Lindblad P, Wolk A, Bergström R, Persson I, Adami H O
Department of Cancer Epidemiology, University Hospital, Uppsala, Sweden.
Cancer Epidemiol Biomarkers Prev. 1994 Dec;3(8):631-9.
The causes of renal cell cancer (RCC) are poorly understood. Besides smoking, obesity remains the only risk factor that is fairly well established. The association between obesity and RCC appears stronger and more consistent in women than in men. We investigated the question of whether this apparent sex difference could be explained by repeated weight changes (weight cycling), less physical exercise, or pharmacological treatment of obesity in women. Structured face-to-face interviews were carried out with 379 (70% of all eligible) incident cases of RCC and 353 (72% of eligible) controls. The relationships between RCC and adult height, weight, and body mass index (BMI), defined as weight/height, were analyzed. Odds ratios (ORs) were estimated through logistic regression. No association was found between adult height and RCC. In men, weight and BMI appeared at most to be weakly related to risk of RCC. In women, higher adult weight and BMI (usual, highest, and lowest) and also high BMI at ages 30, 40, and 50 years were consistently associated with a significantly increased risk of RCC. Women with an usual adult BMI in the top 5% had a nearly 3-fold increased risk of RCC [OR, 2.67; 95% confidence interval (CI), 1.02-7.01]. Compared with individuals with no weight-loss periods, 2 or more such periods implied an OR of 0.96 (95% CI, 0.32-2.90) in men and 3.87 (95% CI, 1.20-12.45) in women. Physical activity at work reduced the risk of RCC in men but not women. Regular use of diet pills containing amphetamine was associated with an increased risk of RCC (OR, 4.06; 95% CI, 1.35-12.22).(ABSTRACT TRUNCATED AT 250 WORDS)
肾细胞癌（RCC）的病因目前仍知之甚少。除吸烟外，肥胖是唯一已明确的风险因素。肥胖与RCC之间的关联在女性中似乎比男性更强且更一致。我们研究了这种明显的性别差异是否可以通过女性反复的体重变化（体重循环）、较少的体育锻炼或肥胖的药物治疗来解释。对379例（占所有符合条件者的70%）RCC新发病例和353例（占符合条件者的72%）对照进行了结构化面对面访谈。分析了RCC与成人身高、体重以及体重指数（BMI，定义为体重/身高）之间的关系。通过逻辑回归估计比值比（OR）。未发现成人身高与RCC之间存在关联。在男性中，体重和BMI与RCC风险最多只是微弱相关。在女性中，较高的成人体重和BMI（通常、最高和最低）以及30岁、40岁和50岁时的高BMI与RCC风险显著增加始终相关。成人BMI处于前5%的女性患RCC的风险几乎增加了3倍[OR，2.67；95%置信区间（CI），1.02 - 7.01]。与没有体重减轻期的个体相比，男性有2个或更多这样的时期时OR为0.96（95%CI，0.32 - 2.90），女性为3.87（95%CI，1.20 - 12.45）。工作中的体力活动可降低男性患RCC的风险，但对女性无效。经常使用含苯丙胺的减肥药与RCC风险增加有关（OR，4.06；95%CI，1.35 - 12.22）。（摘要截断于250字）
