Department of Preventive Medicine, Seoul National University College of Medicine, Seoul, Korea.
Cancer Research Institute, Seoul National University College of Medicine, Seoul, Korea.
Cancer Epidemiol Biomarkers Prev. 2022 Sep 2;31(9):1727-1734. doi: 10.1158/1055-9965.EPI-22-0051.
This study was performed to investigate the association between body mass index (BMI) and gastric cancer in East and Southeast Asia where most of gastric cancer is non-cardia gastric cancer.
On the basis of 8,997 gastric cancer cases among the Asia Cohort Consortium participants from China, Japan, Korea, and Singapore (N = 538,835), we assessed gastric cancer risk according to BMI by calculating hazard ratios (HR) and 95% confidence intervals (CI) using the Cox proportional hazard regression model.
A U-shaped associations between BMI and gastric cancer risk were observed. Gastric cancer risks in underweight group (<18.5 kg/m2) and in obesity group (≥27.5 kg/m2) were higher than reference BMI group (23-24.9 kg/m2; HR, 1.15; 95% CI, 1.05-1.25 for underweight; HR, 1.12; 95% CI, 1.03-1.22 for obesity, respectively). The associations of underweight and obesity with gastric cancer risk were consistent in the analyses for non-cardia gastric cancer, intestinal-type gastric cancer, and late-onset gastric cancer. No significant association of underweight and obesity with the risk of cardia gastric cancer, diffuse-type gastric cancer, and early-onset gastric cancer was observed. In addition, we found that the U-shaped association between BMI and gastric cancer risk remained in nonsmokers, while only underweight was related to increased gastric cancer risk in smokers.
BMI has a U-shaped association with gastric cancer risk in East and Southeast Asian population, especially for the non-cardia gastric cancer, intestinal-type gastric cancer, and late-onset gastric cancer.
Future studies with consideration of anatomic location and histology of gastric cancer are needed to establish the association of underweight as well as obesity with gastric cancer risk.
本研究旨在探讨体质指数（BMI）与东亚和东南亚胃癌之间的关系，这些地区的大多数胃癌是非贲门胃癌。
基于亚洲队列联盟参与者（来自中国、日本、韩国和新加坡）的 8997 例胃癌病例（N=538835），我们使用 Cox 比例风险回归模型，通过计算风险比（HR）和 95%置信区间（CI）来评估 BMI 与胃癌风险之间的关系。
BMI 与胃癌风险之间存在 U 型关联。体重过轻组（<18.5kg/m2）和肥胖组（≥27.5kg/m2）的胃癌风险高于参考 BMI 组（23-24.9kg/m2；体重过轻的 HR，1.15；95%CI，1.05-1.25；肥胖的 HR，1.12；95%CI，1.03-1.22）。在非贲门胃癌、肠型胃癌和晚发性胃癌的分析中，体重过轻和肥胖与胃癌风险的关联是一致的。体重过轻和肥胖与贲门胃癌、弥漫型胃癌和早发性胃癌风险之间无显著关联。此外，我们发现 BMI 与胃癌风险之间的 U 型关联在不吸烟者中仍然存在，而只有体重过轻与吸烟者胃癌风险增加有关。
BMI 与东亚和东南亚人群的胃癌风险呈 U 型关联，尤其是非贲门胃癌、肠型胃癌和晚发性胃癌。
需要进一步的研究来考虑胃癌的解剖部位和组织学特征，以确定体重过轻和肥胖与胃癌风险之间的关系。
