Central adiposity, obesity during early adulthood, and pancreatic cancer mortality in a pooled analysis of cohort studies

被引：106

作者：

Genkinger, J. M. ^{[1
,2
]}

Kitahara, C. M. ^{[3
]}

Bernstein, L. ^{[4
]}

de Gonzalez, A. Berrington ^{[3
]}

Brotzman, M. ^{[5
]}

Elena, J. W. ^{[6
]}

Giles, G. G. ^{[7
,8
]}

Hartge, P. ^{[3
]}

Singh, P. N. ^{[9
,10
]}

Stolzenberg-Solomon, R. Z. ^{[3
]}

Weiderpass, E. ^{[11
,12
,13
,14
]}

Adami, H. -O. ^{[13
,15
]}

Anderson, K. E. ^{[16
,17
]}

Beane-Freeman, L. E. ^{[3
]}

Buring, J. E. ^{[15
,18
,19
]}

Fraser, G. E. ^{[9
,10
]}

Fuchs, C. S. ^{[19
,20
,21
]}

Gapstur, S. M. ^{[22
]}

Gaziano, J. M. ^{[23
,24
]}

Helzlsouer, K. J. ^{[25
,26
]}

Lacey, J. V., Jr.

Linet, M. S. ^{[3
]}

Liu, J. J. ^{[3
]}

Park, Y. ^{[3
,27
]}

Peters, U. ^{[28
,29
]}

Purdue, M. P. ^{[3
]}

Robien, K. ^{[30
]}

Schairer, C. ^{[3
]}

Sesso, H. D. ^{[15
,18
,19
,23
]}

Visvanathan, K. ^{[26
,31
]}

White, E. ^{[28
,29
]}

Wolk, A. ^{[32
]}

Wolpin, B. M. ^{[19
,20
]}

Zeleniuch-Jacquotte, A. ^{[33
,34
]}

Jacobs, E. J. ^{[22
]}

机构：

[1] Columbia Univ, Mailman Sch Publ Hlth, Dept Epidemiol, New York, NY 10032 USA

[2] Columbia Univ, Med Ctr, Herbert Irving Comprehens Canc Ctr, New York, NY 10032 USA

[3] Natl Canc Inst, Div Canc Epidemiol & Genet, NIH, DHHS, Bethesda, MD USA

[4] City Hope Natl Med Ctr, Div Canc Etiol, Duarte, CA 91010 USA

[5] WESTAT Corp, Rockville, MD 20850 USA

[6] NCI, Div Canc Control & Populat Sci, NIH, DHHS, Bethesda, MD 20892 USA

[7] Univ Melbourne, Canc Council Victoria, Canc Epidemiol Ctr, Melbourne, Vic, Australia

[8] Univ Melbourne, Melbourne Sch Populat & Global Hlth, Ctr Biostat & Epidemiol, Melbourne, Vic, Australia

[9] Loma Linda Univ, Sch Med, Dept Epidemiol Biostat & Populat Med, Loma Linda, CA USA

[10] Loma Linda Univ, Ctr Hlth Res, Loma Linda, CA USA

[11] Univ Tromso, Arctic Univ Norway, Fac Hlth Sci, Dept Community Med, Tromso, Norway

[12] Canc Registry Norway, Dept Res, Oslo, Norway

[13] Karolinska Inst, Dept Med Epidemiol & Biostat, Stockholm, Sweden

[14] Folkhalsan Res Ctr, Genet Epidemiol Grp, Helsinki, Finland

[15] Harvard Univ, Sch Publ Hlth, Dept Epidemiol, Boston, MA 02115 USA

[16] Univ Minnesota, Sch Publ Hlth, Div Epidemiol & Community Hlth, Minneapolis, MN USA

[17] Univ Minnesota, Masonic Canc Ctr, Minneapolis, MN USA

[18] Brigham & Womens Hosp, Dept Med, Div Prevent Med, Boston, MA 02115 USA

[19] Harvard Univ, Sch Med, Boston, MA USA

[20] Brigham & Womens Hosp, Dept Med, Channing Lab, Boston, MA USA

[21] Dana Farber Canc Inst, Dept Med Oncol, Boston, MA 02115 USA

[22] Amer Canc Soc, Epidemiol Res Program, Atlanta, GA 30329 USA

[23] Harvard Univ, Brigham & Womens Hosp, Sch Med, Div Aging, Boston, MA 02115 USA

