LBPO.PS01 · 人群科学 · Late-Breaking
减去体重，风险犹存：肥胖成人尽管减重仍存在持续的癌症风险
Losing weight, not risk: Persistent cancer risk despite weight loss in adults with obesity
作者与单位 Authors & Affiliations
摘要 Abstract
中文摘要
重要性：WHO预测，在未来十年内，肥胖将开始在某些地区超过吸烟成为可预防的主要癌症病因。全球有近10亿成人罹患肥胖，因此确定减重是否降低癌症风险至关重要。
目的：确定肥胖成人减重是否与肥胖相关癌症、任何癌症以及选定的心脏代谢结局风险降低相关。
设计、机构与参与者：这项前瞻性、基于人群的队列研究纳入了两个具有实测体重和身高的丹麦队列：哥本哈根城市心脏研究（1976-2019年）和哥本哈根普通人群研究（2003-2019年）。通过国家登记系统对参与者进行随访以追踪新发癌症。在所有参与者中考察了肥胖与癌症风险之间的基线关联。体重变化分析限于至少有2次测量的参与者。哥本哈根城市心脏研究中两次检查之间的中位间隔为7.5年，哥本哈根普通人群研究中为10.3年。Cox比例风险模型经过多变量调整。
结果：在138,376名成人中，与正常体重相比，基线肥胖与肥胖相关癌症风险升高相关（风险比[HR]，1.26；95% CI，1.19-1.35），但与任何癌症风险无关（HR，1.04；95% CI，1.00-1.09）。在33,190名有重复测量的参与者中，减重≥10%与肥胖相关癌症风险降低无关（HR，1.06；95% CI，0.87-1.29），而增重≥10%与风险升高相关（HR，1.20；95% CI，1.05-1.37）。在基线肥胖的参与者中，转变为正常体重与肥胖相关癌症风险降低无关（HR，0.95；95% CI，0.34-2.67）。相比之下，减重与2型糖尿病（HR，0.54；95% CI，0.38-0.77）和高血压（HR，0.11；95% CI，0.02-0.83）风险降低相关。
结论与相关性：在肥胖成人中，即使大幅减重也与肥胖相关癌症或任何癌症风险降低无关，而与2型糖尿病和高血压风险降低相关。这些发现提示，预防肥胖对于癌症预防可能至关重要。
查看英文原文 English abstract
Importance: WHO predicts that obesity will begin to surpass smoking as a leading preventable cause of cancer in some regions within the next decade. With nearly 1 billion adults living with obesity, it is critical to determine whether weight loss reduces cancer risk.
Objective: To determine whether weight loss among adults with obesity is associated with reduced risk of obesity-associated cancer, any cancer, and selected cardiometabolic outcomes.
Design, Setting, and Participants: This prospective population-based cohort study included 2 Danish cohorts with measured weight and height: the Copenhagen City Heart Study (1976-2019) and the Copenhagen General Population Study (2003-2019). Participants were followed for incident cancer through national registries. Baseline associations between obesity and cancer risk were examined among all participants. Analyses of weight change were restricted to participants with at least 2 measurements. The median interval between examinations was 7.5 years in the Copenhagen City Heart Study and 10.3 years in the Copenhagen General Population Study. Cox proportional hazards models were multivariable-adjusted.
Results: Among 138 376 adults, baseline obesity was associated with increased risk of obesity-associated cancer (hazard ratio [HR], 1.26; 95% CI, 1.19-1.35) but not with risk of any cancer (HR, 1.04; 95% CI, 1.00-1.09), compared with normal weight. Among 33 190 participants with repeated measurements, weight loss ≥ 10% was not associated with reduced risk of obesity-associated cancer (HR, 1.06; 95% CI, 0.87-1.29), whereas weight gain ≥ 10% was associated with increased risk (HR, 1.20; 95% CI, 1.05-1.37). Among participants with obesity at baseline, transition to normal weight was not associated with reduced risk of obesity-associated cancer (HR, 0.95; 95% CI, 0.34-2.67). By contrast, weight loss was associated with lower risk of type 2 diabetes (HR, 0.54; 95% CI, 0.38-0.77) and hypertension (HR, 0.11; 95% CI, 0.02-0.83).
Conclusions and Relevance: Among adults with obesity, even substantial weight loss was not associated with reduced risk of obesity-associated cancer or any cancer, whereas it was associated with lower risk of type 2 diabetes and hypertension. These findings suggest that prevention of obesity may be critical for cancer prevention.
利益披露 Disclosure
M. Weischer, None..
M. Dahl, None..
S. Afzal, None..
B. G. Nordestgaard, None.