Hashemi Madani Nahid, Etemadi Arash, Nalini Mahdi, Poustchi Hossein, Khajavi Alireza, Mirzazade Elahe, Mirfakhraei Hosna, Pourshams Akram, Khoshnia Masoud, Gharavi Abdolsamad, Merat Shahin, Khamseh Moahammad E, Malekzadeh Reza
Endocrine Research Center, Institute of Endocrinology and Metabolism, Iran University of Medical Science.
Digestive Oncology Research Center, Digestive Diseases Research Institute, Tehran University of Medical Sciences, Tehran, Iran.
Eur J Cancer Prev. 2021 May 1;30(3):267-274. doi: 10.1097/CEJ.0000000000000657.
BMI does not reflect the location or amount of body fat. We aimed to investigate the role of general and central obesity measures in the prediction of incident gastrointestinal cancers. In this analysis of the Golestan Cohort Study, we included 47 586 cancer-free individuals followed for 12.3 years (IQR: 10.5-13.2). We investigated the association of obesity measures including BMI, waist circumference and waist-to-hip ratio (WHR) at enrollment and the incidence of esophageal, gastric, colorectal and pancreatic cancers. Cox proportional hazard models were used to estimate the association between covariates and gastrointestinal cancer risk. We observed no significant associations between obesity measures and incidence of the above-mentioned gastrointestinal cancers in men. In women, BMI, waist circumference and WHR were associated with significant reductions in the risk of esophageal squamous cell carcinoma (ESCC): hazard ratio (HR): 0.67 [95% confidence interval (CI): 0.56-0.81], HR: 0.71 (95% CI: 0.60-0.84) and HR: 0.80 (95% CI: 0.68- 0.94), respectively. In addition, WHR was associated with significantly increased risks for colorectal cancer (HR: 1.39, 95% CI: 1.08-1.78) and gastric cancer (HR: 1.24, 95% CI: 1.01-1.51) in women. In this study, statistically significant associations between obesity measures and incident esophageal, gastric and colorectal cancers were seen in women.
体重指数（BMI）不能反映身体脂肪的位置或数量。我们旨在研究一般肥胖和中心性肥胖指标在预测胃肠道癌症发病中的作用。在这项对戈勒斯坦队列研究的分析中，我们纳入了47586名无癌症个体，随访12.3年（四分位间距：10.5 - 13.2年）。我们调查了入组时包括BMI、腰围和腰臀比（WHR）在内的肥胖指标与食管癌、胃癌、结直肠癌和胰腺癌发病率之间的关联。采用Cox比例风险模型来估计协变量与胃肠道癌症风险之间的关联。我们观察到男性的肥胖指标与上述胃肠道癌症的发病率之间无显著关联。在女性中，BMI、腰围和WHR与食管鳞状细胞癌（ESCC）风险的显著降低相关：风险比（HR）分别为0.67 [95%置信区间（CI）：0.56 - 0.81]、HR为0.71（95%CI：0.60 - 0.84）和HR为0.80（95%CI：0.68 - 0.94）。此外，WHR与女性结直肠癌（HR：1.39，95%CI：1.08 - 1.78）和胃癌（HR：1.24，95%CI：1.01 - 1.51）风险的显著增加相关。在本研究中，女性的肥胖指标与食管癌、胃癌和结直肠癌的发病之间存在统计学显著关联。
