根据幽门螺杆菌感染的调节作用，体重指数与胃癌风险的关系。
Association between Body Mass Index and Gastric Cancer Risk According to Effect Modification by Helicobacter pylori Infection.
机构信息
Department of Preventive Medicine, Seoul National University College of Medicine, Seoul, Korea.
Cancer Research Institute, Seoul National University, Seoul, Korea.
出版信息
Cancer Res Treat. 2019 Jul;51(3):1107-1116. doi: 10.4143/crt.2018.182. Epub 2018 Nov 21.
PURPOSE
Few studies investigated roles of body mass index (BMI) on gastric cancer (GC) risk according to Helicobacter pylori infection status. This study was conducted to evaluate associations between BMI and GC risk with consideration of H. pylori infection information.
MATERIALS AND METHODS
We performed a case-cohort study (n=2,458) that consists of a subcohort, (n=2,193 including 67 GC incident cases) randomly selected from the Korean Multicenter Cancer Cohort (KMCC) and 265 incident GC cases outside of the subcohort. H. pylori infection was assessed using an immunoblot assay. GC risk according to BMI was evaluated by calculating hazard ratios (HRs) and their 95% confidence intervals (95% CIs) using weighted Cox hazard regression model.
RESULTS
Increased GC risk in lower BMI group (< 23 kg/m2) with marginal significance, (HR, 1.32; 95% CI, 0.98 to 1.77) compared to the reference group (BMI of 23-24.9 kg/m2) was observed. In the H. pylori non-infection, both lower (< 23 kg/m2) and higher BMI (≥ 25 kg/m2) showed non-significantly increased GC risk (HR, 10.82; 95% CI, 1.25 to 93.60 and HR, 11.33; 95% CI, 1.13 to 113.66, respectively). However, these U-shaped associations between BMI and GC risk were not observed in the group who had ever been infected by H. pylori.
CONCLUSION
This study suggests the U-shaped associations between BMI and GC risk, especially in subjects who had never been infected by H. pylori.
目的
很少有研究根据幽门螺杆菌（H. pylori）感染状况调查体重指数（BMI）在胃癌（GC）风险中的作用。本研究旨在评估考虑 H. pylori 感染信息后 BMI 与 GC 风险之间的关联。
材料与方法
我们进行了一项病例-队列研究（n=2458），其中包括一个子队列（n=2193 例，包括 67 例 GC 发病病例），该子队列是从韩国多中心癌症队列（KMCC）中随机选择的，以及 265 例子队列之外的 GC 发病病例。使用免疫印迹法评估 H. pylori 感染情况。使用加权 Cox 风险回归模型计算 BMI 与 GC 风险的风险比（HR）及其 95%置信区间（95%CI）。
结果
与参考组（BMI 为 23-24.9kg/m2）相比，较低 BMI 组（<23kg/m2）的 GC 风险呈上升趋势，但具有边缘显著性（HR，1.32；95%CI，0.98 至 1.77）。在 H. pylori 未感染的人群中，较低（<23kg/m2）和较高 BMI（≥25kg/m2）的 GC 风险均呈非显著性增加（HR，10.82；95%CI，1.25 至 93.60 和 HR，11.33；95%CI，1.13 至 113.66）。然而，在曾经感染过 H. pylori 的人群中，没有观察到 BMI 与 GC 风险之间的这种 U 型关联。
结论
本研究表明 BMI 与 GC 风险之间存在 U 型关联，特别是在从未感染过 H. pylori 的人群中。
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