Suadicani P, Hein H O, Gyntelberg F
Dept. of Occupational Medicine, Rigshospitalet, State University Hospital, Copenhagen, Denmark.
Scand J Gastroenterol. 1993 Mar;28(3):285-8. doi: 10.3109/00365529309096087.
The role of obesity in the risk of colorectal cancer is uncertain. We investigated the association between height and weight and the risk of colorectal cancer in an 18-year follow-up of 5249 employed men aged 40-59 years (mean, 48 years). Cancer of the colon was diagnosed in 51 men, and cancer of the rectum in 42 (all were adenocarcinomas). Adjusted for weight and age, the tertile of men with shortest height had a relative risk (95% confidence limits) of rectum cancer of 3.1 (1.0-9.0, p = 0.04), compared with the tallest tertile. Compared with the tertile of men who weighed the most, the tertile of men who weighed the least had an increased risk of 2.5 (0.9-6.9, p = 0.08) after adjustment for age and height. Compared with men who were in the highest tertile of both height and weight, the men in the lowest tertile of both height and weight had and increased risk of 5.5 (1.2-24.9, p = 0.02). There were no significant differences in height and weight between colon cancer cases and non-cases, but colon cancer cases had a significantly lower body mass index (kg/m2), 24.4 versus 25.3 (p = 0.03). Potentially confounding factors, such as smoking, alcohol, coffee consumption, physical activity on the job and in leisure time, and social class, had no influence on the results. We conclude that low height and low weight were strong predictors of rectal cancer, and that the least obese men had the highest risk of colon cancer.
肥胖在结直肠癌风险中所起的作用尚不确定。我们对5249名年龄在40 - 59岁（平均48岁）的在职男性进行了18年的随访，调查身高、体重与结直肠癌风险之间的关联。51名男性被诊断患有结肠癌，42名患有直肠癌（均为腺癌）。在对体重和年龄进行调整后，身高最矮三分位数的男性患直肠癌的相对风险（95%置信区间）为3.1（1.0 - 9.0，p = 0.04），而身高最高三分位数的男性相比则较低。在对年龄和身高进行调整后，体重最轻三分位数的男性相比体重最重三分位数的男性，患癌风险增加了2.5（0.9 - 6.9，p = 0.08）。与身高和体重均处于最高三分位数的男性相比，身高和体重均处于最低三分位数的男性患癌风险增加了5.5（1.2 - 24.9，p = 0.02）。结肠癌患者与非患者在身高和体重方面没有显著差异，但结肠癌患者的体重指数（kg/m²）显著更低，分别为24.4和25.3（p = 0.03）。潜在的混杂因素，如吸烟、饮酒、咖啡摄入量、工作及休闲时间的身体活动以及社会阶层，对结果均无影响。我们得出结论，身高矮和体重轻是直肠癌的有力预测因素，而肥胖程度最低的男性患结肠癌的风险最高。
