Clinical Epidemiology Unit, Qilu Hospital of Shandong University, Jinan, China.
Department of Epidemiology and Health Statistics, School of Public Health, Shandong University, Jinan, China.
Cancer Med. 2019 Sep;8(12):5769-5778. doi: 10.1002/cam4.2444. Epub 2019 Aug 1.
The relationship between risk of esophageal squamous cell carcinoma (ESCC) and adult height, changes in individual body mass index (BMI) and body shape is not established. We performed a large population-based case-control study, which enrolled a total of 1414 ESCC cases and 1989 controls in a high-incidence area in China. Using face-to-face interview with a structured questionnaire, information on participants' heights, weights, and perceived body shapes at 20 years of age was collected. Additionally, data on weight and perceived body shape among the same participants 10 years prior to ascertainment were collected using the same method. Odd ratios (ORs) of ESCC risk in relation to BMI and body shape were estimated using unconditional logistic regression models. The adjusted results indicated that ESCC risk in adults rapidly rose as height increased, plateauing at 170 cm among men and 157 cm among women. Among participants who were underweight, normal weight, or thinner than body shape 4, body weight loss was associated with increased risk of ESCC, and body weight gain was associated with decreased incidence of ESCC (ORs ranging from 0.40 to 0.76). Notably, however, changes in body weight did not significantly affect ESCC risk among participants who were overweight, obese, or larger than body shape 3. Maintaining a fit body shape and a reasonable BMI is advisable and of vital importance to reduce the risk of ESCC, especially in high-risk areas.
食管鳞状细胞癌(ESCC)的风险与成人身高、个体体重指数(BMI)和体型变化之间的关系尚未确定。我们进行了一项大型基于人群的病例对照研究,共纳入了中国高发地区的 1414 例 ESCC 病例和 1989 例对照。通过面对面的结构化问卷访谈,收集了参与者 20 岁时身高、体重和自我感知体型的信息。此外,还使用相同的方法收集了同一参与者在确诊前 10 年的体重和自我感知体型数据。使用非条件逻辑回归模型估计 BMI 和体型与 ESCC 风险的比值比(OR)。调整后的结果表明,成年人 ESCC 风险随着身高的增加而迅速上升,男性身高在 170cm 左右达到平台期,女性身高在 157cm 左右达到平台期。在体重不足、正常体重或体型小于 4 的参与者中,体重减轻与 ESCC 风险增加相关,而体重增加与 ESCC 发病率降低相关(OR 值范围为 0.40 至 0.76)。然而,值得注意的是,体重变化对超重、肥胖或体型大于 3 的参与者的 ESCC 风险没有显著影响。保持健康的体型和合理的 BMI 是明智且至关重要的,可以降低 ESCC 的风险,尤其是在高危地区。