Department of Preventive Medicine, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA.
Norris Comprehensive Cancer Center, Los Angeles, CA, USA.
Cancer Med. 2021 Jun;10(12):4097-4106. doi: 10.1002/cam4.3958. Epub 2021 May 16.
Compared to non-Hispanic Whites, Japanese Americans, Native Hawaiians, and African Americans have higher incidences of pancreatic cancer (PCa) that are not entirely explained by rates of obesity but may be explained by weight changes throughout adulthood.
The multiethnic cohort is a population-based prospective cohort study that has followed 155,308 participants since its establishment between 1993 and 1996. A total of 1,328 incident cases with invasive PCa were identified through 2015. We conducted separate multivariable Cox proportional hazards models for self-reported weight-change and BMI-change (age 21 to cohort entry) to determine the association with PCa risk, adjusting for potential confounders including weight or BMI at age 21.
The mean age at cohort entry was 59.3 years (SD 8.9). An increased risk of PCa was associated with: 1) weight (HR per10 lbs = 1.06; 95% CI = 1.03-1.09) or BMI (HR per kg/m = 1.04; 95% CI = 1.02-1.05) at age 21; and 2) weight (HR per 10 lbs = 1.03; 95% CI = 1.01-1.05) or BMI (HR = 1.02; 95% CI = 1.00-1.03) at cohort entry. We found increased risk of PCa between weight (HR per 10 lbs = 1.03; 95% CI = 1.01-1.05) and BMI (HR per 5 kg/m = 1.08; 95% CI = 1.01-1.15) change from age 21 to baseline. There were significant interactions between race/ethnicity and weight (p = 0.008) or BMI (p = 0.03) at baseline, and weight (p = 0.02) or BMI (p = 0.02) change. Weight and BMI change through adulthood significantly increased the risk of PCa for Japanese Americans and Latinos, but not for African American, White, or Hawaiian participants.
Our findings indicate that weight or BMI gain has a significant and independent impact on PCa risk, specifically among Latinos and Japanese Americans.
与非西班牙裔白人相比,日裔美国人、夏威夷原住民和非裔美国人患胰腺癌(PCa)的发病率更高,这种情况不能完全用肥胖率来解释,但可能与成年后体重的变化有关。
多民族队列是一项基于人群的前瞻性队列研究,自 1993 年至 1996 年成立以来,一直对 155308 名参与者进行随访。通过 2015 年,共发现 1328 例侵袭性 PCa 新发病例。我们分别对自我报告的体重变化和 BMI 变化(21 岁至队列入组时)进行多变量 Cox 比例风险模型分析,以确定与 PCa 风险的相关性,同时调整了包括 21 岁时的体重或 BMI 在内的潜在混杂因素。
队列入组时的平均年龄为 59.3 岁(标准差 8.9)。PCa 风险与以下因素相关:1)21 岁时的体重(每增加 10 磅,HR = 1.06;95%CI = 1.03-1.09)或 BMI(每增加 1kg/m 2 ,HR = 1.04;95%CI = 1.02-1.05);2)21 岁时的体重(每增加 10 磅,HR = 1.03;95%CI = 1.01-1.05)或 BMI(HR = 1.02;95%CI = 1.00-1.03)。我们发现体重(每增加 10 磅,HR = 1.03;95%CI = 1.01-1.05)和 BMI(每增加 5kg/m 2 ,HR = 1.08;95%CI = 1.01-1.15)从 21 岁到基线的变化与 PCa 风险增加之间存在关联。在种族/民族和基线时的体重(p = 0.008)或 BMI(p = 0.03)以及体重(p = 0.02)或 BMI(p = 0.02)变化之间存在显著的交互作用。成年后体重和 BMI 的变化显著增加了日裔美国人和拉丁裔人群患 PCa 的风险,但对非裔美国人、白人和夏威夷原住民参与者没有影响。
我们的研究结果表明,体重或 BMI 的增加对 PCa 风险有显著且独立的影响,尤其是对拉丁裔和日裔美国人。