Choi In Young, Choi Yoon Jin, Shin Dong Wook, Han Kyung Do, Jeon Keun Hye, Jeong Su-Min, Yoo Jung Eun
Total Healthcare Center, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Korea.
Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Korea.
J Gastroenterol Hepatol. 2021 Oct;36(10):2834-2840. doi: 10.1111/jgh.15558. Epub 2021 Jun 6.
Obesity was suggested to increase the incidence of gastric cancer (GC) in women, but results from previous studies were inconsistent. We investigated the relationship between obesity and the risk of GC according to menopausal status.
We enrolled 1 418 180 premenopausal and 4 854 187 postmenopausal women aged ≥ 40 years using the Korean National Health Insurance System Cohort (2009-2014). We calculated hazard ratios (HRs) and 95% confidence intervals (CIs) for GC incidence according to body mass index (BMI) and waist circumference (WC) using the Cox proportional hazards models.
During the mean follow-up period of 7.2 years, 42 441 women were newly diagnosed with GC. Compared with the group with BMI 18.5-22.9 kg/m , the adjusted HRs (95% CIs) for GC in the groups with BMI < 18.5, 23-24.9, 25-29.9, and ≥ 30 kg/m were 1.12 (0.95-1.33), 0.96 (0.89-1.04), 1.02 (0.94-1.11), and 0.99 (0.83-1.18), respectively, for premenopausal women and 1.07 (1.00-1.14), 1.01 (0.99-1.04), 1.03 (1.00-1.05), and 1.11 (1.10-1.16), respectively, for postmenopausal women. Compared with the group with WC 65-74.9 cm, the adjusted HRs (95% CIs) for GC for the groups with WC < 65, 75-84.9, 85-94.9, and ≥ 90 cm were 1.00 (0.88-1.15), 1.03 (0.96-1.11), 1.10 (0.99-1.22), and 1.02 (0.81-1.27), respectively, for premenopausal women and 1.01 (0.94-1.09), 1.01 (0.99-1.04), 1.09 (1.06-1.13), and 1.14 (1.09-1.19), respectively, for postmenopausal women.
We found a positive association between the highest BMI and WC category and risk of GC in postmenopausal women; however, such an association was not evident in premenopausal women.
有研究表明肥胖会增加女性患胃癌（GC）的风险，但以往研究结果并不一致。我们根据绝经状态调查了肥胖与GC风险之间的关系。
我们使用韩国国民健康保险系统队列（2009 - 2014年）纳入了1418180名40岁及以上的绝经前女性和4854187名绝经后女性。我们使用Cox比例风险模型计算了根据体重指数（BMI）和腰围（WC）得出的GC发病率的风险比（HRs）和95%置信区间（CIs）。
在平均7.2年的随访期内，42441名女性被新诊断为GC。与BMI为18.5 - 22.9kg/m²的组相比，绝经前女性中BMI<18.5、23 - 24.9、25 - 29.9和≥30kg/m²组GC的校正HRs（95% CIs）分别为1.12（0.95 - 1.33）、0.96（0.89 - 1.04）、1.02（0.94 - 1.11）和0.99（0.83 - 1.18），绝经后女性分别为1.07（1.00 - 1.14）、1.01（0.99 - 1.04）、1.03（1.00 - 1.05）和1.11（1.10 - 1.16）。与WC为65 - 74.9cm的组相比，绝经前女性中WC<65、75 - 84.9、85 - 94.9和≥90cm组GC的校正HRs（95% CIs）分别为1.00（0.88 - 1.15）、1.03（0.96 - 1.11）、1.10（0.99 - 1.22）和1.02（0.81 - 1.27），绝经后女性分别为1.01（0.94 - 1.09）、1.01（0.99 - 1.04）、1.09（1.06 - 1.13）和1.14（1.09 - 1.19）。
我们发现绝经后女性中最高的BMI和WC类别与GC风险之间存在正相关；然而，这种关联在绝经前女性中并不明显。
