Intensive Weight Loss Intervention and Cancer Risk in Adults with Type 2 Diabetes: Analysis of the Look AHEAD Randomized Clinical Trial

被引：51

作者：

Yeh, Hsin-Chieh ^{[1
,2
,3
,4
]}

Bantle, John P. ^{[5
]}

Cassidy-Begay, Maria ^{[6
]}

Blackburn, George ^{[7
]}

Bray, George A. ^{[8
]}

Byers, Tim ^{[9
]}

Clark, Jeanne M. ^{[1
]}

Coday, Mace ^{[10
]}

Egan, Caitlin ^{[11
]}

Espeland, Mark A. ^{[12
]}

Foreyt, John P. ^{[13
]}

Garcia, Katelyn ^{[12
]}

Goldman, Valerie ^{[14
]}

Gregg, Edward W. ^{[15
]}

Hazuda, Helen P. ^{[16
]}

Hesson, Louise ^{[17
]}

Hill, James O. ^{[18
]}

Horton, Edward S. ^{[19
]}

Jakicic, John M. ^{[20
]}

Jeffery, Robert W. ^{[21
]}

Johnson, Karen C. ^{[10
]}

Kahn, Steven E. ^{[22
]}

Knowler, William C. ^{[6
]}

Korytkowski, Mary ^{[23
]}

Kure, Anne ^{[22
]}

Lewis, Cora E. ^{[24
]}

Mantzoros, Christos ^{[7
]}

Meacham, Maria ^{[6
]}

Montez, Maria G. ^{[16
]}

Nathan, David M. ^{[14
]}

Pajewski, Nicholas ^{[12
]}

Patricio, Jennifer ^{[25
]}

Peters, Anne ^{[26
]}

Pi-Sunyer, F. Xavier ^{[25
]}

Pownall, Henry ^{[27
]}

Ryan, Donna H. ^{[8
]}

Safford, Monika ^{[28
]}

Sedjo, Rebecca L. ^{[29
]}

Steinburg, Helmut ^{[30
]}

Vitolins, Mara ^{[31
]}

Wadden, Thomas A. ^{[17
]}

Wagenknecht, Lynne E. ^{[32
]}

Wing, Rena R. ^{[11
]}

Wolff, Antonio C. ^{[33
]}

Wyatt, Holly ^{[34
]}

Yanovski, Susan Z. ^{[35
]}

机构：

[1] Johns Hopkins Univ, Dept Med, Baltimore, MD 21218 USA

[2] Johns Hopkins Univ, Dept Epidemiol, Baltimore, MD 21218 USA

[3] Johns Hopkins Univ, Dept Oncol, Baltimore, MD 21218 USA

[4] Johns Hopkins Univ, Welch Ctr Prevent Epidemiol & Clin Res, Baltimore, MD 21218 USA

[5] Univ Minnesota, Sch Med, Dept Med, Minneapolis, MN 55455 USA

[6] Natl Inst Diabet & Digest & Kidney Dis, Phoenix Epidemiol & Clin Res Branch, Phoenix, AZ USA

[7] Beth Israel Deaconess Med Ctr, Boston, MA 02215 USA

[8] Louisiana State Univ, Pennington Biomed Res Ctr, Baton Rouge, LA 70808 USA

[9] Univ Colorado, Colorado Sch Publ Hlth, Dept Epidemiol, Anschutz Med Campus, Aurora, CO USA

[10] Univ Tennessee, Ctr Hlth Sci, Dept Prevent Med, Memphis, TN 38163 USA

[11] Brown Univ, Warren Alpert Med Sch, Psychiat & Human Behav, Providence, RI 02912 USA

[12] Wake Forest Sch Med, Dept Biostat & Data Sci, Div Publ Hlth Sci, Winston Salem, NC 27101 USA

