Περίληψη:
General obesity, as reflected by BMI, is an established risk factor for
esophageal adenocarcinoma (EAC), a suspected risk factor for gastric
cardia adenocarcinoma (GCC) and appears unrelated to gastric non-cardia
adenocarcinoma (GNCC). How abdominal obesity, as commonly measured by
waist circumference (WC), relates to these cancers remains largely
unexplored. Using measured anthropometric data from 391,456 individuals
from the European Prospective Investigation into Cancer and Nutrition
(EPIC) study and 11 years of follow-up, we comprehensively assessed the
association of anthropometric measures with risk of EAC, GCC and GNCC
using multivariable proportional hazards regression. One hundred
twenty-four incident EAC, 193 GCC and 224 GNCC were accrued. After
mutual adjustment, BMI was unrelated to EAC, while WC showed a strong
positive association (highest vs. lowest quintile HR=1.19; 95% CI,
0.63-2.22 and HR=3.76; 1.72-8.22, respectively). Hip circumference (HC)
was inversely related to EAC after controlling for WC, while WC remained
positively associated (HR=0.35; 0.18-0.68, and HR=4.10; 1.94-8.63,
respectively). BMI was not associated with GCC or GNCC. WC was related
to higher risks of GCC after adjustment for BMI and more strongly after
adjustment for HC (highest vs. lowest quintile HR=1.91; 1.09-3.37, and
HR=2.23; 1.28-3.90, respectively). Our study demonstrates that
abdominal, rather than general, obesity is an indisputable risk factor
for EAC and also provides evidence for a protective effect of
gluteofemoral (subcutaneous) adipose tissue in EAC. Our study further
shows that general obesity is not a risk factor for GCC and GNCC, while
the role of abdominal obesity in GCC needs further investigation.
What’s new? While mainly general obesity, as measured by body mass
index, has been investigated in relation to gastric and esophageal
cancer, the effect of a large waist on these cancer sites is unknown. In
this article, the authors report results of extensive analysis of
measured anthropometry, including measures of general (BMI) and
abdominal obesity (waist circumference), collected by the European
Prospective Investigation into Cancer and Nutrition (EPIC). They show
that general obesity is not a risk factor for esophageal and gastric
cancer, while waist circumference strongly increases risk of esophageal
cancer and may potentially be related to gastric cardia cancer.
Συγγραφείς:
Steffen, Annika
Huerta, Jose-Maria
Weiderpass, Elisabete and
Bueno-de-Mesquita, H. B(As)
May, Anne M.
Siersema, Peter D. and
Kaaks, Rudolf
Neamat-Allah, Jasmine
Pala, Valeria
Panico,
Salvatore
Saieva, Calogero
Tumino, Rosario
Naccarati,
Alessio
Dorronsoro, Miren
Sanchez-Cantalejo, Emilio
Ardanaz,
Eva
Ramon Quiros, J.
Ohlsson, Bodil
Johansson, Mattias and
Wallner, Bengt
Overvad, Kim
Halkjaer, Jytte
Tjonneland, Anne
and Fagherazzi, Guy
Racine, Antoine
Clavel-Chapelon, Francoise
and Key, Tim J.
Khaw, Kay-Tee
Wareham, Nick
Lagiou, Pagona
and Bamia, Christina
Trichopoulou, Antonia
Ferrari, Pietro and
Freisling, Heinz
Lu, Yunxia
Riboli, Elio
Cross, Amanda J.
and Gonzalez, Carlos A.
Boeing, Heiner
