 1.42 (95% CI: 1.03-1.95) was observed, respectively. No association was noticed with either type of AL and a birthweight ≥4000 g. To sum up, we found a moderate association between not having a low birthweight and an increased risk of acute leukemias. Birthweight ≥3500 g was also a risk factor for both types of leukemia. This suggests that a greater birthweight may increase the risk of acute leukemias in Mexican children.

摘要

在墨西哥,由于糖尿病、超重和肥胖率居高不下,新生儿体重也有所增加,这可能导致儿童急性白血病 (AL) 的发病率上升。我们在墨西哥城的公立医院进行了一项病例对照研究,旨在了解出生体重较大是否与患白血病的风险增加有关。我们纳入了 2010 年至 2015 年间诊断为急性淋巴细胞白血病 (ALL) 和急性髓细胞白血病 (AML) 的新发病例。对照病例按年龄、性别和医疗机构进行频数匹配。通过儿童性别、拥挤指数、出生顺序和母亲妊娠时的年龄对风险进行调整后,进行 logistic 回归分析。计算调整后的比值比(aOR)和 95%置信区间。共纳入 1455 例病例和 1455 例对照。结果发现,ALL 与儿童出生体重≥2500 g 之间存在明显关联(aOR 2.06;95%CI:1.59,2.66),出生体重≥3500 g 的儿童也存在关联(aOR 1.19;95%CI:1.00,1.41)。对于出生体重≥2500 g 和≥3500 g 的 AML 患者,aOR 分别为 1.77(95%CI:1.07,2.94)和 1.42(95%CI:1.03-1.95)。但未观察到任何类型的 AL 与出生体重≥4000 g 之间存在关联。总之,我们发现出生体重不低与急性白血病风险增加之间存在中度关联。出生体重≥3500 g 也是两种白血病的危险因素。这表明,较大的出生体重可能会增加墨西哥儿童患急性白血病的风险。

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