Association between Body Mass Index and Gastric Cancer Risk According to Effect Modification by Helicobacter pylori Infection
2
조회
0
다운로드
0
인용
0
참고문헌
키워드
초록
Purpose Few studies investigated roles of body mass index (BMI) on gastric cancer (GC) risk according to Helicobacter pylori infection status. This study was conducted to evaluate associations between BMI and GC risk with consideration of H. pylori infection information. Materials and Methods We performed a case-cohort study (n=2,458) that consists of a subcohort (n=2,193 including 67 GC incident cases) randomly selected from the Korean Multicenter Cancer Cohort (KMCC) and 265 incident GC cases outside of the subcohort. H. pylori infection was assessed using an immunoblot assay. GC risk according to BMI was evaluated by calculating hazard ratios (HRs) and their 95% confidence intervals (95% CIs) using weighted Cox hazard regression model. Results Increased GC risk in lower BMI group (< 23 kg/m2) with marginal significance (HR, 1.32; 95% CI, 0.98 to 1.77) compared to the reference group (BMI of 23-24.9 kg/m2) was observed. In the H. pylori non-infection, both lower (< 23 kg/m2) and higher BMI (! 25 kg/m2) showed non-significantly increased GC risk (HR, 10.82; 95% CI, 1.25 to 93.60 and HR, 11.33; 95% CI, 1.13 to 113.66, respectively). However, these U-shaped associations between BMI and GC risk were not observed in the group who had ever been infected by H. pylori. Conclusion This study suggests the U-shaped associations between BMI and GC risk, especially in subjects who had never been infected by H. pylori.
Abstract
Purpose Few studies investigated roles of body mass index (BMI) on gastric cancer (GC) risk according to Helicobacter pylori infection status. This study was conducted to evaluate associations between BMI and GC risk with consideration of H. pylori infection information. Materials and Methods We performed a case-cohort study (n=2,458) that consists of a subcohort (n=2,193 including 67 GC incident cases) randomly selected from the Korean Multicenter Cancer Cohort (KMCC) and 265 incident GC cases outside of the subcohort. H. pylori infection was assessed using an immunoblot assay. GC risk according to BMI was evaluated by calculating hazard ratios (HRs) and their 95% confidence intervals (95% CIs) using weighted Cox hazard regression model. Results Increased GC risk in lower BMI group (< 23 kg/m2) with marginal significance (HR, 1.32; 95% CI, 0.98 to 1.77) compared to the reference group (BMI of 23-24.9 kg/m2) was observed. In the H. pylori non-infection, both lower (< 23 kg/m2) and higher BMI (! 25 kg/m2) showed non-significantly increased GC risk (HR, 10.82; 95% CI, 1.25 to 93.60 and HR, 11.33; 95% CI, 1.13 to 113.66, respectively). However, these U-shaped associations between BMI and GC risk were not observed in the group who had ever been infected by H. pylori. Conclusion This study suggests the U-shaped associations between BMI and GC risk, especially in subjects who had never been infected by H. pylori.
