Department of Biostatistics, School of Public Health, Nanjing Medical University, Nanjing 211166, China.
Department of Critical Care Medicine, Wuxi People's Hospital Affiliated to Nanjing Medical University, Wuxi 214023, China.
Nutrients. 2022 Aug 17;14(16):3370. doi: 10.3390/nu14163370.
(1) Background: The association between metabolic obesity phenotypes and incident lung cancer (LC) remains unclear. (2) Methods: Based on the combination of baseline BMI categories and metabolic health status, participants were categorized into eight groups: metabolically healthy underweight (MHUW), metabolically unhealthy underweight (MUUW), metabolically healthy normal (MHN), metabolically unhealthy normal (MUN), metabolically healthy overweight (MHOW), metabolically unhealthy overweight (MUOW), metabolically healthy obesity (MHO), and metabolically unhealthy obesity (MUO). The Cox proportional hazards model and Mendelian randomization (MR) were applied to assess the association between metabolic obesity phenotypes with LC risk. (3) Results: During a median follow-up of 9.1 years, 3654 incident LC patients were confirmed among 450,482 individuals. Compared with participants with MHN, those with MUUW had higher rates of incident LC (hazard ratio (HR) = 3.24, 95% confidence interval (CI) = 1.33-7.87, = 0.009). MHO and MHOW individuals had a 24% and 18% lower risk of developing LC, respectively (MHO: HR = 0.76, 95% CI = 0.61-0.95, = 0.02; MHO: HR = 0.82, 95% CI = 0.70-0.96, = 0.02). No genetic association of metabolic obesity phenotypes and LC risk was observed in MR analysis. (4) Conclusions: In this prospective cohort study, individuals with MHOW and MHO phenotypes were at a lower risk and MUUW were at a higher risk of LC. However, MR failed to reveal any evidence that metabolic obesity phenotypes would be associated with a higher risk of LC.
（1）背景：代谢肥胖表型与肺癌（LC）发病风险之间的关系尚不清楚。（2）方法：基于基线 BMI 类别和代谢健康状况的组合，将参与者分为 8 组：代谢健康消瘦（MHUW）、代谢不健康消瘦（MUUW）、代谢健康正常（MHN）、代谢不健康正常（MUN）、代谢健康超重（MHOW）、代谢不健康超重（MUOW）、代谢健康肥胖（MHO）和代谢不健康肥胖（MUO）。应用 Cox 比例风险模型和孟德尔随机化（MR）评估代谢肥胖表型与 LC 风险之间的关联。（3）结果：在中位随访 9.1 年期间，在 450482 名个体中确认了 3654 例 LC 发病病例。与 MHN 参与者相比，MUUW 参与者的 LC 发病风险更高（风险比（HR）=3.24，95%置信区间（CI）=1.33-7.87，=0.009）。MHO 和 MHOW 个体发生 LC 的风险分别降低了 24%和 18%（MHO：HR=0.76，95%CI=0.61-0.95，=0.02；MHO：HR=0.82，95%CI=0.70-0.96，=0.02）。MR 分析未发现代谢肥胖表型与 LC 风险之间存在遗传关联。（4）结论：在这项前瞻性队列研究中，MHOW 和 MHO 表型的个体发生 LC 的风险较低，而 MUUW 表型的个体发生 LC 的风险较高。然而，MR 未能揭示任何证据表明代谢肥胖表型与 LC 风险增加有关。
