腰围年数与癌症风险：一项前瞻性研究及其预测性能与腰围和体重指数的比较

Waist circumference-years and cancer risk: a prospective study of the association and comparison of predictive performance with waist circumference and body mass index

BRITISH JOURNAL OF CANCER

影响因子:6.8

分区:医学2区 Top / 肿瘤学2区

发表日期:2024 Nov

作者: Nadin Hawwash, Matthew Sperrin, Glen P Martin, Corinne E Joshu, Roberta Florido, Elizabeth A Platz, Andrew G Renehan

DOI: 10.1038/s41416-024-02860-y

摘要

研究了腰围（WC）和体重指数（BMI）一次性测量或随时间变化与癌症发生的关系。腰围与某些癌症无关BMI。关于累积中心性脂肪和癌症的分析尚缺乏。我们探讨了包含暴露时间的腰围年数（WC ≥102厘米（男性）或 ≥88厘米（女性））与癌症的关系，并将其与单次测量的WC或BMI进行比较。利用前瞻性动脉粥样硬化风险社区研究（ARIC）中连续9年的多次腰围测量，预测每年的腰围变化。采用Cox比例风险模型估算腰围年数、WC或BMI与癌症发生的风险比（HR），在第4次访视时测量。Harrell的C统计量评估预测性能。10,172名参与者在第4次访视后随访癌症，中位随访时间为男性13.7年，女性15.8年。对与肥胖相关的癌症，腰围年数每标准差的HR为1.14（95% CI：1.04, 1.25），1.19（95% CI：1.12, 1.27）。指标预测性能差异微小。这是首个发现腰围年数与癌症正相关的研究。腰围年数未提供超出WC和BMI的额外癌症风险信息。由于BMI在诊所中常规测量，可能优先选择BMI作为预测指标。

Abstract

Associations of waist circumferences (WC) and body mass index (BMI) measured once or over time, with cancer incidence were studied. WC is associated with some cancers independent of BMI. Analyses of cumulative central adiposity and cancer are lacking. We investigated associations between waist circumference-years, incorporating exposure time to WC ≥ 102 cm in men or ≥88 cm in women, and cancer, and compared this with single WC or BMI.Serial WC measurements taken over 9 years in the prospective Atherosclerosis Risk in Communities Study (ARIC) predicted yearly WC. Cox proportional hazards regression estimated hazard ratios (HRs) of cancer incidence for waist circumference-years, WC or BMI, measured in Visit 4. Harrell's C-statistic quantified metric predictive performances.10,172 participants were followed up from Visit 4 for cancer over a median 13.7 for men and 15.8 years for women. For obesity-related cancers, HRs per standard deviation waist circumference-years were 1.14 (95%CI:1.04,1.25) and 1.19 (95%CI:1.12,1.27), respectively. Differences in metric predictive performances were marginal.This is the first study to identify positive associations between waist circumference-years and cancer. Waist circumference-years did not provide additional information on cancer risk beyond that of WC and BMI. BMI is routinely measured in clinic so it may be preferred over WC.