Office of Cancer Screening, National Cancer Center/ National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China.
Department of Central Laboratory, Beijing Obstetrics and Gynecology Hospital, Capital Medical University. Beijing Maternal and Child Health Care Hospital, Beijing, China.
Cancer Med. 2022 Mar;11(5):1336-1346. doi: 10.1002/cam4.4546. Epub 2022 Jan 31.
To investigate the association between the risk of lung cancer and short-term body mass index (BMI) changes in male never-smokers of a large population-based prospective study.
A total of 37,085 male never-smokers from Kailuan cohort with at least ≥2 BMI measurements were recruited in the present study. The BMI change in the follow-up was calculated as the annual percent change between BMI at last examination and that at baseline, and categorized into five groups: stable (-0.1 to <0.1 kg/m /year), minor loss (-1.0 to <0.1 kg/m /year) or gain (0.1 to <1.0 kg/m /year), and major loss (<-1.0 kg/m /year) or gain (≥1.0 kg/m /year). The hazards ratios (HRs) and its 95% confidence intervals (CI) were estimated using Cox regression models.
During a median follow-up of 5.16 years, 224 lung cancer cases were identified. We found a U-shaped association between BMI changes and lung cancer risk. Compared to men with stable BMI, those with major loss had a nearly twofold higher risk of lung cancer (HR = 1.97, 95% CI: 1.12-3.45), as well as those with major gain had more than twofold higher risk of lung cancer (HR = 2.15, 95% CI: 1.15-4.02). The associations existed when the analysis was stratified by BMI, waist circumference and blood lipids, and lipoproteins concentration at baseline examination.
The dramatic changes in BMI, both gain and loss, might increase lung cancer risk. The control of body weight would be a potential way for lung cancer prevention especially for the nonsmokers.
本研究旨在探讨大型基于人群的前瞻性研究中男性从不吸烟者的短期体重指数（BMI）变化与肺癌风险之间的关联。
本研究共纳入 37085 名至少有≥2 次 BMI 测量值的来自开滦队列的男性从不吸烟者。随访期间的 BMI 变化计算为末次检查时 BMI 与基线时 BMI 的年百分比变化，并分为五组：稳定（-0.1 至<0.1kg/m²/年）、轻度下降（-1.0 至<0.1kg/m²/年）或增加（0.1 至<1.0kg/m²/年）以及显著下降（<-1.0kg/m²/年）或增加（≥1.0kg/m²/年）。使用 Cox 回归模型估计危险比（HR）及其 95%置信区间（CI）。
在中位随访 5.16 年期间，共确定了 224 例肺癌病例。我们发现 BMI 变化与肺癌风险之间呈 U 形关联。与 BMI 稳定的男性相比，BMI 显著下降的男性肺癌风险增加近两倍（HR=1.97，95%CI：1.12-3.45），BMI 显著增加的男性肺癌风险增加两倍以上（HR=2.15，95%CI：1.15-4.02）。在按 BMI、腰围和血脂以及基线检查时脂蛋白浓度分层的分析中，均存在这种关联。
BMI 的急剧变化，无论是增加还是减少，都可能增加肺癌风险。控制体重可能是预防肺癌的一种潜在方法，特别是对于不吸烟者。
