成年期体质指数与膀胱癌关系的全人群病例对照研究

Body Mass Index and Bladder Cancer Risk:A Popu-lation-based Case-control Study in Shanghai

[目的]研究成年期体质指数(BMI)与上海市区居民膀胱癌危险性的关系。[方法]采用全人群病例对照研究,共调查1996年1月1日～1998年12月31日期间诊断的上海市区膀胱癌新发病例608例,以及性别、年龄配对的人群对照607例。采用非条件Logistic回归模型,调整可能的混杂因素,估计20岁时、成年期最高体重时及参考年份前10年内BMI与膀胱癌发生的比数比(ORs)和95%可信区间(CIs)。[结果]随着20岁时BMI的增加,男性膀胱癌发生的危险性也增加。与四分位数最低组相比,其他各组的OR值分别为1.51(95%CI:1.01～2.25)、2.24(95%CI:1.52～3.31)和1.80(95%CI:1.20～2.69),趋势检验有统计学意义(P=0.001)。未发现成年期最高体重时及参考年份前10年内BMI与男性膀胱癌的发生有统计学关联。女性成年期各个阶段BMI均与膀胱癌的发生有关。与BMI四分位数最低组相比,三个不同阶段四分位数最高组的OR值分别为3.27(95%CI:1.52～7.03)、2.23(95%CI:1.08～4.60)和3.63(95%CI:1.68～7.85),各组趋势检验均有统计学意义。[结论]男性成年初期BMI可能与膀胱癌的发生有关,女性成年期各阶段的BMI均与膀胱癌的发生有关。

[Purpose] To evaluate the association between body mass index（BMI） at different ages in adulthood and risk of bladder cancer in Shanghai.[Methods] A population-based case-control study was conducted in Shanghai during January 1996 to December 1998.The study included 608 incident cases of bladder cancer and 607 age-and sex-frequency matched population controls.Unconditional logistic regression models were used to estimate the odds ratios（ORs） and 95% confidence intervals（95%CIs） between BMI and bladder cancer risk with adjustment for age,smoking status,history of high risk occupation,history of bladder infections and other confounding factors.[Results] Increased BMI at age 20 was associated with an increased risk of bladder cancer among men.Subjects in the 2nd,3rd,and 4th quartiles of BMI had ORs（95% CIs） of 1.51（95% CI：1.01~2.25）,2.24（95% CI：1.52~3.31） and 1.80（95% CI：1.20~2.69）,respectively,as compared with those in the lowest quartile of BMI（P-value for trend = 0.001）.However,no statistically significant trends were observed for the association between highest BMI over lifetime or BMI at 10 years before reference year and bladder cancer risk.Adulthood BMIs also were associated with an increased risk of bladder cancer for women.ORs（95% CIs） of bladder cancer for women in the highest quartile of the highest BMI over lifetime,age 20 or 10 years prior to reference date were 2.23（95% CI：1.08~4.60）,3.27（95% CI：1.52~7.03）,and 3.63（95% CI：1.68~7.85）,respectively,compared with the lowest quartile of respective BMIs（all P-values for trend0.05）.[Conclusions] BMI in early adult life for men and overall adulthood for women may be associated with the increased risk of bladder cancer.