体重指数和身高与子宫内膜癌风险的总体关联及按组织学亚型的关联:日本一项基于人群的前瞻性队列研究

Association of BMI and height with the risk of endometrial cancer, overall and by histological subtype: a population-based prospective cohort study in Japan.

作者信息

Kawachi Asuka, Shimazu Taichi, Budhathoki Sanjeev, Sawada Norie, Yamaji Taiki, Iwasaki Motoki, Inoue Manami, Tsugane Shoichiro

机构信息

Epidemiology and Prevention Group, Center for Public Health Sciences, National Cancer Center.

Department of Breast and Medical Oncology, National Cancer Center Hospital, Tokyo, Japan.

出版信息

Eur J Cancer Prev. 2019 May;28(3):196-202. doi: 10.1097/CEJ.0000000000000449.

Abstract

Evidence on the association between BMI, height, and endometrial cancer risk, including by subtypes, among Asian populations remains limited. We evaluated the impact of BMI and height on the risk of endometrial cancer, overall and by histological subtype. We prospectively investigated 53 651 Japanese women aged 40-69 years. With an average follow-up duration of 18.6 years, 180 newly diagnosed endometrial cancers were reported, including 119 type 1 and 21 type 2. The association between BMI, height, and endometrial cancer risk was assessed using a Cox proportional hazards regression model with adjustment for potential confounders. Overweight and obesity were associated positively with the risk of endometrial cancer. Compared with BMI of 23.0-24.9 kg/m, hazard ratios (HRs) (95% confidence intervals) were 1.93 (1.17-3.16) for BMI of 27.0-29.9 kg/m and 2.37 (1.20-4.66) for BMI of at least 30.0 kg/m. On analysis by histological subtype, with each increase in BMI of 5 U, the estimated HR of type 1 endometrial cancer increased (HR=1.54, 95% confidence interval: 1.21-1.98), but HR of type 2 endometrial cancer was unaffected. There was no statistically significant association between height and endometrial cancer risk. In conclusion, the risk of endometrial cancer was elevated in women with a BMI of at least 27.0 kg/m. By histological subtype, BMI was associated with type 1, but not type 2 endometrial cancer risk among a population with a relatively low BMI compared with western populations.

摘要

在亚洲人群中,关于体重指数(BMI)、身高与子宫内膜癌风险(包括按亚型划分)之间关联的证据仍然有限。我们评估了BMI和身高对子宫内膜癌总体风险以及按组织学亚型划分的风险的影响。我们对53651名年龄在40至69岁的日本女性进行了前瞻性调查。平均随访时间为18.6年,报告了180例新诊断的子宫内膜癌,其中119例为1型,21例为2型。使用Cox比例风险回归模型评估BMI、身高与子宫内膜癌风险之间的关联,并对潜在混杂因素进行了调整。超重和肥胖与子宫内膜癌风险呈正相关。与BMI为23.0 - 24.9kg/m²相比,BMI为27.0 - 29.9kg/m²时的风险比(HRs)(95%置信区间)为1.93(1.17 - 3.16),BMI至少为30.0kg/m²时为2.37(1.20 - 4.66)。按组织学亚型分析,BMI每增加5个单位,1型子宫内膜癌的估计HR增加(HR = 1.54,95%置信区间:1.21 - 1.98),但2型子宫内膜癌的HR不受影响。身高与子宫内膜癌风险之间无统计学显著关联。总之,BMI至少为27.0kg/m²的女性患子宫内膜癌的风险升高。按组织学亚型划分,与西方人群相比,在BMI相对较低的人群中,BMI与1型子宫内膜癌风险相关,但与2型子宫内膜癌风险无关。

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