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中国内脏脂肪指数累积暴露与胃肠道癌症的关联:一项前瞻性队列研究。

Association of cumulative exposure to Chinese visceral adiposity index and gastrointestinal cancer: a prospective cohort study.

作者信息

Li Jiaxing, Ma Chao, Liu Kuan, Wang Wanchao, Cui Shuqing, Tian Yuan, Dong Zhigang, Wei Wenqiang, Wu Shouling, Liu Siqing

机构信息

First Division of Hepatobiliary and Pancreatic Surgery, Affiliated Hospital of North China University of Science and Technology, Tangshan, Hebei, China.

Graduate School, North China University of Science and Technology, Tangshan, Hebei, China.

出版信息

Front Oncol. 2025 Jul 3;15:1534682. doi: 10.3389/fonc.2025.1534682. eCollection 2025.

Abstract

BACKGROUND

Using the Kailuan Cohort, we investigated the association between cumulative exposure to the Chinese visceral adiposity index (CVAI) and the risk of developing gastrointestinal (GI) cancers.

METHODS

A prospective cohort study was conducted among participants who underwent three consecutive health examinations in the Kailuan Cohort from 2006 to 2010. Participants were categorized into quartiles based on their cumulative CVAI (cumCVAI). The cumulative incidence of GI cancers was estimated using Kaplan-Meier curves. The dose-response relationship between CVAI and the risk of developing GI cancers was examined using restricted cubic spline (RCS) in multivariable adjusted models. Multivariate Cox proportional hazards regression analysis was performed to assess the association between cumCVAI quartiles and the incidence of GI cancers. Furthermore, subgroup analyses and sensitivity analyses were conducted.

RESULTS

A total of 44,213 individuals were included in this study. The incidence rates of GI cancers per 1,000 person-years for the Q1 to Q4 groups were 1.00,1.45,1.62 and 2.11, respectively. The RCS curve demonstrated a significant dose-response relationship between cumCVAI and the occurrence of GI cancers events ( for overall trend < 0.001; for nonlinear trend < 0.001). After adjusting for potential confounders, compared with the Q1 group, the risk of GI cancers was significantly elevated in the Q2 group ( 1.26; 95% 1.01, 1.58), Q3 group ( 1.31; 95% 1.05, 1.64), and Q4 group ( 1.48; 95% 1.19, 1.85). This association was particularly evident in older individuals, females, those with a BMI ≥ 24 kg/m, non-smokers, and non-drinkers.

CONCLUSION

Our findings demonstrate a significant association between high cumCVAI and an increased incidence of GI cancers. Prolonged maintenance of CVAI within optimal levels may serve as a potential preventive strategy for GI cancers.

摘要

背景

利用开滦队列研究,我们调查了中国内脏脂肪指数(CVAI)的累积暴露与胃肠道(GI)癌症发生风险之间的关联。

方法

对2006年至2010年在开滦队列中连续接受三次健康检查的参与者进行了一项前瞻性队列研究。参与者根据其累积CVAI(cumCVAI)被分为四分位数。使用Kaplan-Meier曲线估计GI癌症的累积发病率。在多变量调整模型中,使用受限立方样条(RCS)检验CVAI与GI癌症发生风险之间的剂量反应关系。进行多变量Cox比例风险回归分析,以评估cumCVAI四分位数与GI癌症发病率之间的关联。此外,还进行了亚组分析和敏感性分析。

结果

本研究共纳入44213人。Q1至Q4组每1000人年的GI癌症发病率分别为1.00、1.45、1.62和2.11。RCS曲线显示cumCVAI与GI癌症事件的发生之间存在显著的剂量反应关系(总体趋势<0.001;非线性趋势<0.001)。在调整潜在混杂因素后,与Q1组相比,Q2组(1.26;95% 1.01,1.58)、Q3组(1.31;95% 1.05,1.64)和Q4组(1.48;95% 1.19,1.85)的GI癌症风险显著升高。这种关联在老年人、女性、BMI≥24 kg/m的人、非吸烟者和不饮酒者中尤为明显。

结论

我们的研究结果表明,高cumCVAI与GI癌症发病率增加之间存在显著关联。将CVAI长期维持在最佳水平可能是预防GI癌症的潜在策略。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d50b/12267042/9feeb15cbbd0/fonc-15-1534682-g001.jpg

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