中国全科医学
中國全科醫學
중국전과의학
CHINESE GENERAL PRACTICE
2015年
1期
41-46
,共6页
闫立辉%陕忠远%孙颖%阎英%卢智泉
閆立輝%陝忠遠%孫穎%閻英%盧智泉
염립휘%협충원%손영%염영%로지천
食管肿瘤%体质指数%腰臀比%病例对照研究
食管腫瘤%體質指數%腰臀比%病例對照研究
식관종류%체질지수%요둔비%병례대조연구
Esophageal neoplasms%Body mass index%Waist to hip ratio%Case _ control study
目的:探讨中老年人体质指数(BMI)、腰臀比(WHR)与食管癌的关系。方法采用以医院为基础的病例对照研究。选取2012年9月—2013年3月入住辽宁医学院附属第一医院、附属第三医院和锦州市中心医院肿瘤科和胸外科病房,经临床组织病理学诊断为食管癌,年龄≥40岁的282例食管癌患者为病例组;选取与病例同期入住相同医院,未患食管及其他消化系统癌症,罹患其他疾病的282例患者为对照组。采用标准调查表对患者进行面对面调查,同时对身高、体质量、腰围、臀围进行测量,并计算 BMI 及 WHR。结果两组患者的年龄、性别、职业、文化程度、居住地及高血压史间差异均无统计学意义(p >0.05);家庭人均月收入、吸烟、饮酒及糖尿病史间差异均有统计学意义(p <0.05)。病例组的 BMI 为(24.43±3.40) kg/ m2,对照组为(22.79±3.30) kg/ m2;病例组男性的WHR 为(0.96±0.05),对照组男性为(0.91±0.05);病例组女性的 WHR 为(0.95±0.05),对照组女性为(0.90±0.07),两组间差异均有统计学意义(p <0.05)。单因素 Logistic 回归分析结果显示,病例组 BMI 为24.00~27.99 kg/ m2、≥28.00 kg/ m2患者发生食管癌的危险性分别为对照组 BMI 为18.50~23.99 kg/ m2患者的1.526倍和1.817倍;WHR >0.95患者发生食管癌的危险性是对照组 WHR <0.83患者的1.854倍。在调整了性别、年龄等多种混杂因素后,多因素 Logistic 回归分析结果显示,与对照组 BMI 为18.50~23.99 kg/ m2患者比较,病例组 BMI 为24.00~27.99 kg/ m2、≥28.00 kg/ m2患者发生食管癌的危险性分别升高59.4%和78.2%;与 WHR <0.83的患者比较,WHR为0.83~0.89、0.90~0.94、>0.94患者发生食管癌的危险性分别升高4.8%、32.6%和36.5%。结论 BMI、WHR是发生食管癌的重要危险因素,超重和肥胖的人群发生食管癌的危险性明显增加,维持正常体质量可能是食管癌发病的保护因素。
目的:探討中老年人體質指數(BMI)、腰臀比(WHR)與食管癌的關繫。方法採用以醫院為基礎的病例對照研究。選取2012年9月—2013年3月入住遼寧醫學院附屬第一醫院、附屬第三醫院和錦州市中心醫院腫瘤科和胸外科病房,經臨床組織病理學診斷為食管癌,年齡≥40歲的282例食管癌患者為病例組;選取與病例同期入住相同醫院,未患食管及其他消化繫統癌癥,罹患其他疾病的282例患者為對照組。採用標準調查錶對患者進行麵對麵調查,同時對身高、體質量、腰圍、臀圍進行測量,併計算 BMI 及 WHR。結果兩組患者的年齡、性彆、職業、文化程度、居住地及高血壓史間差異均無統計學意義(p >0.05);傢庭人均月收入、吸煙、飲酒及糖尿病史間差異均有統計學意義(p <0.05)。病例組的 BMI 為(24.43±3.40) kg/ m2,對照組為(22.79±3.30) kg/ m2;病例組男性的WHR 為(0.96±0.05),對照組男性為(0.91±0.05);病例組女性的 WHR 為(0.95±0.05),對照組女性為(0.90±0.07),兩組間差異均有統計學意義(p <0.05)。單因素 Logistic 迴歸分析結果顯示,病例組 BMI 為24.00~27.99 kg/ m2、≥28.00 kg/ m2患者髮生食管癌的危險性分彆為對照組 BMI 為18.50~23.99 kg/ m2患者的1.526倍和1.817倍;WHR >0.95患者髮生食管癌的危險性是對照組 WHR <0.83患者的1.854倍。在調整瞭性彆、年齡等多種混雜因素後,多因素 Logistic 迴歸分析結果顯示,與對照組 BMI 為18.50~23.99 kg/ m2患者比較,病例組 BMI 為24.00~27.99 kg/ m2、≥28.00 kg/ m2患者髮生食管癌的危險性分彆升高59.4%和78.2%;與 WHR <0.83的患者比較,WHR為0.83~0.89、0.90~0.94、>0.94患者髮生食管癌的危險性分彆升高4.8%、32.6%和36.5%。結論 BMI、WHR是髮生食管癌的重要危險因素,超重和肥胖的人群髮生食管癌的危險性明顯增加,維持正常體質量可能是食管癌髮病的保護因素。
