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中国东南部扬中地区 40-69 岁人群肥胖症的流行状况及其决定因素,以及肥胖症与上消化道疾病的相关性。

Prevalence and determinants of obesity and its association with upper gastrointestinal diseases in people aged 40-69 years in Yangzhong, southeast China.

机构信息

Institute of Tumour Prevention and Control, Yangzhong People's Hospital, Yangzhong, 212200, China.

Department of Gastroenterology, Zhongda Hospital, Southeast University, Nanjing, 210000, China.

出版信息

Sci Rep. 2024 Sep 10;14(1):21153. doi: 10.1038/s41598-024-72313-2.

Abstract

Several international epidemiological studies have established a link between obesity and upper gastrointestinal cancer (UGC), but Chinese evidence is limited. This study aimed to determine the prevalence of obesity, especially central obesity, while investigating its association with upper gastrointestinal diseases in the high-risk population of Yangzhong, a typical high-risk area for UGC in southeastern China. We conducted a cross-sectional study from November 2017 to June 2021 involving 6736 residents aged 40-69. Multivariate logistic regression was used to assess independent factors influencing overweight/obesity and central obesity. We also analyzed the relationship between obesity and upper gastrointestinal diseases using multinomial logistic regression. The prevalence of overweight, obesity, waist circumference (WC), waist-to-hip ratio (WHR), and waist-to-height ratio (WHtR)-central obesity were 40.6%, 12.0%, 49.9%, 79.4%, and 63.7%, respectively. Gender, age, smoking, tea consumption, sufficient vegetable, pickled food, spicy food, eating speed, physical activity, family history of cancer, and family history of common chronic disease were associated with overweight /obesity and central obesity. Besides, education and missing teeth were only associated with central obesity. General and central obesity were positively associated with UGC, while general obesity was negatively associated with UGC precancerous diseases. There were no significant associations between obesity and UGC precancerous lesions. Subgroup analyses showed that general and central obesity was positively associated with gastric cancer but not significantly associated with esophageal cancer. Obesity is negatively and positively associated with gastric and esophageal precancerous diseases, respectively. In conclusion, general and central obesity were at high levels in the target population in this study. Most included factors influenced overweight/obesity and central obesity simultaneously. Policymakers should urgently develop individualized measures to reduce local obesity levels according to obesity characteristics. Besides, obesity increases the risk of UGC but decreases the risk of UGC precancerous diseases, especially in the stomach. The effect of obesity on the precancerous diseases of the gastric and esophagus appears to be the opposite. No significant association between obesity and upper gastrointestinal precancerous lesions was found in the study. This finding still needs to be validated in cohort studies.

摘要

几项国际流行病学研究已经确定了肥胖与上消化道癌症(UGC)之间存在关联,但中国的证据有限。本研究旨在确定肥胖,特别是中心性肥胖的流行率,同时调查其与中国东南部典型 UGC 高危地区扬中高危人群中上消化道疾病的关系。我们进行了一项横断面研究,纳入了 2017 年 11 月至 2021 年 6 月期间 6736 名年龄在 40-69 岁的居民。采用多变量逻辑回归评估超重/肥胖和中心性肥胖的独立影响因素。我们还使用多项逻辑回归分析了肥胖与上消化道疾病之间的关系。超重、肥胖、腰围(WC)、腰臀比(WHR)和腰高比(WHtR)-中心性肥胖的流行率分别为 40.6%、12.0%、49.9%、79.4%和 63.7%。性别、年龄、吸烟、饮茶、蔬菜充足、腌制食品、辛辣食品、进食速度、体力活动、癌症家族史和常见慢性疾病家族史与超重/肥胖和中心性肥胖有关。此外,教育程度和缺牙仅与中心性肥胖有关。一般和中心性肥胖与 UGC 呈正相关,而一般肥胖与 UGC 癌前病变呈负相关。肥胖与 UGC 癌前病变之间没有显著关联。亚组分析表明,一般和中心性肥胖与胃癌呈正相关,但与食管癌无显著相关性。肥胖与胃癌和食管癌癌前病变呈负相关和正相关。总之,在本研究的目标人群中,一般和中心性肥胖处于较高水平。大多数纳入的因素同时影响超重/肥胖和中心性肥胖。决策者应根据肥胖特点,紧急制定个性化措施来降低当地肥胖水平。此外,肥胖会增加 UGC 的风险,但会降低 UGC 癌前病变的风险,特别是在胃部。肥胖对胃和食管癌前疾病的影响似乎相反。本研究中未发现肥胖与上消化道癌前病变之间存在显著关联。这一发现仍需要在队列研究中验证。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/832c/11387473/efb91c3f7fa2/41598_2024_72313_Fig1_HTML.jpg

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