Yang Song, Ni Xinmiao, Jian Jun, Wang Lei, Chen Zhiyuan, Liu Xiuheng
Department of Urology, Renmin Hospital of Wuhan University, Wuhan, China.
Institute of Urologic Disease, Renmin Hospital of Wuhan University, Wuhan, China.
Transl Androl Urol. 2025 Mar 30;14(3):519-528. doi: 10.21037/tau-24-521. Epub 2025 Mar 26.
Adult obesity increases the risk of kidney cancer (KIC), yet the link between early body size traits and KIC remains uncertain. This study aimed to investigate the causal relationship between early body size characteristics and KIC, including its subtypes, using Mendelian randomization (MR).
We utilized data from public genome-wide association study (GWAS) databases on birth weight and body mass index (BMI) across childhood, adolescence, and adulthood as exposure variables, and KIC and its subtypes as outcome variables. A two-way two-sample MR analysis was performed to explore these associations, with the inverse variance weighted (IVW) method as the primary analytical approach and sensitivity analyses to assess result stability.
IVW analysis revealed significant associations between childhood obesity [odds ratio (OR) =1.08, 95% confidence interval (CI): 1.04-1.14, P<0.001], childhood BMI (OR =1.23, 95% CI: 1.07-1.42, P=0.003), adolescent BMI (OR =1.22, 95% CI: 1.07-1.40, P=0.003), and adult BMI (OR =1.75, 95% CI: 1.41-2.17, P<0.001) with increased risk of KIC. Similar associations were observed for clear cell renal cell carcinoma (ccRCC), with childhood obesity (OR =1.09, 95% CI: 1.02-1.15, P=0.007), childhood BMI (OR =1.33, 95% CI: 1.14-1.55, P<0.001), adolescent BMI (OR =1.24, 95% CI: 1.04-1.47, P=0.01), and adult BMI (OR =1.97, 95% CI: 1.51-2.57, P<0.001) significantly linked to higher ccRCC risk. No evidence of reverse causation was found.
This study provides MR evidence supporting a causal association between early-life obesity and KIC. Our findings suggest that reducing obesity in early life may have a potential positive impact on the prevention of KIC.
成人肥胖会增加患肾癌(KIC)的风险,但早期身体大小特征与KIC之间的联系仍不明确。本研究旨在利用孟德尔随机化(MR)方法探讨早期身体大小特征与KIC及其亚型之间的因果关系。
我们将来自公共全基因组关联研究(GWAS)数据库中关于儿童期、青少年期和成年期的出生体重和体重指数(BMI)数据作为暴露变量,将KIC及其亚型作为结果变量。进行了双向双样本MR分析以探索这些关联,采用逆方差加权(IVW)方法作为主要分析方法,并进行敏感性分析以评估结果的稳定性。
IVW分析显示,儿童期肥胖[优势比(OR)=1.08,95%置信区间(CI):1.04 - 1.14,P<0.001]、儿童期BMI(OR =1.23,95% CI:1.07 - 1.42,P =0.003)、青少年期BMI(OR =1.22,95% CI:1.07 - 1.40,P =0.003)和成年期BMI(OR =1.75,95% CI:1.41 - 2.17,P<0.001)与KIC风险增加显著相关。对于透明细胞肾细胞癌(ccRCC)也观察到类似的关联,儿童期肥胖(OR =1.09,95% CI:1.02 - 1.15,P =0.007)、儿童期BMI(OR =1.33,95% CI:1.14 - 1.55,P<0.001)、青少年期BMI(OR =1.24,95% CI:1.04 - 1.47,P =0.01)和成年期BMI(OR =1.97,95% CI:1.51 - 2.57,P<0.001)与ccRCC风险升高显著相关。未发现反向因果关系的证据。
本研究提供了MR证据,支持早期肥胖与KIC之间存在因果关联。我们的研究结果表明,在生命早期减轻肥胖可能对预防KIC有潜在的积极影响。