Department of Preventive Medicine, Seoul National University College of Medicine, Seoul, Republic of Korea.Occupational and Environmental Epidemiology Branch, National Cancer Institute, Bethesda, Maryland, USA.
Cancer Research Institute, Seoul National University, Seoul, Republic of Korea.Occupational and Environmental Epidemiology Branch, National Cancer Institute, Bethesda, Maryland, USA.
Thyroid. 2022 Mar;32(3):306-314. doi: 10.1089/thy.2021.0445. Epub 2022 Jan 11.
Although previous meta-analyses have suggested a dose-response relationship between body mass index (BMI) and thyroid cancer risk, limited evidence has been presented about Asian populations. To assess this association among Asian populations, where underweight is more prevalent than in other regions, a pooled analysis from the Asia Cohort Consortium was conducted. Baseline height and weight were measured in five cohorts and self-reported in eight cohorts. Thyroid cancer incidence was ascertained by linkage to local cancer registries. Cohorts were treated as a stratum in the Cox proportional hazard model to estimate the pooled hazard ratios (HRs) and corresponding confidence intervals (CIs) from the estimates for each cohort. All analyses were stratified by sex. A total of 538,857 men and women from 13 cohorts from mainland China, Korea, Japan, and Singapore were included in the analysis. During a mean of 15.1 years of follow-up, 1132 thyroid cancer cases were ascertained. Using a BMI of 18.5-22.9 kg/m as a reference, an elevated risk of thyroid cancer was observed for groups with a BMI between 25 and 29.9 kg/m (HR: 1.31, [CI: 0.95-1.80]) and a BMI of 30 kg/m and greater (HR: 1.84, [CI: 0.89-3.81]) in men. Thyroid cancer risk was elevated in women with a BMI of 23-24.9 kg/m (HR: 1.26, [CI: 1.07-1.48]). The HRs for 5-U increment of BMI showed a linear association among men (HR: 1.25, [CI 1.10-1.55]) but not among women (HR: 1.07, [CI: 0.97-1.18]). Although the overall thyroid cancer risk was lower among underweight men and women, the papillary cancer risk may be elevated among underweight men (HR: 2.24, [CI: 0.75-6.66]). While higher BMI is associated with an elevated risk of thyroid cancer in both men and women, the association of underweight BMI may differ by sex and histological subtype.
尽管先前的荟萃分析表明，体重指数（BMI）与甲状腺癌风险之间存在剂量反应关系，但有关亚洲人群的证据有限。为了评估亚洲人群中的这种关联，其中体重不足比其他地区更为普遍，亚洲队列联盟进行了一项汇总分析。五个队列的基线身高和体重进行了测量，八个队列进行了自我报告。甲状腺癌的发病率通过与当地癌症登记处的联系来确定。队列在 Cox 比例风险模型中作为一个层进行处理，以从每个队列的估计值中估算出汇总的危险比（HR）和相应的置信区间（CI）。所有分析均按性别分层。 中国大陆、韩国、日本和新加坡的 13 个队列的 538857 名男性和女性参与了分析。在平均 15.1 年的随访期间，确定了 1132 例甲状腺癌病例。使用 18.5-22.9kg/m2 的 BMI 作为参考，BMI 为 25-29.9kg/m2（HR：1.31，[95%CI：0.95-1.80]）和 BMI 为 30kg/m2 及以上的组观察到甲状腺癌风险升高（HR：1.84，[95%CI：0.89-3.81]）。BMI 为 23-24.9kg/m2 的女性甲状腺癌风险升高（HR：1.26，[95%CI：1.07-1.48]）。男性 BMI 每增加 5 个单位，HRs 呈线性关联（HR：1.25，[95%CI 1.10-1.55]），但女性无此关联（HR：1.07，[95%CI：0.97-1.18]）。尽管体重不足的男性和女性的总体甲状腺癌风险较低，但体重不足的男性的乳头状癌风险可能升高（HR：2.24，[95%CI：0.75-6.66]）。 虽然较高的 BMI 与男性和女性的甲状腺癌风险升高有关，但较低的 BMI 与性别和组织学亚型有关。
