代谢功能障碍和肥胖相关癌症：来自横断面全国健康和营养检查调查的结果。
Metabolic dysfunction and obesity-related cancer: Results from the cross-sectional National Health and Nutrition Examination Survey.
机构信息
Department of Population Health Sciences, University of Utah, Salt Lake City, Utah, USA.
Huntsman Cancer Institute, University of Utah, Salt Lake City, Utah, USA.
出版信息
Cancer Med. 2023 Jan;12(1):606-618. doi: 10.1002/cam4.4912. Epub 2022 Jun 19.
BACKGROUND
Metabolic syndrome (MetS), a group of risk factors that define metabolic dysfunction in adults, is strongly associated with obesity and is an emerging risk factor for cancer. However, the association of MetS and degree of metabolic dysfunction with obesity-related cancer is unknown.
METHODS
Using National Health and Nutrition Examination Survey data from 1999 to 2018, we identified 528 obesity-related cancer cases and 18,972 cancer-free participants. MetS was defined as the presence of or treatment for ≥3 of hyperglycemia, hypertension, hypertriglyceridemia, low HDL-cholesterol, and abdominal obesity. A metabolic syndrome score (MSS) was computed as the total number of abnormal MetS parameters to determine the severity of metabolic dysfunction. Odds ratios (ORs) and 95% confidence intervals (CIs) were estimated using multivariable logistic regression models, adjusting for sociodemographic and lifestyle factors.
RESULTS
About 45.7% of obesity-related cancer cases were classified as having MetS compared with only 33.0% of cancer-free participants. Overall, MetS and MSS were not associated with obesity-related cancer. However, MSS was associated with higher obesity-related cancer risk among participants under 50 years of age (OR [95% CI] = 1.28 [1.08-1.52]). When evaluating MSS categorically, compared with healthy participants with no abnormal MetS parameters (MSS = 0), participants with one or two abnormal parameters had a statistically significant higher risk of obesity-related cancer (OR [95% CI] = 1.73 [1.06-2.83]).
CONCLUSIONS
Metabolic dysfunction is associated with a higher risk of obesity-related cancer, particularly in young adults under 50 years of age, and among participants with one or two abnormal metabolic parameters. A more accurate indicator of metabolic dysfunction, beyond metabolic syndrome, is needed to better assist in stratifying individuals for obesity-related cancer risk.
背景
代谢综合征（MetS）是一组定义成年人代谢功能障碍的风险因素，它与肥胖密切相关，并且是癌症的一个新兴风险因素。然而，代谢综合征和代谢功能障碍的程度与肥胖相关癌症的关系尚不清楚。
方法
利用 1999 年至 2018 年的全国健康与营养调查数据，我们确定了 528 例肥胖相关癌症病例和 18972 例无癌症病例的参与者。代谢综合征的定义为存在或治疗≥3 种异常，包括高血糖、高血压、高三酰甘油血症、低高密度脂蛋白胆固醇和腹型肥胖。计算代谢综合征评分（MSS）作为异常代谢综合征参数的总数，以确定代谢功能障碍的严重程度。使用多变量逻辑回归模型估计比值比（OR）和 95%置信区间（CI），并调整社会人口统计学和生活方式因素。
结果
约 45.7%的肥胖相关癌症病例被归类为患有代谢综合征，而无癌症的参与者中只有 33.0%患有代谢综合征。总体而言，代谢综合征和 MSS 与肥胖相关癌症无关。然而，MSS 与 50 岁以下参与者的肥胖相关癌症风险较高相关（OR[95%CI]为 1.28[1.08-1.52]）。当按 MSS 分类评估时，与没有异常代谢综合征参数的健康参与者（MSS=0）相比，有一个或两个异常参数的参与者肥胖相关癌症的风险显著更高（OR[95%CI]为 1.73[1.06-2.83]）。
结论
代谢功能障碍与肥胖相关癌症风险增加相关，尤其是在 50 岁以下的年轻成年人中，以及在有一个或两个异常代谢参数的参与者中。需要一种更准确的代谢功能障碍指标，而不仅仅是代谢综合征，以更好地帮助分层肥胖相关癌症风险。
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