Department of Urology, Bucheon St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea.
Department of Urology, Dongnam Institute of Radiological & Medical Sciences, Cancer Center, Busan, Republic of Korea.
World J Urol. 2019 Nov;37(11):2393-2400. doi: 10.1007/s00345-019-02690-1. Epub 2019 Feb 26.
The previous epidemiological studies about the associations between obesity and bladder cancer risk have reported inconsistent results. Therefore, we analyzed whether the abdominal obesity effected on the risk of developing bladder cancer according to body mass index (BMI) using nationally representative data from the National Health Insurance System (NHIS).
Among people who underwent at least one health examination from 2009 to 2012 in Korea, 11,823,876 men without a previous diagnosis of bladder cancer were followed up until December 2015. Multiple Cox regression analysis was conducted to determine the hazard ratio (HR) and 95% confidence interval (CI) for the association between bladder cancer and BMI or waist circumference (WC).
Significant upward trends in the risk of bladder cancer were observed with increasing BMI or WC according to the multivariate-adjusted model. However, the association between BMI and bladder cancer is influenced by the presence of abdominal obesity. In the group with WC < 90 cm, there was no significant change in the HRs for bladder cancer development beyond the reference BMI. In contrast, the HRs for bladder cancer showed statistically significant increase as the BMI increased beyond the reference BMI in the group with WC ≥ 90 cm.
This population-based study showed that increasing BMI and increasing WC were risk factors for developing bladder cancer in men, independent of confounding variables. However, there was a discrepancy in the trend of bladder cancer development according to BMI between the groups with abdominal obesity and without abdominal obesity.
先前有关肥胖与膀胱癌风险之间关联的流行病学研究结果并不一致。因此,我们使用国家健康保险系统(NHIS)的全国代表性数据,分析了根据身体质量指数(BMI),腹型肥胖是否会对膀胱癌发病风险产生影响。
在韩国,2009 年至 2012 年间至少接受过一次体检的人群中,我们对 11823876 名未被诊断患有膀胱癌的男性进行了随访,随访时间截至 2015 年 12 月。采用多变量 Cox 回归分析,确定膀胱癌与 BMI 或腰围(WC)之间的关联的风险比(HR)和 95%置信区间(CI)。
根据多变量调整模型,随着 BMI 或 WC 的增加,膀胱癌的风险呈显著上升趋势。然而,BMI 与膀胱癌之间的关联受到腹型肥胖的影响。在 WC<90cm 的组中,超过参考 BMI 的 BMI 与膀胱癌发展之间的 HR 没有明显变化。相比之下,在 WC≥90cm 的组中,超过参考 BMI 的 BMI 与膀胱癌的 HR 呈统计学显著增加。
这项基于人群的研究表明,BMI 和 WC 的增加是男性膀胱癌发生的危险因素,与混杂因素无关。然而,在存在和不存在腹型肥胖的两组中,BMI 与膀胱癌发展的趋势存在差异。