School of Medicine, Nankai University, Tianjin, China.
Department of Hepatobiliary Surgery, Kailuan General Hospital, Tangshan, China.
Cancer Res Treat. 2024 Jan;56(1):238-246. doi: 10.4143/crt.2023.539. Epub 2023 Aug 2.
Although obesity is associated with numerous diseases, the risks of disease may depend on metabolically healthy status. Nevertheless, it is unclear to whether metabolically healthy status affects risk of gastrointestinal (GI) cancer in general Chinese population.
A total of 114,995 participants who met the criteria were included from the Kailuan Study. The study participants were divided into four groups according to body mass index (BMI)/waist circumference (WC) and metabolic status. Incident of GI cancer (esophageal cancer, gastric cancer, liver cancer, biliary cancer, pancreatic cancer, and colorectal cancer) during 2006-2020 were confirmed by review of medical records. The Cox proportional hazard regression models were used to assess the association metabolically healthy status with the risk of GI cancer by calculating the hazard ratios (HR) and 95% confidence interval (CI).
During a mean 13.76 years of follow-up, we documented 2,311 GI cancers. Multivariate Cox regression analysis showed that compared with the metabolically healthy normal-weight group, metabolically healthy obese (MHO) participants demonstrated an increased risk of developing GI cancer (HR, 1.54; 95% CI, 1.11 to 2.13) by BMI categories. However, such associations were not found for WC category. These associations were moderated by age, sex, and anatomical site of the tumor. Individuals with metabolic unhealthy normal-weight or metabolic unhealthy obesity phenotype also have an increased risk of GI cancer.
MHO phenotype was associated with increased risk of GI cancer. Moreover, individuals who complicated by metabolic unhealthy status have an increased risk of developing GI cancer. Hence, clinicians should consider the risk of incident GI cancer in people with abnormal metabolically healthy status and counsel them about metabolic fitness and weight control.
尽管肥胖与许多疾病有关，但疾病风险可能取决于代谢健康状况。然而，代谢健康状况是否会影响一般中国人群的胃肠道（GI）癌症风险尚不清楚。
本研究共纳入了符合标准的 114995 名来自开滦研究的参与者。根据体重指数（BMI）/腰围（WC）和代谢状态，研究参与者被分为四组。通过审查病历确认 2006-2020 年期间发生的 GI 癌症（食管癌、胃癌、肝癌、胆管癌、胰腺癌和结直肠癌）。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）来评估代谢健康状况与 GI 癌症风险之间的关联。
在平均 13.76 年的随访期间，我们记录了 2311 例 GI 癌症。多变量 Cox 回归分析显示，与代谢健康正常体重组相比，按 BMI 分类，代谢健康肥胖（MHO）参与者发生 GI 癌症的风险增加（HR，1.54；95%CI，1.11 至 2.13）。然而，对于 WC 分类，未发现这种关联。这些关联受年龄、性别和肿瘤解剖部位的调节。代谢不健康正常体重或代谢不健康肥胖表型的个体也有发生 GI 癌症的风险增加。
MHO 表型与 GI 癌症风险增加相关。此外，代谢不健康状态的个体发生 GI 癌症的风险增加。因此，临床医生应考虑代谢健康状态异常人群发生 GI 癌症的风险，并就代谢健康和体重控制为他们提供咨询。
