沈洁,莫淼,戴卫星,周昌明,王泽洲,蔡国响,翟连芳,徐烨,郑莹.肥胖与大肠高风险腺瘤发病风险研究[J].中华流行病学杂志,2020,41(10):1643-1648 |
肥胖与大肠高风险腺瘤发病风险研究 |
Association between obesity and risk for colorectal advanced adenoma |
收稿日期:2020-04-10 出版日期:2020-10-27 |
DOI:10.3760/cma.j.cn112338-20200410-00553 |
中文关键词: 结直肠肿瘤 肥胖 大肠高风险腺瘤 |
英文关键词: Colorectal neoplasm Obesity Colorectal advanced adenoma |
基金项目: |
作者 | 单位 | E-mail | 沈洁 | 复旦大学附属肿瘤医院肿瘤预防部, 上海 200032 复旦大学上海医学院肿瘤学系, 上海 200032 | | 莫淼 | 复旦大学附属肿瘤医院肿瘤预防部, 上海 200032 复旦大学上海医学院肿瘤学系, 上海 200032 | | 戴卫星 | 复旦大学上海医学院肿瘤学系, 上海 200032 | | 周昌明 | 复旦大学附属肿瘤医院肿瘤预防部, 上海 200032 复旦大学上海医学院肿瘤学系, 上海 200032 | | 王泽洲 | 复旦大学附属肿瘤医院肿瘤预防部, 上海 200032 复旦大学上海医学院肿瘤学系, 上海 200032 | | 蔡国响 | 复旦大学上海医学院肿瘤学系, 上海 200032 复旦大学附属肿瘤医院大肠外科, 上海 200032 | | 翟连芳 | 上海市闵行区七宝社区卫生服务中心 201101 | | 徐烨 | 复旦大学上海医学院肿瘤学系, 上海 200032 复旦大学附属肿瘤医院大肠外科, 上海 200032 | | 郑莹 | 复旦大学附属肿瘤医院肿瘤预防部, 上海 200032 复旦大学上海医学院肿瘤学系, 上海 200032 | zhengying@fudan.edu.cn |
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中文摘要: |
目的 探讨肥胖与大肠高风险腺瘤发病风险的关系。方法 以参加2008年上海市社区大肠癌筛查研究中的45~74岁的社区居民为研究对象,收集筛查前风险因素和筛查后肠镜诊断结果,并结合人工主动随访收集大肠高风险腺瘤发病的结局信息,采用多因素Cox比例风险回归模型分析BMI与大肠高风险腺瘤发病的风险比(HR)和95% CI。结果 20 811名研究对象共计随访122 739.36人年,平均随访时间为5.87年,共收集大肠高风险腺瘤657例。与体重正常者相比,肥胖者(BMI≥28.0 kg/m2)大肠高风险腺瘤发病风险增加21%,调整年龄、性别、大肠癌家族史、文化程度、婚姻状况、生活方式特征如吸烟、饮酒、脂肪类食物摄入、油炸或腌制类食物摄入及蔬菜水果摄入情况等因素后,肥胖者发生大肠高风险腺瘤的HR值为1.25(95% CI:1.04~1.51)。进一步按年龄、性别及大肠癌家族史进行分层分析后发现,在男性、>60岁人群中,肥胖者与体重正常者相比,大肠高风险腺瘤的发生风险更大(男性:HR=1.57,95% CI:1.20~2.04;>60岁人群:HR=1.63,95% CI:1.23~2.16)。结论 肥胖是大肠高风险腺瘤发病风险独立的危险因素,发病风险随BMI的增加而增加。 |
英文摘要: |
Objectives To understand the association between obesity and the risk for colorectal advanced adenoma. Methods Community residents aged 45 to 74 who had participated in the Shanghai community-based colorectal cancer (CRC) screening project in 2008 were included in our study. Anthropometries information including body weight, height and risk factors for colorectal advanced adenoma were collected. Results on colonoscopic diagnosis and personal health records were used for supplementary outcome information retrieval. Multivariate Cox proportional hazard regression models were used to evaluate the hazard ratio (HR) and 95% CI of obesity on the risk for colorectal advanced adenoma. Results 20 811 residents were followed up for 122 739.36 person- years, with a median follow-up time of 5.87 years. A total of 657 cases of advanced adenomas were identified. After adjusting for potential confounding risk factors such as age, sex, family history of CRC, level of education, marriage, cigarette smoking, alcohol drinking, foods intake including fat, fried or pickled, vegetables and fruits etc., the HR was 1.25 (95% CI: 1.04-1.51) for obese people when compared with the normal weight persons. Further stratified analysis by age, gender and family history of CRC, results showed that obese people had a much higher risk of colorectal advanced adenoma than those with normal weight (male: HR=1.57, 95% CI: 1.20-2.04; more than 60- year-old: HR=1.63, 95% CI: 1.23-2.16). Conclusion Data from this large scale population-based study revealed that obesity might be an independent risk factor for colorectal advanced adenoma and the risk increases along with the increase of BMI in China. |
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