Department of Gastrointestinal Surgery, Beijing Shijitan Hospital, Capital Medical University, Beijing, China.
Department of Clinical Nutrition, Beijing Shijitan Hospital, Capital Medical University, Beijing, China.
Front Endocrinol (Lausanne). 2024 Oct 16;15:1333488. doi: 10.3389/fendo.2024.1333488. eCollection 2024.
Obesity is as an important risk factor for chronic diseases. Metabolically healthy obesity (MHO) is considered a benign state. The association between metabolic health and obesity categories and cancer risk remains unclear. This study aimed to investigate the relationship between metabolic health status combined with obesity phenotypes and the risk of cancer.
Data from 91,834 participants in the Kailuan cohort were analyzed, excluding individuals with a body mass index (BMI) < 18.5 kg/m² and those with a history of cancer. Obesity phenotypes were classified based on BMI and waist circumference (WC) combined with metabolic health status, resulting in six phenotypes. Cox proportional hazard regression models were used to assess the association between metabolic health and obesity phenotypes with cancer risk and all-cause mortality.
The prevalence of metabolically healthy obesity and metabolically unhealthy obesity defined by BMI was 6.86% and 12.18%, while that defined by WC was 20.79% and 25.76%, respectively. Compared to metabolically healthy participants, individuals with an unhealthy metabolic status had a significantly higher risk of cancer (HR, 1.09; 95% CI, 1.03-1.15; p=0.004). The hazard ratios for cancer were 1.19, 1.23, 1.20, and 1.55 for individuals with one, two, three, and four metabolic disorders, respectively. Among those classified as metabolically unhealthy, both overweight and obesity were associated with a protective effect on cancer risk (HR, 0.88; 95% CI, 0.80-0.96; p=0.006 for overweight; HR, 0.87; 95% CI, 0.78-0.97; p=0.010 for obesity). However, abdominal obesity significantly increased cancer risk in both metabolically healthy and unhealthy participants. In subgroup analysis, simple obesity showed a protective trend against cancer in those with respiratory cancers, while abdominal obesity consistently posed a risk for various cancer types.
Metabolically unhealthy status and abdominal obesity are risk factors for cancer and all-cause mortality, whereas simple obesity offers protective effects against cancer and all-cause mortality in metabolically unhealthy individuals. These findings suggest that maintaining metabolic health and reducing the metabolic risks associated with abdominal obesity should be key targets for cancer prevention.
肥胖是慢性病的一个重要危险因素。代谢健康型肥胖（MHO）被认为是一种良性状态。代谢健康与肥胖类别和癌症风险之间的关系仍不清楚。本研究旨在探讨代谢健康状况与肥胖表型相结合与癌症风险的关系。
分析了来自开滦队列的 91834 名参与者的数据，排除了 BMI<18.5kg/m²和有癌症病史的个体。根据 BMI 和腰围（WC）与代谢健康状况相结合，将肥胖表型分为六类。使用 Cox 比例风险回归模型评估代谢健康与肥胖表型与癌症风险和全因死亡率的关系。
BMI 定义的代谢健康肥胖和代谢不健康肥胖的患病率分别为 6.86%和 12.18%，WC 定义的患病率分别为 20.79%和 25.76%。与代谢健康的参与者相比，代谢状态不健康的个体患癌症的风险显著更高（HR，1.09；95%CI，1.03-1.15；p=0.004）。患有一种、两种、三种和四种代谢紊乱的个体患癌症的风险比分别为 1.19、1.23、1.20 和 1.55。在代谢不健康的人群中，超重和肥胖与癌症风险的保护作用相关（HR，0.88；95%CI，0.80-0.96；p=0.006 超重；HR，0.87；95%CI，0.78-0.97；p=0.010 肥胖）。然而，腹部肥胖在代谢健康和不健康的参与者中都显著增加了癌症风险。在亚组分析中，单纯性肥胖对呼吸系统癌症具有保护趋势，而腹部肥胖则对各种癌症类型均构成风险。
代谢不健康状态和腹部肥胖是癌症和全因死亡率的危险因素，而单纯性肥胖对代谢不健康个体的癌症和全因死亡率具有保护作用。这些发现表明，维持代谢健康和降低与腹部肥胖相关的代谢风险应该是癌症预防的重点目标。
