Nam Su Youn, Jeong Jihyeon, Lee Won Kee, Jeon Seong Woo
Gastroenterology, Kyungpook National University Hospital, Buk-gu, Daegu, Korea.
Department of Statistics, Kyungpook National University, Buk-gu, Daegu, Korea.
Int J Obes (Lond). 2022 Sep;46(9):1644-1651. doi: 10.1038/s41366-022-01161-9. Epub 2022 Jun 10.
Simultaneous evaluation of sex-specific effect of body mass index (BMI) and hyperglycemia on the risk of gastric cancer has been rarely reported. Here, we investigated the sex-specific effect of BMI and hyperglycemia on gastric cancer.
Persons who underwent National gastric cancer screening from 2006 to 2007 and had no gastric cancer at baseline, were enrolled and followed up to 2015. The risk of gastric cancer by BMI and glucose was measured using risk ratios (RRs) and 95% confidence intervals (CI). Adjusted Cox analysis was performed to evaluate the risk of death.
Gastric cancers developed in 29,775 of 5.17 million. In the adjusted analysis, low BMI (<18.5 kg/m; RR, 1.44; 95% CI, 1.36-1.53) and high fasting glucose (≥126 mg/dL; RR, 1.09; 95% CI, 1.05-1.13) increased the risk of gastric cancer. In sex-specific analysis, its risk by BMI was modified L-shape with cut-off value of 23 kg/m in men and 18.5 kg/m in women. Low BMI increased gastric cancer risk in men (RR, 1.39; 95% CI, 1.30-1.50) and women (RR, 1.48; 95% CI, 1.33-1.64). High fasting glucose increased the risk of gastric cancer in women (RR, 1.19; 95% CI, 1.11-1.28), but not in men. Low BMI increased all-cause mortality with cut-off value of 23 kg/m in men and 18.5 kg/m in women.
Gastric cancer risk and all-cause mortality by BMI was L-shape with sex-specific cut-off value. The effect of fasting glucose on gastric cancer risk was different by sex.
体重指数（BMI）和高血糖对胃癌风险的性别特异性影响的同步评估鲜有报道。在此，我们研究了BMI和高血糖对胃癌的性别特异性影响。
纳入2006年至2007年接受全国胃癌筛查且基线时无胃癌的人群，并随访至2015年。使用风险比（RRs）和95%置信区间（CIs）来衡量BMI和血糖与胃癌的风险。进行校正Cox分析以评估死亡风险。
在517万人群中，有29,775人患胃癌。在校正分析中，低BMI（<18.5kg/m²；RR，1.44；95%CI，1.36 - 1.53）和高空腹血糖（≥126mg/dL；RR，1.09；95%CI，1.05 - 1.13）会增加胃癌风险。在性别特异性分析中，BMI对胃癌风险的影响呈L形，男性的临界值为23kg/m²，女性为18.5kg/m²。低BMI会增加男性（RR，1.39；95%CI，1.30 - 1.50）和女性（RR，1.48；95%CI，1.33 - 1.64）的胃癌风险。高空腹血糖会增加女性（RR，1.19；95%CI，1.11 - 1.28）而非男性的胃癌风险。低BMI会增加全因死亡率，男性的临界值为23kg/m²，女性为18.5kg/m²。
BMI对胃癌风险和全因死亡率的影响呈L形，且有性别特异性临界值。空腹血糖对胃癌风险的影响存在性别差异。
