尽管内脏脂肪组织 (VAT) 在致癌作用中的作用已得到公认，但由于成像数据的可用性有限，其与传统肥胖措施之外的癌症风险的独立关联仍然未知。我们使用基于弹性网络回归的 VAT 体积 (L) 估算方程通过腹部 MRI 扫描对英国生物银行 (UKB; N = 23,148) 参与者的子队列进行人口统计和人体测量数据分析。该方程在 2017-2018 年国家健康和营养检查调查 (NHANES) 的 2,713 名参与者中根据性别、年龄和种族群体进行了外部验证。然后，我们将该方程应用于包含 461,665 名参与者的 UKB 总体队列，使用 Cox 比例风险模型评估估计增值税 (eVAT) 与癌症风险之间的前瞻性关联。我们还计算了与 eVAT 和 BMI 相关的癌症人群归因风险 (PAR)。在内部和外部验证中，eVAT 与测量的 VAT 具有高度相关性 (r = 0.81-0.86)。在 UKB 的中位 12 年随访期间，我们记录了 37,397 例癌症病例； eVAT 与肥胖相关癌症和个体癌症风险升高显着相关，与 BMI 和腰围无关。与高（四分位数 2-4 vs 1）eVAT (9.0-11.6%) 相关的总癌症 PAR 高于高 BMI（Q2-4 vs 1；5.0-8.2%）。eVAT 在 UKB 和 NHANES 中均表现强劲，与癌症风险相关，与体重指数和腰围无关。这项研究为增值税估算提供了一个潜在的临床工具，并强调增值税可以成为癌症预防的重要目标。© 作者 2024。由牛津大学出版社出版。版权所有。如需权限，请发送电子邮件至：journals.permissions@oup.com。

Despite the recognized role of visceral adipose tissue (VAT) in carcinogenesis, its independent association with cancer risk beyond traditional obesity measures remains unknown due to limited availability of imaging data.We developed an estimation equation for VAT volume (L) using Elastic Net Regression based on demographic and anthropometric data in a subcohort of participants in the UK Biobank (UKB; N = 23,148) with abdominal MRI scans. This equation was externally validated in 2,713 participants from the 2017-2018 National Health and Nutrition Examination Survey (NHANES) according to sex, age, and race groups. We then applied the equation to the overall UKB cohort of 461,665 participants to evaluate the prospective association between estimated VAT (eVAT) and cancer risk using Cox proportional hazards models. We also calculated the population attributable risk (PAR) of cancer associated with eVAT and BMI.eVAT showed a high correlation with measured VAT in internal and external validations (r = 0.81-0.86). During a median 12-year follow-up in the UKB, we documented 37,397 incident cancer cases; eVAT was significantly associated with elevated risk of obesity-related and individual cancers, independent of BMI and waist circumference. PAR for total cancer associated with high (quartiles 2-4 vs 1) eVAT (9.0-11.6%) was higher than high BMI (Q2-4 vs 1; 5.0-8.2%).eVAT showed robust performance in both UKB and NHANES and was associated with cancer risk independent of BMI and waist circumference. This study provides a potential clinical tool for VAT estimation and underscores that VAT can be an important target for cancer prevention.© The Author(s) 2024. Published by Oxford University Press. All rights reserved. For permissions, please email: journals.permissions@oup.com.