肥胖與非何杰金氏淋巴瘤風險增加有關


  【24drs.com】青年時的肥胖與後來發生非何杰金氏淋巴瘤(NHL)的風險增加有關,此外,NHL風險與婦女攝取反式脂肪、男性及女性少吃蔬菜有關。
  
  這些研究結果來自發表於美國癌症研究國際研討會第10屆年會(開拓癌症預防研究)的一篇研究。
  
  18歲時身體質量指數(BMI)30 kg/m2以上的婦女(與BMI小於21 kg/m2者相較)發生NHL的風險高出19% (風險比[HR]為1.19),男性的風險大致上更高;21歲時BMI值30 kg/m2以上者(與BMI小於23 kg/m2者相較)的風險高出63%(HR,1.63)。
  
  資料來源是兩篇著名的大型流行病學研究。
  
  哈佛公衛學院流行病學研究員、在海報展示中發表研究結果的Bertrand博士解釋,探討的資料包括護士健康研究[NHS]的大型婦女世代,以及健康專業人員追蹤研究[HPFS]的大型男性世代。
  
  研究發現,18-21歲時肥胖與後來發生非何杰金氏淋巴瘤風險增加有關。Bertrand博士指出,不過沒有評估研究對象肥胖的期間有多久。
  
  她表示,這只是概論,研究對象自我報告在18-21歲時的體重,青年時的BMI和成年時的BMI有高度關聯,我們發現目前的BMI和男性的NHL有關,但是女性則無。
  
  Bertrand博士提醒,這些是初步結果,需要有其他研究驗證。她解釋,我們不是很暸解這個疾病的風險因素,特別是那些可調控的風險因素。因此,探討飲食和生活型態的研究相當重要;或許可以找到針對那些高風險者的預防方式資料。
  
  她指出,在未來,她們研究團隊將探討孩童時的體重與隨著年紀的變化。雖然已經有許多資料,但這些都只是初步結果,不過,或許可以有更多機會找到及早預防的方式。
  
  NHS之前的分析中,14年的追蹤後,研究者報告指出NHL和攝取反式脂肪為正相關,NHL和攝取蔬菜則是負相關。目前的研究是為了延伸這些初步結果,Bertrand博士等人評估了NHL風險和肥胖的關聯,更特別探討了飲食之脂肪、蔬果的因素。
  
  研究對象包括了完成1980年NHS飲食頻率問卷[FFQ]的91,227名婦女,以及完成1986年HPFS FFQ的47,542名男性,這些人都沒有癌症病史,到了2008年,女性有966例確認的偶發NHL診斷,到了2006年,男性有566個案例。
  
  除了青年時的肥胖,對於BMI值30 kg/m2以上的男性,目前的BMI和NHL風險有關(HR,1.48),不過,在BMI值30 kg/m2以上的婦女並未發現此關聯(HR,0.88)。
  
  作者們也發現,整體和特定的飲食脂肪與NHL風險並無關聯,但資料顯示,飲食中攝取最多反式脂肪的婦女,整體NHL風險增加但未達統計上的顯著意義(HR, 1.19)。
  
  此外,每天吃4份以上蔬果的男性和女性與每天吃不到2份者相較時,NHL風險略為降低(男性HR為0.87;女性HR為0.84),水果攝取總量和NHL無關,作者們結論表示,這是有病因異質性的,有超過30種NHL組織型,目前正有研究分析NHS和HPFS這兩個世代中,肥胖及飲食與主要NHL組織型的關係,對於NHL病理和預防應可獲得更深入的見解。
  
  資料來源: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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