Feng Xiang, Zhu Jinhua, Hua Zhaolai, Dai Chun, Tong Haiyuan, Yang Bin
Institute of Tumour Prevention and Control, People's Hospital of Yangzhong City, Zhenjiang, Jiangsu, China
Institute of Tumour Prevention and Control, People's Hospital of Yangzhong City, Zhenjiang, Jiangsu, China.
BMJ Open. 2025 Jul 28;15(7):e087639. doi: 10.1136/bmjopen-2024-087639.
This study aimed to explore the relationship between multiple anthropometric indicators (AIs), oesophageal squamous cell carcinoma (ESCC) and precancerous lesions.
Cross-sectional study.
A total of 10 115 participants aged 40-69 years, recruited between 2017 and 2022 from Yangzhong City, Jiangsu Province, Southeast China, were included in the analysis.
The association of 11 AIs with ESCC and precancerous lesions was analysed using multivariate logistic regression and restricted cubic splines (RCS).
The prevalence of ESCC and precancerous lesions was 4.52%. Multivariate logistic regression analyses revealed that AIs were not significantly associated with ESCC or precancerous lesions in the total population (all p>0.05). Among men, only the fourth quartile (Q4) level of A Body Shape Index (ABSI) was protective against ESCC and precancerous lesions compared with the first quartile (Q1) (OR = 0.648, 95% CI = 0.440 to 0.955). Among women, the Q4 level of waist circumference (OR=1.612, 95% CI=1.066 to 2.438), third quartile (Q3) level of waist-to-hip ratio (WHR) (OR=1.890, 95% CI=1.252 to 2.854), Q4 level of Conicity Index (CI) (OR=1.869, 95% CI=1.227 to 2.848), and Q3 (OR=1.993, 95% CI=1.266 to 3.136) and Q4 (OR=2.137, 95% CI=1.380 to 3.310) ABSI levels were associated with an increased risk of ESCC and precancerous lesions compared with Q1 (all p<0.05). The risk of ESCC and precancerous lesions increased by 28.5% (OR=1.285, 95% CI=1.117 to 1.480) and 30.6% (OR=1.306, 95% CI=1.139 to 1.496), respectively, for each SD increase in the CI and ABSI among women (all p<0.05). RCS analyses demonstrated a non-linear association between Body Mass Index (BMI) in men and WHR in women with ESCC and precancerous lesions (all p for overall/non-linear <0.05). There was a positive linear association between CI and ABSI for ESCC and precancerous lesions in women (all p for overall <0.05; p for non-linear >0.05).
Abdominal obesity and moderately overweight in men appeared to reduce the risk of ESCC and precancerous lesions. However, increasing levels of abdominal obesity in women are associated with a higher risk of ESCC and precancerous lesions. The heterogeneity in the role of adiposity, especially abdominal obesity, on ESCC and precancerous lesions between genders emphasises the importance of maintaining an appropriate body weight.
本研究旨在探讨多种人体测量指标（AIs）与食管鳞状细胞癌（ESCC）及癌前病变之间的关系。
横断面研究。
2017年至2022年期间从中国东南部江苏省扬中市招募的10115名年龄在40 - 69岁之间的参与者纳入分析。
使用多因素逻辑回归和受限立方样条（RCS）分析11种人体测量指标与ESCC及癌前病变的关联。
ESCC及癌前病变的患病率为4.52%。多因素逻辑回归分析显示，在总人群中，人体测量指标与ESCC或癌前病变无显著关联（所有p>0.05）。在男性中，与第一四分位数（Q1）相比，只有身体形状指数（ABSI）的第四四分位数（Q4）水平对ESCC及癌前病变有保护作用（OR = 0.648，95%CI = 0.440至0.955）。在女性中，腰围的Q4水平（OR = 1.612，95%CI = 1.066至2.438）、腰臀比（WHR）的第三四分位数（Q3）水平（OR = 1.890，95%CI = 1.252至2.854）、锥度指数（CI）的Q4水平（OR = 1.869，95%CI = 1.227至2.848）以及Q3（OR = 1.993，95%CI = 1.266至3.136）和Q4（OR = 2.137，95%CI = 1.380至3.310）的ABSI水平与ESCC及癌前病变风险增加相关，与Q1相比（所有p<0.05）。女性中，CI和ABSI每增加1个标准差，ESCC及癌前病变风险分别增加28.5%（OR = 1.285，95%CI = 1.117至1.480）和30.6%（OR = 1.306，95%CI = 1.139至1.496）（所有p<0.05）。RCS分析表明，男性的体重指数（BMI）和女性的WHR与ESCC及癌前病变之间存在非线性关联（所有总体/非线性p<0.05）。女性中，CI和ABSI与ESCC及癌前病变之间存在正线性关联（所有总体p<0.05；非线性p>0.05）。
男性腹部肥胖和中度超重似乎可降低ESCC及癌前病变的风险。然而，女性腹部肥胖程度增加与ESCC及癌前病变风险较高相关。肥胖尤其是腹部肥胖在ESCC及癌前病变中性别作用的异质性强调了维持适当体重的重要性。
