代谢综合征及其组分与胃癌发生风险前瞻性队列研究

Associations of metabolic syndrome and its components with risk of gastric cancer:a prospective cohort study

目的全面地评估代谢综合征(MetS)及其组分与胃癌风险间的关联。方法基于英国生物样本库队列474929名参与者数据研究代谢综合征及其组分与不同性别、解剖位置的胃癌之间的关联,使用Cox模型估计多变量风险比(HR)和95%置信区间(CI),并调整人口社会特征、饮食习惯、生活方式和药物使用等混杂因素。结果在为期6.5年的中位随访时间内,一共有335例胃癌事件的发生,其中包括139例食管胃交界处腺癌(EJAC)和196例胃腺癌(GAC)。Met S只与男性EJAC风险显著相关(HR=1.63,95%CI:1.11~2.41),与GAC风险无关(HR=1.15,95%CI:0.77~1.71)。女性人群Met S与胃癌发病风险并无显著关联,无论是EJAC还是GAC。各代谢组分中,只有腰围增大与男性EJAC风险存在显著关联(HR=1.72,95%CI:1.05~2.80)。女性人群无任何代谢组分与胃癌风险相关。结论Met S是男性胃癌的潜在危险因素,这一正向关联主要是由EJAC而非GAC驱动的。腹部肥胖与男性EJAC风险增加有关。

Objective To investigate comprehensively the association between metabolic syndrome(MetS)and gastric cancer.Methods Met S and its components in relation to gastric cancer by sex and anatomical site for 474929 participants from the UK Biobank cohort were investigated.Multivariable hazard ratio(HR)and 95%confidence interval(CI)were estimated using Cox models adjusting for demography,dietary habits,lifestyle factors and drugs use.Results During a median follow-up of 6.5 years,a total of 335 cases of gastric cancer were documented,including 139 cases of esophagogastric junction adenocarcinoma(EJAC)and 196 cases of gastric adenocarcinoma(GAC).Individuals with Met S(HR=1.63,95%CI:1.11-2.41)had increased risk of EJAC in men,but not GAC(HR=1.15,95%CI:0.77-1.71).In females,Met S was not associated with risk of GC regardless of cancer location.Regarding associations between the individual metabolic components and gastric cancer,increased waist circumference(HR=1.72,95%CI:1.05-2.80)was independently related to EJAC in men.No metabolic component alone had a statistically significant association with gastric cancer in women.Conclusions Met S was a potential risk factor for gastric cancer in men,and the positive association was largely driven by EJAC but not GAC.Abdominal obesity was associated with an increased risk of EJAC in men.