Division of Endocrinology and Metabolism, Department of Internal Medicine, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea.
Department of Biostatics, Catholic University College of Medicine, Seoul, Republic of Korea.
Sci Rep. 2019 Feb 7;9(1):1546. doi: 10.1038/s41598-018-38203-0.
Obesity is a risk factor for many cancers including breast, esophageal, colon, and thyroid cancer. We aimed to evaluate the association of thyroid cancer with body mass index (BMI), waist circumference (WC), and weight change. This nationwide population-based cohort study included 11,323,006 adults who joined the national health screening program. Weight change was defined as the difference between the weight of the subjects measured during the study period and the weight at the time of four years ago. For evaluating the association between the weight change and the risk of thyroid cancer, subjects without weight change for four years were defined as the reference group. Mean age was 50.1 ± 13.7 years and 44% were female. In total, 50,464 subjects (0.4%) had newly-diagnosed thyroid cancer. After multivariable analyses, the incidence of thyroid cancer increased significantly in subjects with larger WC as well as higher BMI (P < 0.001 and P < 0.001, respectively). In subjects who were lean and became obese, the incidence of thyroid cancers increased significantly (hazard ratio [HR] 1.15 [1.11-1.19]). In subjects who were obese and became lean, the incidence of thyroid cancers decreased significantly (HR 0.89 [0.86-0.93]). These results demonstrated that higher BMI and larger WC were significantly associated with an increased risk of thyroid cancer. Weight gain in lean subjects was associated with an increased risk of thyroid cancer, and weight reduction in subjects with obesity was associated with a decreased risk of thyroid cancer.
肥胖是许多癌症的风险因素,包括乳腺癌、食管癌、结肠癌和甲状腺癌。我们旨在评估甲状腺癌与体重指数(BMI)、腰围(WC)和体重变化的关系。这项全国性基于人群的队列研究纳入了 11323006 名参加国家健康筛查计划的成年人。体重变化定义为研究期间测量的受试者体重与四年前体重的差值。为了评估体重变化与甲状腺癌风险之间的关系,将四年体重无变化的受试者定义为参照组。平均年龄为 50.1±13.7 岁,44%为女性。共有 50464 名受试者(0.4%)被诊断为新发甲状腺癌。经过多变量分析,WC 较大和 BMI 较高的受试者甲状腺癌的发病率显著增加(P<0.001 和 P<0.001)。在体重较轻但变为肥胖的受试者中,甲状腺癌的发病率显著增加(HR 1.15[1.11-1.19])。在肥胖但变为体重较轻的受试者中,甲状腺癌的发病率显著降低(HR 0.89[0.86-0.93])。这些结果表明,较高的 BMI 和较大的 WC 与甲状腺癌风险的增加显著相关。体重较轻的受试者体重增加与甲状腺癌风险增加相关,而肥胖受试者体重减轻与甲状腺癌风险降低相关。