一生中的身高、腰围、体重指数和身体体型与胶质瘤风险
Height, waist circumference, body mass index, and body somatotype across the life course and risk of glioma.
作者信息
Cote David J, Downer Mary K, Smith Timothy R, Smith-Warner Stephanie A, Egan Kathleen M, Stampfer Meir J
机构信息
Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA.
Department of Epidemiology, Harvard T. H. Chan School of Public Health, 677 Huntington Avenue, Boston, MA, USA.
出版信息
Cancer Causes Control. 2018 Aug;29(8):707-719. doi: 10.1007/s10552-018-1052-x. Epub 2018 Jun 26.
PURPOSE
Recent studies have suggested height as a risk factor for glioma, but less is known regarding body mass index (BMI) or other anthropomorphic measures. We evaluated the association between body habitus and risk of glioma.
METHODS
We evaluated the association of measures of height, BMI, waist circumference, and somatotypes with risk of glioma in two prospective cohorts, the Nurses' Health Study and the Health Professionals Follow-Up Study.
RESULTS
We documented 508 incident cases of glioma (321 glioblastoma [GBM]). In both cohorts, we found no significant association between adult BMI or waist circumference and risk of glioma, with pooled HR for BMI of 1.08 (95% CI 0.85-1.38 comparing ≥ 30 to < 25 kg/m) and for waist circumference of 1.05 (95% CI 0.80-1.37 highest vs. lowest quintile). Higher young adult BMI (at age 18 in NHS and 21 in HPFS) was associated with modestly increased risk of glioma in the pooled cohorts (pooled HR 1.35, 95% CI 1.06-1.72 comparing ≥ 25 kg/m vs. less; HR 1.34 for women and 1.37 for men). Analysis of body somatotypes suggested reduced risk of glioma among women with heavier body types at all ages this measure was assessed (HRs ranging from 0.52 to 0.65 comparing highest tertile to lowest tertile), but no significant association among men. Height was associated with increased risk of glioma among women (HR 1.09, 95% CI 1.04-1.14 per inch), but not significantly among men. Within the 8 years prior to diagnosis, cases had no material weight loss compared to non-cases. All results were similar when limited to GBM.
CONCLUSION
Adult BMI and waist circumference were not associated with glioma. Higher BMI at age 21 for men and at age 18 for women was modestly associated with risk in the pooled cohort. Based on body somatotypes, however, women with heavier body types during childhood and young adulthood may be at lower risk of glioma, although this association was not observed later in life with measurements of BMI. Greater height was associated with increased risk, and the trend was more pronounced in women.
目的
近期研究表明身高是胶质瘤的一个风险因素，但关于体重指数（BMI）或其他人体测量指标的了解较少。我们评估了体型与胶质瘤风险之间的关联。
方法
我们在两项前瞻性队列研究，即护士健康研究和卫生专业人员随访研究中，评估了身高、BMI、腰围和体型测量指标与胶质瘤风险的关联。
结果
我们记录了508例新发胶质瘤病例（321例胶质母细胞瘤[GBM]）。在两项队列研究中，我们发现成人BMI或腰围与胶质瘤风险之间无显著关联，BMI的合并风险比为1.08（95%CI 0.85 - 1.38，比较≥30与<25 kg/m²），腰围的合并风险比为1.05（95%CI 0.80 - 1.37，最高五分位数与最低五分位数相比）。较高的青年期BMI（护士健康研究中为18岁时，卫生专业人员随访研究中为21岁时）与合并队列中胶质瘤风险适度增加相关（合并风险比1.35，95%CI 1.06 - 1.72，比较≥25 kg/m²与更低水平；女性风险比为1.34，男性为1.37）。体型分析表明，在所有评估该指标的年龄段中，体型较重的女性患胶质瘤的风险降低（最高三分位数与最低三分位数相比，风险比范围为0.52至0.65），但男性中无显著关联。身高与女性患胶质瘤风险增加相关（每英寸风险比1.09，95%CI 1.04 - 1.14），但男性中无显著关联。在诊断前的8年内，病例与非病例相比没有明显体重减轻。当仅限于GBM时，所有结果相似。
结论
成人BMI和腰围与胶质瘤无关。在合并队列中，男性21岁和女性18岁时较高的BMI与风险适度相关。然而，基于体型，儿童期和青年期体型较重的女性患胶质瘤的风险可能较低，尽管在生命后期通过BMI测量未观察到这种关联。身高越高风险越高，且这种趋势在女性中更明显。
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