体质指数与非吸烟女性肺癌关系的病例对照研究

A Case Control Study on Relationship between Body Mass Index and Lung Cancer in Non smoking Women

目的研究分析体质指数（ＢＭＩ）与非吸烟女性肺癌的关系。方法１９９２年２月至１９９３年１２月，根据在上海地区开展的一项大规模女性肺癌人群基础上的病例对照研究，共调查了非吸烟女性肺癌病例５０４例及人群对照６０１例。结果随着体质指数的降低，肺癌的危险性增加。以最低一组ＢＭＩ的调整比数比（ＯＲ）来看，与参比组相比，其患肺癌的危险性约增加了１倍，而且有明显的剂量反应关系存在（趋势检验，Ｐ＝０．０００２）。分析中调整了年龄、文化程度和经济收入三个混杂因素。进一步结合国内女性肺癌研究中所发现的一些主要危险因素，用非条件ｌｏｇｉｓｔｉｃ回归模型调整了诸如被动吸烟、饮茶、眼睛受油烟烟雾刺激程度、烹调常用油类型、肺结核、肺癌家族史、月经初潮年龄和月经周期等因素，以及一些膳食营养素（如维生素Ｃ和Ｅ、β胡萝卜素、总能量和总脂肪的摄入量）。调整后的结果，ＢＭＩ与女性肺癌的关系仍然存在。研究中还按肺癌的不同组织学类型做了分析。结果是ＢＭＩ与女性肺癌的关系主要表现在肺腺癌。结论体质指数可能是非吸烟女性肺癌的危险因素之一。

Objective To investigate the relationship between body mass index (BMI) and lung cancer in non smoking women. Methods A population based case control study on lung cancer in non smoking women was conducted during February 1992 to December 1993 in Shanghai. Totally,504 cases of lung cancer of non smoking women and 601 population controls were studied. Results The risk of lung cancer increased with the decrease of BMI. The odds ratio of lung cancer in non smoking women was 1.95, as compared to controls with the highest quartile of their BMI,with a dose-response pattern ( P <0.000 2 with χ 2 test for trend ),adjusted for age,schooling and income. Non conditional logistic regression analysis was used to adjust for some main risk factors found in other studies carried out at home,such as passive smoking,tea drinking,eye irritation by cooking oil fume,kinds of cooking oils,pulmonary tuberculosis,family history of lung cancer,age of menarche ,menstrual cycle and dietary nutrition(including intake of vitamins C and E,β-carotene,total fat and calorie ),was used to adjust. There still existed relationship between BMI and lung cancer in non smoking women after adjustment for those factors.Stratification analysis showed that there was relationship mainly between BMI and lung adenocarcinoma. Conclusion BMI may be a risk factor for lung cancer in non smoking women.