참고문헌 (28)
- Ferlay J, "Cancer incidence and mortality worldwide: sources, methods and major patterns in GLOBOCAN 2012", Int J Cancer, 136, pp.E359~E386 (2012)
- Soerjomataram I, "Global burden of cancer in 2008 : a systematic analysis of disability-adjusted life-years in 12 world regions", Lancet, 380, pp.1840~1850 (2012)
- 정규원, "Cancer Statistics in Korea: Incidence, Mortality, Survival, and Prevalence in 2014", Cancer Research and Treatment, 49(2), pp.292~305 (2017), 대한암학회
- Nguyen DM, "The epidemiology of obesity", Gastroenterol Clin North Am, 39, pp.1~7 (2010)
- Calle EE, "Overweight, obesity and cancer : epidemiological evidence and proposed mechanisms", Nat Rev Cancer, 4, pp.579~591 (2004)
- Abnet CC, "A prospective study of BMI and risk of oesophageal and gastric adenocarcinoma", Eur J Cancer, 44, pp.465~471 (2008)
- Corley DA, "Abdominal obesity and the risk of esophageal and gastric cardia carcinomas", Cancer Epidemiol Biomarkers Prev, 17, pp.352~358 (2008)
- Merry AH, "Body mass index, height and risk of adenocarcinoma of the oesophagus and gastric cardia : a prospective cohort study", Gut, 56, pp.1503~1511 (2007)
- Chen Y, "Body mass index and risk of gastric cancer : a meta-analysis of a population with more than ten million from 24 prospective studies", Cancer Epidemiol Biomarkers Prev, 22, pp.1395~1408 (2013)
- Bhaskaran K, "Body-mass index and risk of 22 specific cancers:a population-based cohort study of 5.24 million UK adults", Lancet, 384, pp.755~765 (2014)
- Fan JH, "Body mass index and risk of gastric cancer : a 30-year followup study in the Linxian general population trial cohort", Cancer Sci, 108, pp.1667~1672 (2017)
- Wayman J, "Monitoring the changing pattern of esophago-gastric cancer : data from a UK regional cancer registry", Cancer Causes Control, 12, pp.943~949 (2001)
- Bray F, "Cancer incidence in five continents : inclusion criteria, highlights from Volume X and the global status of cancer registration", Int J Cancer, 137, pp.2060~2071 (2015)
- Colquhoun A, "Global patterns of cardia and non-cardia gastric cancer incidence in 2012", Gut, 64, pp.1881~1888 (2015)
- Schistosomes, liver flukes and Helicobacter pylori. IARC monographs on the evaluation of carcinogenic risks to humans. Vol. 61, "IARC Working Group on the Evaluation of Carcinogenic Risks to Humans", International Agency Research on Cancer, ~ (1994)
- Argent RH, "Differences in Helicobacter pylori CagA tyrosine phosphorylation motif patterns between western and East Asian strains, and influences on interleukin-8 secretion", J Med Microbiol, 57(Pt 9), pp.1062~1067 (2008)
- Lender N, "Review article : associations between Helicobacter pylori and obesity : an ecological study", Aliment Pharmacol Ther, 40, pp.24~31 (2014)
- Yoo KY, "Korean multi-center cancer cohort study including a biological materials bank(KMCC-I)", Asian Pac J Cancer Prev, 3, pp.85~92 (2002)
- Obesity: preventing and managing the global epidemic: report on a WHO consultation, "World Health Organization", World Health Organization, ~, pp.No.894 (1997)
- Yamaoka Y, "Mechanisms of disease : Helicobacter pylori virulence factors", Nat Rev Gastroenterol Hepatol, 7, pp.629~641 (2010)
- Park CY, "New serological assay for detection of putative Helicobacter pylori virulence factors", J Clin Microbiol, 40, pp.4753~4756 (2002)
- Barlow WE, "Analysis of casecohort designs", J Clin Epidemiol, 52, pp.1165~1172 (1999)
- Monteiro R, "Chronic inflammation in obesity and the metabolic syndrome", Mediators Inflamm, 2010, pp.289645~ (2010)
- Marti A, "Obesity and immune function relationships", Obes Rev, 2, pp.131~140 (2001)
- Bird JK, "Risk of deficiency in multiple concurrent micronutrients in children and adults in the United States", Nutrients, 9, pp.E655~ (2017)
- Kong P, "Vitamin intake reduce the risk of gastric cancer: meta-analysis and systematic review of randomized and observational studies", PLoS One, 9, pp.e116060~ (2014)
- Reuter S, "Oxidative stress, inflammation, and cancer: how are they linked?", Free Radic Biol Med, 49, pp.1603~1616 (2010)
- Dolan K, "New classification of oesophageal and gastric carcinomas derived from changing patterns in epidemiology", Br J Cancer, 80, pp.834~842 (1999)