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(2023-02-27 21:24):
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Metabolically (un)healthy obesity and risk of obesity-related cancers: a pooled study
合并研究：新陈代谢（非）健康的肥胖和与肥胖有关的癌症风险
10.1093/jnci/djad008
基于超79万名欧洲人BMI和代谢评分（通过血压、血糖和甘油三酯定义），评估代谢处于异常或正常的人群与癌症风险间的关联；
相比代谢健康体重正常者，代谢异常的肥胖人群患肥胖相关癌症、结直肠癌、胆囊癌等风险增加，子宫内膜癌、肝癌和肾细胞癌的风险最高；
代谢健康的肥胖人群患肥胖相关癌症、男性结肠癌、子宫内膜癌和胆囊癌等风险增加，尽管风险关系较弱；
BMI和代谢健康状况叠加会增加肥胖相关癌症、直肠癌及子宫内膜癌等风险。
Abstract:
BACKGROUND: Studies of obesity with or without metabolic aberrations, commonly termed metabolically unhealthy or healthy obesity, in relation to cancer risk are scarce.METHODS: We investigated body mass index (normal weight, …
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BACKGROUND: Studies of obesity with or without metabolic aberrations, commonly termed metabolically unhealthy or healthy obesity, in relation to cancer risk are scarce.METHODS: We investigated body mass index (normal weight, overweight, obesity) jointly and in interaction with metabolic health status in relation to obesity-related cancer risk (n = 23 630) among 797 193 European individuals. A metabolic score comprising mid-blood pressure, plasma glucose, and triglycerides was used to define metabolically healthy and unhealthy status. Hazard ratios (HRs) and multiplicative interactions were assessed using Cox regression, and additive interactions were assessed using the relative excess risk for interaction. All statistical tests were 2-sided.RESULTS: Metabolically unhealthy obesity, with a baseline prevalence of 7%, was, compared with metabolically healthy normal weight, associated with an increased relative risk of any obesity-related cancer and of colon, rectal, pancreas, endometrial, liver, gallbladder, and renal cell cancer (P < .05), with the highest risk estimates for endometrial, liver, and renal cell cancer (HR = 2.55-3.00). Metabolically healthy obesity showed a higher relative risk for any obesity-related cancer and colon (in men), endometrial, renal cell, liver, and gallbladder cancer, though the risk relationships were weaker. There were no multiplicative interactions, but there were additive, positive interactions between body mass index and metabolic health status on obesity-related and rectal cancer among men and on endometrial cancer (P < .05).CONCLUSIONS: This study highlights that the type of metabolic obesity phenotype is important when assessing obesity-related cancer risk. In general, metabolic aberrations further increased the obesity-induced cancer risk, suggesting that obesity and metabolic aberrations are useful targets for prevention.
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