[13] Baylor Coll Med, Dept Med, Houston, TX 77030 USA

[14] Massachusetts Gen Hosp, Diabet Clin Res Ctr, Boston, MA 02114 USA

[15] Imperial Coll London, Dept Epidemiol & Biostat, London, England

[16] Univ Texas Hlth Sci Ctr San Antonio, Dept Med, San Antonio, TX 78229 USA

[17] Univ Penn, Perelman Sch Med, Ctr Weight & Eating Disorders, Philadelphia, PA 19104 USA

[18] Univ Alabama Birmingham, Dept Nutr Sci, Birmingham, AL 35294 USA

[19] Joslin Diabet Ctr, Dept Med, Boston, MA 02215 USA

[20] Univ Pittsburgh, Dept Hlth & Phys Act, Pittsburgh, PA USA

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

[22] Univ Washington, Dept Med, VA Puget Sound Hlth Care Syst, Seattle, WA USA

[23] Univ Pittsburgh, Dept Med, Pittsburgh, PA USA

[24] Univ Alabama Birmingham, Sch Med, Div Prevent Med, Birmingham, AL USA

[25] Columbia Univ, Med Ctr, New York, NY USA

[26] Univ Southern Calif, Keck Sch Med, Dept Med, Los Angeles, CA 90007 USA

[27] Baylor Coll Med, Div Cardiol, Houston, TX 77030 USA

[28] Cornell Univ, Weill Cornell Med Coll, Dept Med, New York, NY 10021 USA

[29] Univ Colorado, Dept Community & Behav Hlth, Colorado Sch Publ Hlth, Anschutz Med Campus, Aurora, CO USA

[30] Univ Tennessee, Ctr Hlth Sci, Dept Med, Memphis, TN 38163 USA

[31] Wake Forest Sch Med, Dept Epidemiol & Prevent, Div Publ Hlth Sci, Winston Salem, NC 27101 USA

[32] Wake Forest Sch Med, Div Publ Hlth Sci, Winston Salem, NC 27101 USA

[33] Johns Hopkins Sydney Kimmel Canc Ctr, Dept Oncol, Baltimore, MD USA

[34] Univ Colorado, Dept Med, Sch Med, Anschutz Med Campus, Aurora, CO USA

[35] Natl Inst Diabet & Digest & Kidney Dis, NIH, Bethesda, MD USA

来源：

OBESITY | 2020年 / 28卷 / 09期

关键词：

BODY-MASS INDEX; LIFE-STYLE INTERVENTION; POSTMENOPAUSAL WOMEN; BARIATRIC SURGERY; POOLED ANALYSIS; EXERCISE; METAANALYSIS; OBESITY; OVERWEIGHT; POPULATION;

D O I：

10.1002/oby.22936

中图分类号：

R5 [内科学];

学科分类号：

1002 ; 100201 ;

摘要：

Objective This study was designed to determine whether intensive lifestyle intervention (ILI) aimed at weight loss lowers cancer incidence and mortality. Methods Data from the Look AHEAD trial were examined to investigate whether participants randomized to ILI designed for weight loss would have reduced overall cancer incidence, obesity-related cancer incidence, and cancer mortality, as compared with the diabetes support and education (DSE) comparison group. This analysis included 4,859 participants without a cancer diagnosis at baseline except for nonmelanoma skin cancer. Results After a median follow-up of 11 years, 684 participants (332 in ILI and 352 in DSE) were diagnosed with cancer. The incidence rates of obesity-related cancers were 6.1 and 7.3 per 1,000 person-years in ILI and DSE, respectively, with a hazard ratio (HR) of 0.84 (95% CI: 0.68-1.04). There was no significant difference between the two groups in total cancer incidence (HR, 0.93; 95% CI: 0.80-1.08), incidence of nonobesity-related cancers (HR, 1.02; 95% CI: 0.83-1.27), or total cancer mortality (HR, 0.92; 95% CI: 0.68-1.25). Conclusions An ILI aimed at weight loss lowered incidence of obesity-related cancers by 16% in adults with overweight or obesity and type 2 diabetes. The study sample size likely lacked power to determine effect sizes of this magnitude and smaller.

引用

页码：1678 / 1686

页数：9

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