ANN Oncol:惊!!肥胖会导致癌症 ??

2018-01-16 惠语 肿瘤资讯

肥胖不仅有悖于国人的审美,还会导致诸多慢性病。在一些研究中表明体重指数(BMI)与某些部位(如消化系统)癌症发病风险呈相关,但与其他部位癌症的关系尚无统一结论。

肥胖不仅有悖于国人的审美,还会导致诸多慢性病。在一些研究中表明体重指数(BMI)与某些部位(如消化系统)癌症发病风险呈相关,但与其他部位癌症的关系尚无统一结论。2017年底发表在Annals of Oncology的一项umbrella review,综合分析了26项BMI与癌症发病风险之间关系的Meta分析,力求为读者带来最权威的结论。

目的:

为BMI与多种癌症发生风险之间的关系提供较为全面的概述,并通过分析论证证据的强度。

方法:

研究只纳入评价BMI与各癌种发病风险之间的计量反应Meta分析,共计26篇。采用umbrella review(即对多项Meta分析进行综述),重新综合分析了BMI与20种癌症(膀胱癌,脑癌,乳腺癌结肠癌,直肠癌,子宫内膜癌,胆囊癌,胃癌白血病,肝癌、肺癌,黑色素瘤,多发性骨髓瘤,非何杰金氏淋巴瘤,食道癌,卵巢癌胰腺癌,前列腺癌,肾癌,甲状腺癌)之间的发病关系,并按照以下标准对各癌种与BMI的关联强度进行了区分:

√最高级关联强度:Meta分析中无论固定效应还是随机效应检验中都存在较强的统计学关联性(P<0.001),95%预测区间(PI)不包含1,并且各个研究间没有大的异质性和发表偏倚;

√中等关联强度:随机效应检验P<0.05,95%PI包含1;

√低级别关联强度:随机效应检验P<0.05,95%PI包含1,并且存在大的研究间异质性或者存在发表偏倚;

√无关联:随机效应检验P<0.05。

结果:

五种癌症(白血病,多发性骨髓瘤,胰腺癌,子宫内膜癌,直肠癌和肾细胞癌)与BMI达到最高级关联强度;三种癌症(恶性黑色素瘤,非霍奇金淋巴瘤和食管腺癌)与BMI达到中等级别的关联强度;对于脑和中枢神经系统肿瘤,乳腺癌,结肠癌,胆囊癌,肺癌,肝癌,卵巢癌和甲状腺癌与BMI之间存在低级别的关联程度;而膀胱癌,胃癌和前列腺癌的发生与BMI之间没有关联性。

结论:

BMI增加与癌症发生之间的关系在不同癌症间差异较大。通过剂量反应性Meta分析,白血病,多发性骨髓瘤,胰腺癌,子宫内膜癌,直肠癌和肾细胞癌的发生与BMI增加有较强的关联性。



文献纳入流程图

原始出处:
Choi EK, , Park HB, Lee KH, et al. Body mass index and 20-specific cancers: re-analyses of dose-response meta-analyses of observational studies. Ann Oncol. 2017 Dec 28. doi: 10.1093/annonc/mdx819. 

