Ardesch F H, Ruiter R, Mulder M, Lahousse L, Stricker B H C, Kiefte-de Jong J C
Department of Epidemiology, Erasmus Medical Center, Rotterdam, Netherlands.
Department of Public Health and Primary Care/LUMC Campus The Hague, Leiden University Medical Center, The Hague, Netherlands.
Front Oncol. 2020 Nov 10;10:591110. doi: 10.3389/fonc.2020.591110. eCollection 2020.
The association between obesity and lung cancer (LC) remains poorly understood. However, other indices of obesity on the basis of body shape instead of body size have not been examined yet. The aim of this study was to evaluate the association between different indices of body size and body shape and the risk of LC. In particular, this study examined the association between A Body Shape Index, a more precise indicator of abdominal fat than traditional anthropometric measures, and the risk of LC.
In the prospective cohort the Rotterdam Study, we analysed data of 9,689 participants. LC diagnoses were based on medical records and anthropometric measurements were assessed at baseline. Cox-regression analyses with corresponding Hazard Ratios were used to examine the association between the anthropometric measurements and the risk of LC with adjustment for potential confounders. Potential non-linear associations were explored with cubic splines using the Likelihood ratio (LR) test.
During follow-up, 319 participants developed LC. Body mass Index (BMI) was inversely associated with the risk of lung cancer (HR 0.94, 95% CI: 0.91-0.97) and persisted after excluding lung cancer cases during the first 10 years of follow-up. There was evidence for a non-linear association between BMI and the risk of lung cancer (0,04, df = 1), which indicated that the inverse association between BMI and lung cancer was mainly present in non-obese participants. Waist circumference (WC) (HR 1.03 95% CI: 1.01-1.05), Waist-to-Hip Ratio (WHR) (HR 1.23 95% CI: 1.09-1.38) and ABSI (A Body Shape Index) (HR 1.17 95% CI: 1.05-1.30) were positively and linearly associated with the risk of lung cancer.
Body shape rather than body size may be an important risk indicator of LC. Future research should focus on the role of visceral fat and the risk of LC as well as the underlying mechanisms.
肥胖与肺癌（LC）之间的关联仍未得到充分理解。然而，基于身体形状而非身体大小的其他肥胖指标尚未得到研究。本研究的目的是评估不同身体大小和身体形状指标与肺癌风险之间的关联。特别是，本研究考察了身体形状指数（一种比传统人体测量方法更精确的腹部脂肪指标）与肺癌风险之间的关联。
在鹿特丹研究这个前瞻性队列中，我们分析了9689名参与者的数据。肺癌诊断基于医疗记录，人体测量在基线时进行评估。使用相应风险比的Cox回归分析来检验人体测量与肺癌风险之间的关联，并对潜在混杂因素进行调整。使用似然比（LR）检验的三次样条来探索潜在的非线性关联。
在随访期间，319名参与者患上了肺癌。体重指数（BMI）与肺癌风险呈负相关（风险比0.94，95%置信区间：0.91 - 0.97），并且在排除随访前10年的肺癌病例后仍然存在。有证据表明BMI与肺癌风险之间存在非线性关联（P = 0.04，自由度 = 1），这表明BMI与肺癌之间的负相关主要存在于非肥胖参与者中。腰围（WC）（风险比1.03，95%置信区间：1.01 - 1.05）、腰臀比（WHR）（风险比1.23，95%置信区间：1.09 - 1.38）和身体形状指数（ABSI）（风险比1.17，95%置信区间：1.05 - 1.30）与肺癌风险呈正线性相关。
身体形状而非身体大小可能是肺癌的一个重要风险指标。未来的研究应关注内脏脂肪的作用以及肺癌风险及其潜在机制。
