A prospective cohort study of obesity and risk of oesophageal and gastric adenocarcinoma in the NIH–AARP Diet and Health Study
| Autor: | Arthur Schatzkin, Christian C. Abnet, Mark G. O'Doherty, Albert R. Hollenbeck, Neal D. Freedman |
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| Rok vydání: | 2011 |
| Předmět: |
Male
medicine.medical_specialty Esophageal Neoplasms Adenocarcinoma Gastroenterology Article Body Mass Index Cohort Studies Waist–hip ratio Risk Factors Stomach Neoplasms Surveys and Questionnaires Internal medicine medicine Humans Prospective Studies Risk factor Prospective cohort study Abdominal obesity Aged Proportional Hazards Models Waist-Hip Ratio business.industry Incidence Middle Aged medicine.disease Gastric Cardia Adenocarcinoma United States digestive system diseases Surgery National Institutes of Health (U.S.) Obesity Abdominal Female Waist Circumference medicine.symptom business Body mass index Follow-Up Studies Cohort study |
| Zdroj: | Gut. 61:1261-1268 |
| ISSN: | 1468-3288 0017-5749 |
| Popis: | Objective The incidence of oesophageal adenocarcinoma (EAC) has increased rapidly over the past 40 years and accumulating evidence suggests that obesity, as measured by body mass index (BMI), is a major risk factor. It remains unclear whether abdominal obesity is associated with EAC and gastric adenocarcinoma. Design Cox proportional hazards regression was used to examine associations between overall and abdominal obesity with EAC and gastric adenocarcinoma among 218 854 participants in the prospective NIH–AARP cohort. Results 253 incident EAC, 191 gastric cardia adenocarcinomas and 125 gastric non-cardia adenocarcinomas accrued to the cohort. Overall obesity (BMI) was positively associated with EAC and gastric cardia adenocarcinoma risk (highest (≥35 kg/m 2 ) vs referent (18.5– 2 ); HR 2.11, 95% CI 1.09 to 4.09 and HR 3.67, 95% CI 2.00 to 6.71, respectively). Waist circumference was also positively associated with EAC and gastric cardia adenocarcinoma risk (highest vs referent; HR 2.01, 95% CI 1.35 to 3.00 and HR 2.22, 95% CI 1.43 to 3.47, respectively), whereas waist-to-hip ratio (WHR) was positively associated with EAC risk only (highest vs referent; HR 1.81, 95% CI 1.24 to 2.64) and persisted in patients with normal BMI (18.5– 2 ). Mutual adjustment of WHR and BMI attenuated both, but did not eliminate the positive associations for either with risk of EAC. In contrast, the majority of the anthropometric variables were not associated with adenocarcinomas of the gastric non-cardia. Conclusion Overall obesity was associated with a higher risk of EAC and gastric cardia adenocarcinoma, whereas abdominal obesity was found to be associated with increased EAC risk; even in people with normal BMI. |
| Databáze: | OpenAIRE |
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