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createdAvatar=https://wx.qlogo.cn/mmopen/NUyjXTCJjo5nmIH5IQqCKjJgSCuicPWUWOUcdqt1ROPnEiaOYN4pSHibDv8la3OxNLalvuvUXn8clpJlrpuyTpckgt9OPkeSSdT/0, createdBy=8fd71930726, createdName=半夏微凉, createdTime=Wed Jan 17 09:15:43 CST 2018, time=2018-01-17, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=279330, encodeId=83382e933011, content=学习了新知识, beContent=null, objectType=article, channel=null, level=null, likeNumber=23, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://img.medsci.cn/20201006/4db877c2887649beb09cb5effd0b38c7/916f66edd48a4e77b20ebc3e14b6e45c.jpg, createdBy=141e1980133, createdName=Y—xianghai, createdTime=Wed Jan 17 08:11:14 CST 2018, time=2018-01-17, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=279318, encodeId=76ed2e931842, content=学习学习.继续关注, beContent=null, objectType=article, channel=null, level=null, likeNumber=17, replyNumber=0, topicName=null, 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    2018-08-24 minlingfeng
  2. 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13:11:23 CST 2018, time=2018-01-24, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=280510, encodeId=f9322805108d, content=有高关联的癌症和想象中不一样。有合理性的研究应该不少了, beContent=null, objectType=article, channel=null, level=null, likeNumber=59, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=191d1636362, createdName=wodexinxi, createdTime=Sun Jan 21 03:22:20 CST 2018, time=2018-01-21, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=280435, encodeId=a533280435f6, content=肥胖可导致癌症早就有人说了, beContent=null, objectType=article, channel=null, level=null, likeNumber=50, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://cdnapi.center.medsci.cn/medsci/head/2017/10/10/16d33b9abecd6440b30b37e6ad8db1a6.jpg, createdBy=f6f72168266, createdName=阿杜12138, createdTime=Sat Jan 20 19:26:46 CST 2018, time=2018-01-20, status=1, 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    2018-01-24 天地飞扬

    这个事得好好研究研究

    0

  3. 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topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=93f31631454, createdName=1dd8c52fm63(暂无匿称), createdTime=Wed Jan 17 07:54:23 CST 2018, time=2018-01-17, status=1, ipAttribution=)]
    2018-01-21 wodexinxi

    有高关联的癌症和想象中不一样。有合理性的研究应该不少了

    0

  4. 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    2018-01-20 阿杜12138

    肥胖可导致癌症早就有人说了

    0

  5. 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    2018-01-18 jambiya
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topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=93f31631454, createdName=1dd8c52fm63(暂无匿称), createdTime=Wed Jan 17 07:54:23 CST 2018, time=2018-01-17, status=1, ipAttribution=)]
    2018-01-17 邓启付

    个人认为他们之间的关系似乎太牵强

    0

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topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=93f31631454, createdName=1dd8c52fm63(暂无匿称), createdTime=Wed Jan 17 07:54:23 CST 2018, time=2018-01-17, status=1, ipAttribution=)]
    2018-01-17 明月清辉

    谢谢分享.学习了

    0

  8. 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topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=93f31631454, createdName=1dd8c52fm63(暂无匿称), createdTime=Wed Jan 17 07:54:23 CST 2018, time=2018-01-17, status=1, ipAttribution=)]
    2018-01-17 半夏微凉

    学习了谢谢分享

    0

  9. 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topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=93f31631454, createdName=1dd8c52fm63(暂无匿称), createdTime=Wed Jan 17 07:54:23 CST 2018, time=2018-01-17, status=1, ipAttribution=)]
    2018-01-17 Y—xianghai

    学习了新知识

    0

  10. 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    2018-01-17 1dd8c52fm63(暂无匿称)

    学习学习.继续关注

    0

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赖氨酰氧化酶(LOX)是对胶原纤维交联和纤维化发展至关重要的酶。纤维化的特征在于胶原纤维的过多积累,其也是与肥胖相关的功能失调性脂肪组织(AT)的特征之一,与2型糖尿病相关。

Diabetes:发现糖皮质激素促进肥胖发生的新通路

中国科学院上海健康院郭非凡研究组近日在国际学术期刊Diabetes上发表了一篇文章,他们在进一步了解糖皮质激素如何诱导肥胖发生方面取得了新的进展。

BMJ:有肥胖基因?饮食管理对你更有用!

近日,来自杜兰大学的研究人员进行了一项非常有意思的前瞻性队列研究,探究了健康饮食模式的改善是否会和肥胖的遗传易感性相互作用,对体重指数和体重的长期变化产生影响。