一种体型指数（ABSI）而非体重指数（BMI）与前列腺癌特异性死亡率相关：来自美国 NHANES 数据库的证据。

A body shape index (ABSI) but not body mass index (BMI) is associated with prostate cancer-specific mortality: Evidence from the US NHANES database.

机构信息

Department of Pediatrics, Taipei Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, New Taipei City, Taiwan.

Department of Biology, University of Washington, Seattle, WA, USA.

出版信息

Prostate. 2024 Jun;84(9):797-806. doi: 10.1002/pros.24698. Epub 2024 Apr 1.

DOI:10.1002/pros.24698

PMID:38558412

Abstract

BACKGROUND

Prostate cancer (PCa) is a common malignancy in males and obesity may play a role in its development and progression. Associations between visceral obesity measured by a body shape index (ABSI) and PCa mortality have not been thoroughly investigated. This study assessed the associations between ABSI, body mass index (BMI), and long-term PCa-specific mortality using a nationally representative US database.

METHODS

This population-based longitudinal study collected data of males aged ≥40 years diagnosed with PCa and who underwent surgery and/or radiation from the National Health and Nutrition Examination Survey database 2001-2010. All included participants were followed through the end of 2019 using the National Center for Health Statistics Linked Mortality File. Associations between PCa-specific mortality, BMI, and ABSI were determined using Cox proportional hazards regression and receiver operating characteristic (ROC) curve analysis.

RESULTS

Data of 294 men (representing 1,393,857 US nationals) were analyzed. After adjusting for confounders, no significant associations were found between BMI (adjusted hazard ratio [aHR] = 1.06, 95% confidence interval [CI]: 0.97-1.16, p = 0.222), continuous ABSI (aHR = 1.29, 95% CI: 0.83-2.02, p = 0.253), or ABSI in category (Q4 vs. Q1-Q3: aHR = 1.52, 95% CI: 0.72-3.24, p = 0.265), and greater risk of PCa-specific mortality. However, among participants who had been diagnosed within 4 years, the highest ABSI quartile but not in BMI was significantly associated with greater risk for PCa-specific mortality (Q4 vs. Q1-Q3: aHR = 5.34, 95% CI: 2.26-12.62, p = 0.001). In ROC analysis for this subgroup, the area under the curve of ABSI alone for predicting PCa-specific mortality was 0.638 (95% CI: 0.448-0.828), reaching 0.729 (95% CI: 0.490-0.968 when combined with other covariates.

CONCLUSIONS

In US males with PCa diagnosed within 4 years, high ABSI but not BMI is independently associated with increased PCa-specific mortality.

摘要

背景

前列腺癌（PCa）是男性常见的恶性肿瘤，肥胖可能在其发生和发展中起作用。通过身体形态指数（ABSI）测量的内脏肥胖与 PCa 死亡率之间的关联尚未得到彻底研究。本研究使用美国全国代表性数据库评估了 ABSI、体重指数（BMI）与长期 PCa 特异性死亡率之间的关系。

方法

这项基于人群的纵向研究收集了 2001 年至 2010 年期间，在国家健康与营养检查调查数据库中接受过前列腺癌手术和/或放疗的年龄≥40 岁男性的 PCa 患者数据。所有纳入的参与者均通过国家卫生统计中心关联死亡率文件随访至 2019 年底。使用 Cox 比例风险回归和受试者工作特征（ROC）曲线分析来确定 PCa 特异性死亡率、BMI 和 ABSI 之间的关系。

结果

对 294 名男性（代表 1393857 名美国国民）的数据进行了分析。在调整混杂因素后，BMI（调整后的危险比[aHR]=1.06，95%置信区间[CI]：0.97-1.16，p=0.222）、连续 ABSI（aHR=1.29，95%CI：0.83-2.02，p=0.253）或 ABSI 类别（Q4 与 Q1-Q3：aHR=1.52，95%CI：0.72-3.24，p=0.265）与 PCa 特异性死亡率的增加均无显著关联。然而，在诊断后 4 年内的参与者中，最高的 ABSI 四分位数与 PCa 特异性死亡率的增加显著相关，但 BMI 则不然（Q4 与 Q1-Q3：aHR=5.34，95%CI：2.26-12.62，p=0.001）。在该亚组的 ROC 分析中，ABSI 单独预测 PCa 特异性死亡率的曲线下面积为 0.638（95%CI：0.448-0.828），当与其他协变量结合时，曲线下面积达到 0.729（95%CI：0.490-0.968）。