Amr Sania, Wolpert Beverly J, St George Diane Marie, James India, Loffredo Christopher A
Department of Epidemiology and Public Health, University of Maryland School of Medicine, 660 West Redwood Street HH 109, Baltimore, MD, 21201, USA.
Marlene and Stuart Greenebaum Comprehensive Cancer Center, University of Maryland School of Medicine, Baltimore, MD, USA.
Cancer Causes Control. 2019 Mar;30(3):249-258. doi: 10.1007/s10552-019-1131-7. Epub 2019 Jan 21.
Investigators have reported inconsistent findings regarding associations between body mass index (BMI) and bladder cancer risk, and they have postulated that sex steroids mediate such associations. We assessed the impact of BMI on the relationship between bladder cancer risk and combinations of age at first childbirth, parity, and age at menopause, among Egyptian women.
We used data from our multicenter case-control study of 419 cases and 786 controls in logistic regression models to estimate adjusted odds ratios (AORs) and 95% confidence intervals (CIs) of such associations.
Age > 18 years at first childbirth and parity ≤ 6 were significantly associated with bladder cancer risk, which was higher when both factors (AOR = 2.31, 95% CI = 1.55-3.43) and age at menopause < 45 years (AOR = 3.51, 95% CI = 1.88-6.55) were present. Early menopause was associated with higher bladder cancer risk in obese (AOR = 2.90, 95% CI = 1.40-5.98) but not normal weight women (AOR = 0.98, 95% CI = 0.58-1.65; P = 0.11), and the risk was greatest when both first childbirth at age > 18 years and parity ≤ 6 were present (AOR = 7.60, 95% CI = 1.84-31.35); however, overweight and obesity were associated with significantly lower bladder cancer risk (AOR = 0.59, 95% CI = 0.43-0.81, and AOR = 0.26, 95% CI = 0.18-0.38, respectively).
Body mass index appears to modify bladder cancer risk in Egyptian women after menopause by slightly enhancing the risk associated with low estrogen exposure among the obese only. Longitudinal studies of the BMI role in bladder malignancy in this distinctive population are required.
研究人员报告了关于体重指数（BMI）与膀胱癌风险之间关联的不一致结果，并推测性类固醇介导了这种关联。我们评估了BMI对埃及女性膀胱癌风险与首次生育年龄、产次和绝经年龄组合之间关系的影响。
我们在逻辑回归模型中使用了来自多中心病例对照研究的419例病例和786例对照的数据，以估计此类关联的调整优势比（AOR）和95%置信区间（CI）。
首次生育年龄>18岁和产次≤6与膀胱癌风险显著相关，当同时存在这两个因素（AOR = 2.31，95% CI = 1.55 - 3.43）以及绝经年龄<45岁（AOR = 3.51，95% CI = 1.88 - 6.55）时，风险更高。绝经早与肥胖女性（AOR = 2.90，95% CI = 1.40 - 5.98）而非体重正常女性（AOR = 0.98，95% CI = 0.58 - 1.65；P = 0.11）的膀胱癌风险较高相关，并且当同时存在首次生育年龄>18岁和产次≤6时风险最大（AOR = 7.60，95% CI = 1.84 - 31.35）；然而，超重和肥胖与显著较低的膀胱癌风险相关（分别为AOR = 0.59，95% CI = 0.43 - 0.81，以及AOR = 0.26，95% CI = 0.18 - 0.38）。
体重指数似乎仅通过略微增加肥胖女性中低雌激素暴露相关的风险来改变埃及绝经后女性的膀胱癌风险。需要对这一独特人群中BMI在膀胱恶性肿瘤中的作用进行纵向研究。
