肥胖与非何杰金氏淋巴瘤风险增加有关


  【24drs.com】青年时的肥胖与后来发生非何杰金氏淋巴瘤(NHL)的风险增加有关,此外,NHL风险与妇女摄取反式脂肪、男性及女性少吃蔬菜有关。
  
  这些研究结果来自发表于美国癌症研究国际研讨会第10届年会(开拓癌症预防研究)的一篇研究。
  
  18岁时身体质量指数(BMI)30 kg/m2以上的妇女(与BMI小于21 kg/m2者相较)发生NHL的风险高出19% (风险比[HR]为1.19),男性的风险大致上更高;21岁时BMI值30 kg/m2以上者(与BMI小于23 kg/m2者相较)的风险高出63%(HR,1.63)。
  
  资料来源是两篇著名的大型流行病学研究。
  
  哈佛公卫学院流行病学研究员、在海报展示中发表研究结果的Bertrand博士解释,探讨的资料包括护士健康研究[NHS]的大型妇女世代,以及健康专业人员追踪研究[HPFS]的大型男性世代。
  
  研究发现,18-21岁时肥胖与后来发生非何杰金氏淋巴瘤风险增加有关。Bertrand博士指出,不过没有评估研究对象肥胖的期间有多久。
  
  她表示,这只是概论,研究对象自我报告在18-21岁时的体重,青年时的BMI和成年时的BMI有高度关联,我们发现目前的BMI和男性的NHL有关,但是女性则无。
  
  Bertrand博士提醒,这些是初步结果,需要有其它研究验证。她解释,我们不是很了解这个疾病的风险因素,特别是那些可调控的风险因素。因此,探讨饮食和生活型态的研究相当重要;或许可以找到针对那些高风险者的预防方式资料。
  
  她指出,在未来,她们研究团队将探讨孩童时的体重与随著年纪的变化。虽然已经有许多资料,但这些都只是初步结果,不过,或许可以有更多机会找到及早预防的方式。
  
  NHS之前的分析中,14年的追踪后,研究者报告指出NHL和摄取反式脂肪为正相关,NHL和摄取蔬菜则是负相关。目前的研究是为了延伸这些初步结果,Bertrand博士等人评估了NHL风险和肥胖的关联,更特别探讨了饮食之脂肪、蔬果的因素。
  
  研究对象包括了完成1980年NHS饮食频率问卷[FFQ]的91,227名妇女,以及完成1986年HPFS FFQ的47,542名男性,这些人都没有癌症病史,到了2008年,女性有966例确认的偶发NHL诊断,到了2006年,男性有566个案例。
  
  除了青年时的肥胖,对于BMI值30 kg/m2以上的男性,目前的BMI和NHL风险有关(HR,1.48),不过,在BMI值30 kg/m2以上的妇女并未发现此关联(HR,0.88)。
  
  作者们也发现,整体和特定的饮食脂肪与NHL风险并无关联,但资料显示,饮食中摄取最多反式脂肪的妇女,整体NHL风险增加但未达统计上的显著意义(HR, 1.19)。
  
  此外,每天吃4份以上蔬果的男性和女性与每天吃不到2份者相较时,NHL风险略为降低(男性HR为0.87;女性HR为0.84),水果摄取总量和NHL无关,作者们结论表示,这是有病因异质性的,有超过30种NHL组织型,目前正有研究分析NHS和HPFS这两个世代中,肥胖及饮食与主要NHL组织型的关系,对于NHL病理和预防应可获得更深入的见解。
  
  资料来源:http://www.24drs.com/professional/list/content.asp?x_idno=6636&x_classno=0&x_chkdelpoint=Y
  
  

Obesity Linked to Increased Risk for Non-Hodgkin's Lymphoma

By Roxanne Nelson
Medscape Medical News

October 24, 2011 (Boston, Massachusetts) — Obesity in young adulthood is associated with an increased risk for non-Hodgkin's lymphoma (NHL) later in life. In addition, NHL risk might be associated with trans fat intake in women and a low intake of vegetables in men and women.

These findings come from a study presented here at the Tenth Annual American Association for Cancer Research International Conference on Frontiers in Cancer Prevention Research.

Women with a body mass index (BMI) of 30 kg/m2 or higher at 18 years of age (compared with a BMI below 21 kg/m2) had a 19% higher risk for NHL (hazard ratio [HR], 1.19). The risk for men was substantially higher; those with a BMI of 30 kg/m2 or higher at 21 years of age (compared with a BMI below 23 kg/m2) had a risk that was 63% higher (HR, 1.63).

The data sources are 2 large well-known epidemiology studies.

"We looked at data from the Nurses Health Study [NHS], which is a large cohort of women, and we also looked at data from the Health Professionals' Follow-Up Study [HPFS], which is a large cohort of men," explained study author Kimberly Bertrand, ScD, a research fellow in the Department of Epidemiology at the Harvard School of Public Health, Boston, Massachusetts, who presented the results of the study during a poster session.

We found that "being obese as a young adult (ages 18 to 21) was associated with an increased risk of non-Hodgkin's lymphoma later in life," she said. Dr. Bertrand noted that the length of time that a person was obese has not yet been evaluated.

"This was basically a snapshot — what people reported their weight to be at age 18 through age 21," she told Medscape Medical News. "Body mass index in early adulthood is highly correlated with body mass index in adulthood. We saw that current body mass index was associated with NHL in men, but we didn't see that in women."

These are preliminary results and need to be confirmed in other trials, Dr. Bertrand cautioned. "We don't understand the risk factors for this disease very well, especially modifiable risk factors," she explained. "That's why research that looks at diet and lifestyle is really important; it might inform future prevention messages aimed at people who are at a higher risk."

In the future, she pointed out, her team is going to look at body weight in childhood and weight change over time. "We have a lot of data. Again, these are just preliminary results," she noted. However, "there may be great opportunities for preventive measures to be taken earlier."

Trans Fats and Veggies

In previous analyses of the NHS, the researchers reported positive associations between NHL and trans fat intake and inverse associations between NHL and vegetable intake after14 years of follow-up. The current study was undertaken to expand on these earlier findings. Dr. Bertrand and colleagues evaluated the association between risk for NHL and obesity, specific types of dietary fats, and fruits and vegetables.

The cohort consisted of 91,227 women who completed the 1980 NHS food frequency questionnaire (FFQ) and 47,542 men who completed the 1986 HPFS FFQ and had no history of cancer. There were 966 confirmed incident diagnoses of NHL among women through 2008 and 566 cases among men through 2006.

In addition to obesity in early adulthood, current BMI was associated with NHL in men with a BMI of 30 kg/m2 or higher (HR, 1.48). However, this association was not observed in women a BMI of 30 kg/m2 or higher (HR, 0.88).

The authors also found that total and specific dietary fats were not associated with NHL risk, but data suggested that women who consumed the highest amounts of trans fat in their diets had a nonstatistically significant increased risk for NHL overall (HR, 1.19).

In addition, both men and women who consumed 4 or more servings of vegetables per day, compared with those who consumed less than 2 servings per day, had a slightly lower risk for NHL (HR for men, 0.87; HR for women, 0.84). Total fruit intake was not associated with NHL.

"It is plausible that there is etiologic heterogeneity across the more than 30 NHL histologic subtypes," conclude the authors. "Ongoing analyses to examine the relationship of obesity and diet with major NHL histologic subtypes in the NHS and HPFS may yield further insights into their roles in NHL etiology and prevention."

Tenth Annual American Association for Cancer Research (AACR) International Conference on Frontiers in Cancer Prevention Research: Abstract A73. Presented October 23, 2011.

    
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