| 杨 欢,王宇婷,范金虎,等.体重变化与食管癌死亡风险分析：基于林县普通人群营养干预试验随访结果[J].中国肿瘤,2025,34(4):319-325. |
| 体重变化与食管癌死亡风险分析：基于林县普通人群营养干预试验随访结果 |
| Weight Change and Mortality Risk of Esophageal Cancer Analysis： a Follow-Up Study in Linxian General Population Nutrition Intervention Cohort |
| 投稿时间：2024-08-05 |
| DOI：10.11735/j.issn.1004-0242.2025.04.A010 |
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| 中文关键词: 体重 食管癌 死亡 队列研究 河南 |
| 英文关键词:weight esophageal cancer mortality cohort study Henan |
| 基金项目:中美营养干预与生物样本保存课题资助项目（75N91022C00059） |
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| 中文摘要: |
| 摘 要：［目的］ 基于中国林县普通人群营养干预试验随访资料，探究体重变化与长期食管癌死亡风险之间的关系。［方法］ 分别在1985年和1991年对河南省原林县的21 028名基线40~69岁健康居民进行2次体重测量，并前瞻性随访其食管癌死亡情况。随访时间截至2016年3月，按2次体重测量的体重差值分为4组，以体重维持组（体重变化<2 kg）作为参照组，采用Cox比例风险模型计算体重减轻≥2 kg组、体重增加2~5 kg组及体重增加≥5 kg组人群的食管癌死亡风险比（hazard ratio，HR）和95%置信区间（confidence interval，CI）。［结果］在末次体重测量后的长期随访中，共计发生1 681例食管癌死亡病例。在调整基线年龄和性别之后，体重增加2~5 kg组、体重增加≥5 kg组人群的食管癌死亡风险较体重维持组分别降低13%（HR=0.87，95%CI：0.77~1.00）、16%（HR=0.84，95%CI：0.72~1.00），而体重减轻≥2 kg组人群的食管癌死亡风险较体重维持组增加23%（HR=1.23，95%CI：1.09~1.38）。在调整了年龄、性别、基线体质指数（body mass index，BMI）分组、吸烟情况、饮酒情况、肿瘤家族史、受教育程度、社区及营养干预因素后，体重减轻≥2 kg仍能显著增加食管癌死亡风险（HR=1.19，95%CI：1.06~1.34）。亚组分析显示，体重变化与年龄、性别、基线BMI状态对食管癌死亡风险影响的交互作用均无统计学意义。［结论］ 体重减轻可能与食管癌死亡风险增加相关。食管鳞状细胞癌高发地区人群可在保持健康体重状态的情况下尽量维持当前体重或适当增重以降低食管癌死亡风险。 |
| 英文摘要: |
| Abstract： ［Purpose］ To explore the association between body weight change and long-term risk of esophageal cancer mortality based on Linxian General Population Nutrition Intervention study. ［Methods］ A total of 21 028 healthy residents aged 40~69 years old at baseline in Linxian of Henan Province were recruited as the study cohort， their body weight were measured in late 1985 and early 1991， and the esophageal cancer mortality was prospectively followed up until March 2016. The cohort was divided into four groups according to weight difference between the two measurements， the body weight maintenance group (change <2 kg) was used as the reference group. The Cox proportional risk model was used to estimate the hazard ratio (HR) and 95% confidence interval (CI) for death from esophageal cancer in the weight loss ≥2 kg group， weight gain 2~5 kg group and weight gain ≥5 kg group. ［Results］ A total of 1 681 esophageal cancer deaths occurred during the follow-up after the last weight measurement. After adjusting for baseline age and sex， the risk of esophageal cancer death was 13% (HR=0.87， 95%CI： 0.77~1.00) and 16% (HR=0.84， 95%CI： 0.72~1.00) lower in the weight gain 2~5 kg and ≥5 kg groups compared to the weight maintenance group， respectively. The risk of esophageal cancer death was 23% higher in the weight loss ≥2 kg group than in the weight maintenance group (HR=1.23， 95%CI： 1.09~1.38). After adjusting for age， sex， baseline BMI group， smoking status， alcohol consumption， family history of cancer， education level， commune and nutritional intervention arms， weight loss ≥2 kg was still associated with a significantly increased risk of esophageal cancer death (HR=1.19， 95%CI： 1.06~1.34). Subgroup analysis showed there was no statistically significant interaction between changes in body weight and age， sex， and baseline BMI status on the risk of esophageal cancer death. ［Conclusion］ Weight loss is associated with an increased risk of esophageal cancer death. People in the high incidence area of esophageal squamous cell carcinoma should maintain their current weight or gain weight appropriately while maintaining a healthy weight state to reduce the risk of esophageal cancer death. |
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