Association of anthropometric indicators with oesophageal squamous carcinoma and precancerous lesions in people aged 40-69 years from high-risk setting in China: a population-based study.

OBJECTIVES

This study aimed to explore the relationship between multiple anthropometric indicators (AIs), oesophageal squamous cell carcinoma (ESCC) and precancerous lesions.

DESIGN

Cross-sectional study.

PARTICIPANTS

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.

MAIN OUTCOME MEASURES

The association of 11 AIs with ESCC and precancerous lesions was analysed using multivariate logistic regression and restricted cubic splines (RCS).

RESULTS

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).

CONCLUSIONS

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.