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姐妹研究中的体重循环与癌症风险

Weight Cycling and Cancer Risk in the Sister Study.

作者信息

Stevens Victoria L, Priest Jessica, Wilkerson Jesse, D'Aloisio Aimee A, Sandler Dale P

机构信息

Public Health and Scientific Research, DLH, Durham, NC.

Epidemiology Branch, National Institutes of Environmental and Health Sciences, Research Triangle Park, Durham, NC.

出版信息

Am J Epidemiol. 2025 Aug 29. doi: 10.1093/aje/kwaf191.

Abstract

Weight cycling, when weight is repeatedly lost intentionally and then regained, may perturb biological processes that could influence cancer development. However, results from epidemiologic studies of weight cycling are mixed and provide no clear answer as to whether this behavior alters cancer risk. We examined the association of weight cycling and cancer incidence among 45,004 women enrolled in the Sister Study (2003-2009) and followed through October 12, 2020. Weight cycling was defined using baseline responses about the number of times ≥20 pounds (9 kilograms) was lost and then regained. Multivariable-adjusted hazards ratios and 95% confidence intervals for all cancers and five individual cancers (breast, endometrial, ovarian, colorectal, and kidney) were estimated using Cox proportional hazards regression modeling. Weight cycling was not associated with an increased risk of any cancer after bodyweight was adjusted for and was inversely associated with risk of all cancers (HR 6+ episodes 0.89, 95% CI 0.80-0.97; P-trend <0.01) and breast cancer (HR 6 + episodes 0.82, 95% CI 0.69-0.97; P-trend <0.01). The inverse trend for breast cancer was only seen in obese and in postmenopausal women. These findings suggest that weight cycling, independent of bodyweight, does not increase cancer risk and, for breast cancer, is associated with decreased risk.

摘要

体重循环,即体重反复被有意减轻然后又恢复,可能会扰乱那些可能影响癌症发展的生物学过程。然而,关于体重循环的流行病学研究结果并不一致,对于这种行为是否会改变癌症风险也没有给出明确答案。我们在参与姐妹研究(2003 - 2009年)并随访至2020年10月12日的45,004名女性中,研究了体重循环与癌症发病率之间的关联。体重循环是根据关于体重减轻≥20磅(9千克)然后又恢复的次数的基线回答来定义的。使用Cox比例风险回归模型估计了所有癌症以及五种特定癌症(乳腺癌、子宫内膜癌、卵巢癌、结直肠癌和肾癌)的多变量调整风险比和95%置信区间。在对体重进行调整后,体重循环与任何癌症风险增加均无关联,且与所有癌症风险呈负相关(体重循环6次及以上者的风险比为0.89,95%置信区间为0.80 - 0.97;P趋势<0.01)以及与乳腺癌风险呈负相关(体重循环6次及以上者的风险比为0.82,95%置信区间为0.69 - 0.97;P趋势<0.01)。乳腺癌的这种负相关趋势仅在肥胖女性和绝经后女性中可见。这些发现表明,体重循环独立于体重之外,不会增加癌症风险,对于乳腺癌而言,还与风险降低有关。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/723b/12498545/5d252bd0af12/nihms-2113542-f0001.jpg

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