Research Centre of Applied and Preventive Cardiovascular Medicine, University of Turku, Turku, Finland.
Heart Center, Turku University Hospital and University of Turku, Turku, Finland.
Int J Obes (Lond). 2022 Feb;46(2):393-399. doi: 10.1038/s41366-021-01000-3. Epub 2021 Nov 2.
In high-income countries, cancer is the leading cause of death among middle-aged adults. Prospective data on the effects of childhood risk exposures on subsequent cancer mortality are scarce.
We examined whether childhood body mass index (BMI), blood pressure, glucose and lipid levels were associated with adult cancer mortality, using data from 21,012 children enrolled aged 3-19 years in seven prospective cohort studies from the U.S., Australia, and Finland that have followed participants from childhood into adulthood. Cancer mortality (cancer as a primary or secondary cause of death) was captured using registries.
354 cancer deaths occurred over the follow-up. In age-, sex, and cohort-adjusted analyses, childhood BMI (Hazard ratio [HR], 1.13; 95% confidence interval [CI] 1.03-1.24 per 1-SD increase) and childhood glucose (HR 1.22; 95%CI 1.01-1.47 per 1-SD increase), were associated with subsequent cancer mortality. In a multivariable analysis adjusted for age, sex, cohort, and childhood measures of fasting glucose, total cholesterol, triglycerides, and systolic blood pressure, childhood BMI remained as an independent predictor of subsequent cancer mortality (HR, 1.24; 95%CI, 1.03-1.49). The association of childhood BMI and subsequent cancer mortality persisted after adjustment for adulthood BMI (HR for childhood BMI, 1.35; 95%CI 1.12-1.63).
Higher childhood BMI was independently associated with increased overall cancer mortality.
在高收入国家,癌症是导致中年人群死亡的主要原因。关于儿童时期风险暴露对随后癌症死亡率影响的前瞻性数据很少。
我们使用来自美国、澳大利亚和芬兰的 7 项前瞻性队列研究的数据,这些研究共纳入了 21012 名年龄在 3-19 岁的儿童,从儿童期开始一直随访到成年期,研究了儿童时期的体重指数(BMI)、血压、血糖和血脂水平是否与成人癌症死亡率相关。癌症死亡率(癌症作为主要或次要死因)通过登记捕获。
在随访期间发生了 354 例癌症死亡。在年龄、性别和队列调整分析中,儿童时期的 BMI(危险比 [HR],每增加 1-SD 为 1.13;95%置信区间 [CI] 为 1.03-1.24)和儿童时期的血糖(HR 为 1.22;95%CI 为 1.01-1.47)与随后的癌症死亡率相关。在校正了年龄、性别、队列和儿童时期的空腹血糖、总胆固醇、甘油三酯和收缩压等测量值后,在多变量分析中,儿童时期的 BMI 仍然是随后癌症死亡率的独立预测因素(HR,1.24;95%CI,1.03-1.49)。在调整成年 BMI 后,儿童 BMI 与随后的癌症死亡率之间的关联仍然存在(儿童 BMI 的 HR,1.35;95%CI,1.12-1.63)。
较高的儿童 BMI 与总体癌症死亡率的增加独立相关。