Centre for Bone and Arthritis Research, Institute of Medicine, the Sahlgrenska Academy at University of Gothenburg, Gothenburg, Sweden.
Department of Pediatrics, Institute of Clinical Sciences, The Sahlgrenska Academy at University of Gothenburg, Gothenburg, Sweden.
Int J Cancer. 2020 Nov 1;147(9):2355-2362. doi: 10.1002/ijc.33015. Epub 2020 May 1.
Hematologic malignancies are common and the incidence is increasing. Adult obesity has been associated with hematologic malignancies (HM), but the importance of body mass index (BMI) in childhood and during puberty has not been evaluated. The aim of the present study was to evaluate the relative contribution of BMI and height in childhood and during puberty for the risk of adult HM. 37 669 men born in 1946 to 1961 who had weight and height measured at 8 (childhood) and 20 (young adult age) years of age available from the BMI Epidemiology Study were included in the study. Pubertal BMI change was calculated as BMI at 20 years of age minus BMI at 8 years of age. Information on HM was retrieved from Swedish registers (459 cases of HM). Hazard ratios (HR) and 95% confidence intervals (CI) were estimated by Cox regressions. Childhood BMI (HR 1.11 per SD increase [95% CI 1.02-1.23]), but not pubertal BMI change, was associated with hematologic malignancies in a linear manner. Childhood BMI was, independent of childhood height, associated with the diagnostic entities Non-Hodgkin lymphoma (HR 1.14 [95% CI 1.00-1.30]) and its largest subgroup diffuse large B-cell lymphoma (HR 1.31 [95% CI 1.03-1.67]). Childhood height was associated with multiple myeloma (HR 1.30 [95% CI 1.04-1.64]) independent of childhood BMI. We conclude that childhood but not puberty is the critical developmental period regarding future risk of HM and we suggest that elevated childhood BMI is a determinant of Non-Hodgkin lymphoma and diffuse large B-cell lymphoma.
血液系统恶性肿瘤很常见，其发病率正在上升。成人肥胖与血液系统恶性肿瘤（HM）有关，但儿童期和青春期的体重指数（BMI）的重要性尚未得到评估。本研究旨在评估儿童期和青春期 BMI 和身高对成年 HM 风险的相对贡献。
共有 37669 名 1946 年至 1961 年出生的男性参与了本研究，他们在 BMI 流行病学研究中接受了 8 岁（儿童期）和 20 岁（青年期）时的体重和身高测量。青春期 BMI 变化的计算方法为 20 岁时的 BMI 减去 8 岁时的 BMI。HM 的信息来自瑞典登记处（459 例 HM）。使用 Cox 回归估计危险比（HR）和 95%置信区间（CI）。
儿童期 BMI（每 SD 增加 1.11 [95%CI 1.02-1.23]），而青春期 BMI 变化与血液系统恶性肿瘤呈线性相关。儿童期 BMI 与非霍奇金淋巴瘤（HR 1.14 [95%CI 1.00-1.30]）及其最大亚组弥漫性大 B 细胞淋巴瘤（HR 1.31 [95%CI 1.03-1.67]）的诊断实体独立于儿童期身高相关。儿童期身高与多发性骨髓瘤（HR 1.30 [95%CI 1.04-1.64]）相关，独立于儿童期 BMI。
我们得出结论，儿童期而不是青春期是未来 HM 风险的关键发育期，我们认为升高的儿童期 BMI 是非霍奇金淋巴瘤和弥漫性大 B 细胞淋巴瘤的决定因素。
