Institute of Health and Wellbeing, University of Glasgow, Glasgow, United Kingdom.
Institute of Cardiovascular and Medical Sciences, University of Glasgow, Glasgow, United Kingdom.
Am J Clin Nutr. 2021 Feb 2;113(2):401-409. doi: 10.1093/ajcn/nqaa335.
Body mass index (BMI) and waist circumference (WC) are measures of general and central obesity, respectively, and both have been shown to be associated with cancer. However, there is insufficient evidence of their combined association with the risk of cancer.
This study aimed to investigate the associations of combinations of BMI and WC with cancer at 22 sites.
A total of 386,101 (54.5% women) UK Biobank participants aged from 37 to 73 y were included. The outcomes were incidence of and mortality from cancer at 22 sites. Participants were categorized as normal weight (BMI 18.5-24.9) or overweight (including obese, BMI ≥ 25) and as normal WC or centrally obese (WC ≥ 94 cm for men and ≥80 cm for women). Four mutually exclusive groups were derived: 1) normal weight without central obesity, 2) normal weight with central obesity, 3) overweight without central obesity, and 4) overweight with central obesity. We used Cox proportional hazards models to estimate HRs and 95% CIs.
The mean follow-up period was 8.8 y. Compared with participants with normal weight and WC, men who were overweight and centrally obese had higher cancer incidence risk at 3 sites [stomach (HR: 1.75; 95% CI: 1.33, 2.32; Padj = 0.002), kidney (HR: 1.45; 95% CI: 1.17, 1.81; Padj = 0.016), and colorectal (HR: 1.31; 95% CI: 1.17, 1.47; Padj < 0.001) cancer]. Similar associations were found at 4 sites in women [endometrial (HR: 2.48; 95% CI: 2.06, 2.98; Padj < 0.001), uterine (HR: 2.23; 95% CI: 1.89, 2.64; Padj < 0.001), kidney (HR: 1.84; 95% CI: 1.37, 2.46; Padj = 0.001), and breast (HR: 1.24; 95% CI: 1.16, 1.32; Padj < 0.001) cancer] and for all-cause cancer (HR: 1.07; 95% CI: 1.03, 1.10; Padj = 0.003). Only endometrial cancer mortality (HR: 3.28; 95% CI: 1.77, 6.07; Padj = 0.004) was significantly associated with being overweight and centrally obese.
The combination of general and central obesity was associated with a higher risk at several cancer sites and some associations were sex-specific.
体重指数（BMI）和腰围（WC）分别衡量的是总体肥胖和中心型肥胖，两者都与癌症有关。然而，目前还没有足够的证据表明它们的联合与癌症风险之间存在关联。
本研究旨在调查 BMI 和 WC 组合与 22 个部位癌症风险之间的关系。
纳入了 386101 名（54.5%为女性）年龄在 37 至 73 岁的英国生物银行参与者。研究终点为 22 个部位的癌症发病率和死亡率。参与者被分为正常体重（BMI 18.5-24.9）或超重（包括肥胖，BMI≥25）以及正常 WC 或中心型肥胖（男性 WC≥94cm，女性 WC≥80cm）。共得出 4 个互斥组：1）无中心型肥胖的正常体重，2）有中心型肥胖的正常体重，3）无中心型肥胖的超重，4）有中心型肥胖的超重。我们使用 Cox 比例风险模型来估计 HR 和 95%CI。
平均随访时间为 8.8 年。与正常体重和 WC 的参与者相比，超重且中心型肥胖的男性在 3 个部位的癌症发病率更高[胃（HR：1.75；95%CI：1.33，2.32；Padj=0.002）、肾（HR：1.45；95%CI：1.17，1.81；Padj=0.016）和结直肠（HR：1.31；95%CI：1.17，1.47；Padj<0.001）癌症]。在女性中，也在 4 个部位发现了类似的关联[子宫内膜（HR：2.48；95%CI：2.06，2.98；Padj<0.001）、子宫（HR：2.23；95%CI：1.89，2.64；Padj<0.001）、肾（HR：1.84；95%CI：1.37，2.46；Padj=0.001）和乳腺癌（HR：1.24；95%CI：1.16，1.32；Padj<0.001）癌症]和全因癌症（HR：1.07；95%CI：1.03，1.10；Padj=0.003）。只有子宫内膜癌的死亡率（HR：3.28；95%CI：1.77，6.07；Padj=0.004）与超重和中心型肥胖显著相关。
总体肥胖和中心型肥胖的结合与多个癌症部位的更高风险相关，并且一些关联具有性别特异性。
