Pennington Biomedical Research Center, Baton Rouge, Louisiana.
LSU Health Sciences Center New Orleans School of Medicine, New Orleans, Louisiana.
Cancer Epidemiol Biomarkers Prev. 2022 Aug 2;31(8):1532-1538. doi: 10.1158/1055-9965.EPI-22-0207.
Race modifies the association between anthropometric measures of obesity and cancer risk. However, the degree to which abdominal visceral adipose tissue (VAT) and total fat mass (FM) are associated with cancer risk is not known.
The sample included 3,017 White and 1,347 Black adults who were assessed between 1995 and 2016 and followed for outcome assessment through 2017. Abdominal VAT and FM were measured using imaging techniques. The co-primary endpoints were diagnosis of histologically confirmed invasive cancer (excluding nonmelanoma skin cancer) or death from cancer. Multivariable Cox proportional hazards models quantified the HR of incident cancer and cancer mortality.
There were 353 incident cancer cases and 75 cancer deaths in an average of 12.9 years of follow-up. Both VAT [HR, 1.21; 95% confidence interval (CI), 1.09-1.36] and FM (HR, 1.25; 95% CI, 1.10-1.43) were significantly associated with incident cancer, while VAT (HR, 1.28; 95% CI, 1.01-1.61) was significantly associated with cancer mortality after adjustment for several covariates. VAT remained significantly associated with cancer incidence (HR, 1.22; 95% CI, 1.03-1.46) after additional inclusion of FM in the multivariable model, but not vice versa. There were no significant sex- or race-interactions.
VAT was associated with risk of cancer and cancer mortality in this cohort, and the associations did not differ by sex or race. The association between VAT and incident cancer was largely independent of total FM.
Our results suggest that utility of anthropometry in assessing obesity-related cancer risk may need to be further refined by including more direct measures of adiposity.
种族会改变肥胖的人体测量学指标与癌症风险之间的关联。然而，腹部内脏脂肪组织（VAT）和总脂肪量（FM）与癌症风险的关联程度尚不清楚。
该样本包括 3017 名白人成年人和 1347 名黑人成年人，他们在 1995 年至 2016 年间接受评估，并通过 2017 年进行了结局评估。使用影像学技术测量腹部 VAT 和 FM。主要终点是诊断组织学证实的浸润性癌症（不包括非黑色素瘤皮肤癌）或癌症死亡。多变量 Cox 比例风险模型量化了癌症发病和癌症死亡的风险比（HR）。
在平均 12.9 年的随访中，有 353 例癌症发病和 75 例癌症死亡。VAT[HR，1.21；95%置信区间（CI），1.09-1.36]和 FM（HR，1.25；95%CI，1.10-1.43）与癌症发病均显著相关，而 VAT（HR，1.28；95%CI，1.01-1.61）在调整了几个协变量后与癌症死亡率显著相关。在多变量模型中进一步纳入 FM 后，VAT 与癌症发病率的相关性仍然显著（HR，1.22；95%CI，1.03-1.46），但反之则不成立。没有显著的性别或种族交互作用。
在本队列中，VAT 与癌症风险和癌症死亡率相关，且这些相关性在性别或种族之间没有差异。VAT 与癌症发病的相关性在很大程度上独立于总 FM。
我们的研究结果表明，在评估肥胖相关癌症风险时，人体测量学的应用可能需要进一步细化，纳入更直接的肥胖测量指标。
