Department of Urology, Faculty of Medicine and Health, Örebro University, Örebro, Sweden.
Clinical Epidemiology and Biostatistics, School of Medical Sciences, Örebro University, Örebro, Sweden.
Int J Cancer. 2019 Sep 1;145(5):1232-1237. doi: 10.1002/ijc.32147. Epub 2019 Feb 20.
While overweight among adults has been linked with renal cell carcinoma (RCC) risk, little is known about the potential influence of overweight and obesity during adolescence. To ascertain if adolescent body mass index is associated with subsequent risk of RCC, we identified a cohort of 238,788 Swedish men who underwent mandatory military conscription assessment between 1969 and 1976 at a mean age of 18.5 years. At the time of conscription assessment, physical and psychological tests were performed including measurements of height and weight. Participants were followed through linkage to the Swedish Cancer Registry to identify incident diagnoses of RCC. The association between body mass index (BMI, kg/m ) at conscription assessment and subsequent RCC was evaluated using multivariable Cox regression. During a follow-up of up to 37 years, 266 men were diagnosed with RCC. We observed a trend for higher RCC risk with increasing BMI during adolescence, where one-unit increase in BMI conferred a 6% increased risk of RCC (95% CI 1.01-1.10). compared to normal weight men (BMI 18.5- < 25), men with overweight (BMI 25- < 30) or obesity (BMI ≥30) had hazard ratios for RCC of 1.76 (95% CI 1.16-2.67) and 2.87 (95% CI 1.26-6.25), respectively. The link between overweight/obesity and RCC appear to be already established during late adolescence. Prevention of unhealthy weight gain during childhood and adolescence may thus be a target in efforts to decrease the burden of RCC in the adult population.
虽然成年人超重与肾细胞癌 (RCC) 风险相关，但对于青少年时期超重和肥胖对 RCC 潜在影响知之甚少。为了确定青少年的体重指数是否与随后的 RCC 风险相关，我们确定了一个由 238788 名瑞典男性组成的队列，这些男性于 1969 年至 1976 年期间在平均 18.5 岁时接受了强制性兵役评估。在兵役评估时，进行了身体和心理测试，包括身高和体重的测量。通过与瑞典癌症登记处的链接，对参与者进行随访，以确定 RCC 的发病诊断。使用多变量 Cox 回归评估兵役评估时的体重指数（BMI，kg/m ）与随后的 RCC 之间的关联。在长达 37 年的随访期间，有 266 名男性被诊断出患有 RCC。我们观察到青少年时期 BMI 升高与 RCC 风险增加呈趋势，BMI 每增加一个单位，RCC 的风险增加 6%（95%CI 1.01-1.10）。与正常体重男性（BMI 18.5-<25）相比，超重（BMI 25-<30）或肥胖（BMI ≥30）男性的 RCC 风险比分别为 1.76（95%CI 1.16-2.67）和 2.87（95%CI 1.26-6.25）。超重/肥胖与 RCC 之间的联系似乎在青少年晚期就已经建立。因此，在儿童和青少年时期预防不健康的体重增加可能是降低成年人群 RCC 负担的目标之一。