[24] VA Boston Healthcare Syst, Massachusetts Vet Epidemiol Res & Informat Ctr, Ctr Geriatr Res Educ & Clin, Boston, MA USA

[25] St Johns Mercy Med Ctr, Prevent & Res Ctr, Baltimore, MD USA

[26] Johns Hopkins Bloomberg Sch Publ Hlth, Dept Epidemiol, Baltimore, MD USA

[27] Washington Univ, Div Publ Hlth Sci, Sch Med, St Louis, MO 63130 USA

[28] Fred Hutchinson Canc Res Ctr, Seattle, WA 98104 USA

[29] Univ Washington, Dept Epidemiol, Seattle, WA 98195 USA

[30] George Washington Univ, Milken Inst Sch Publ Hlth, Dept Exercise & Nutr Sci, Washington, DC USA

[31] Johns Hopkins Sch Med, Sidney Kimmel Canc Ctr, Dept Med Oncol, Baltimore, MD USA

[32] Karolinska Inst, Inst Environm Med, Div Nutr Epidemiol, S-10401 Stockholm, Sweden

[33] NYU, Dept Populat Hlth, New York, NY USA

[34] NYU, Perlmutter Canc Ctr, New York, NY USA

来源：

ANNALS OF ONCOLOGY | 2015年 / 26卷 / 11期

关键词：

central adiposity; BMI; pancreatic cancer; pooled analysis; BODY-MASS INDEX; LONGITUDINAL FOLLOW-UP; WAIST CIRCUMFERENCE; CARDIOVASCULAR-DISEASE; ABDOMINAL ADIPOSITY; INSULIN-RESISTANCE; PHYSICAL-ACTIVITY; RISK; HEALTH; WEIGHT;

D O I：

10.1093/annonc/mdv355

中图分类号：

R73 [肿瘤学];

学科分类号：

100214 ;

摘要：

positively associated with pancreatic cancer. However, little evidence exists regarding the influence of central adiposity, a high BMI during early adulthood, and weight gain after early adulthood on pancreatic cancer risk. Design: We conducted a pooled analysis of individual-level data from 20 prospective cohort studies in the National Cancer Institute BMI and Mortality Cohort Consortium to examine the association of pancreatic cancer mortality with measures of central adiposity ( e. g. waist circumference; n = 647 478; 1947 pancreatic cancer deaths), BMI during early adulthood ( ages 18- 21 years) and BMI change between early adulthood and cohort enrollment, mostly in middle age or later ( n = 1 096 492; 3223 pancreatic cancer deaths). Multivariable hazard ratios ( HRs) and 95% confidence intervals ( CIs) were calculated using Cox proportional hazards regression models. Results: Higher waist-to-hip ratio ( HR = 1.09, 95% CI 1.02- 1.17 per 0.1 increment) and waist circumference ( HR = 1.07, 95% CI 1.00- 1.14 per 10 cm) were associated with increased risk of pancreatic cancer mortality, even when adjusted for BMI at baseline. BMI during early adulthood was associated with increased pancreatic cancer mortality ( HR = 1.18, 95% CI 1.11- 1.25 per 5 kg/ m2), with increased risk observed in both overweight and obese individuals ( compared with BMI of 21.0 to < 23 kg/ m(2), HR = 1.36, 95% CI 1.20- 1.55 for BMI 25.0 < 27.5 kg/ m2, HR = 1.48, 95% CI 1.20- 1.84 for BMI 27.5 to < 30 kg/ m2, HR = 1.43, 95% CI 1.11- 1.85 for BMI = 30 kg/ m2). BMI gain after early adulthood, adjusted for early adult BMI, was less strongly associated with pancreatic cancer mortality ( HR = 1.05, 95% CI 1.01- 1.10 per 5 kg/ m2). Conclusions: Our results support an association between pancreatic cancer mortality and central obesity, independent of BMI, and also suggest that being overweight or obese during early adulthood may be important in influencing pancreatic cancer mortality risk later in life.

引用

页码：2257 / 2266

页数：10

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