목적:탐토중노년인체질지수(BMI)、요둔비(WHR)여식관암적관계。방법채용이의원위기출적병례대조연구。선취2012년9월—2013년3월입주료녕의학원부속제일의원、부속제삼의원화금주시중심의원종류과화흉외과병방,경림상조직병이학진단위식관암,년령≥40세적282례식관암환자위병례조;선취여병례동기입주상동의원,미환식관급기타소화계통암증,리환기타질병적282례환자위대조조。채용표준조사표대환자진행면대면조사,동시대신고、체질량、요위、둔위진행측량,병계산 BMI 급 WHR。결과량조환자적년령、성별、직업、문화정도、거주지급고혈압사간차이균무통계학의의(p >0.05);가정인균월수입、흡연、음주급당뇨병사간차이균유통계학의의(p <0.05)。병례조적 BMI 위(24.43±3.40) kg/ m2,대조조위(22.79±3.30) kg/ m2;병례조남성적WHR 위(0.96±0.05),대조조남성위(0.91±0.05);병례조녀성적 WHR 위(0.95±0.05),대조조녀성위(0.90±0.07),량조간차이균유통계학의의(p <0.05)。단인소 Logistic 회귀분석결과현시,병례조 BMI 위24.00~27.99 kg/ m2、≥28.00 kg/ m2환자발생식관암적위험성분별위대조조 BMI 위18.50~23.99 kg/ m2환자적1.526배화1.817배;WHR >0.95환자발생식관암적위험성시대조조 WHR <0.83환자적1.854배。재조정료성별、년령등다충혼잡인소후,다인소 Logistic 회귀분석결과현시,여대조조 BMI 위18.50~23.99 kg/ m2환자비교,병례조 BMI 위24.00~27.99 kg/ m2、≥28.00 kg/ m2환자발생식관암적위험성분별승고59.4%화78.2%;여 WHR <0.83적환자비교,WHR위0.83~0.89、0.90~0.94、>0.94환자발생식관암적위험성분별승고4.8%、32.6%화36.5%。결론 BMI、WHR시발생식관암적중요위험인소,초중화비반적인군발생식관암적위험성명현증가,유지정상체질량가능시식관암발병적보호인소。
[AbstraCt] ObjeCtive To explore the association between body mass index(BMI),waist to hip ratio(WHR)and esophageal cancer risk in middle aged and elderly people. Methods A hospital _ based case _ control study was conducted. Cases (n = 282)were esophageal cancer patients who were hospitalized in department of oncology and chest surgery,the First Affiliated Hospital and the Third Affiliated Hospital,Liaoning Medical University and Central Hospital,Jinzhou from September,2012 to March,2013 and confirmed by clinical histopathological examination,and controls(n = 282)were patients admitted to the same hospital for different diseases. All of them received face _ to _ face investigation with a standardized questionnaire. Their height and weight,waist circumference and hip circumference were measured and BMI and WHR were calculated. Results There was no statistically significant difference between two groups about age,gender,occupation,education background,and place of residence,as well as the history of hypertension( p > 0. 05 );but the differences in monthly family income per person, drinking,smoking and diabetic history were significant( p < 0. 05). BMI was(24. 43 ± 3. 40) kg/ m2 in case group and (22. 79 ± 3. 30)kg/ m2 in control group;WHR was(0. 96 ± 0. 05)in male cases,(0. 91 ± 0. 05)in male controls,(0. 95± 0. 05)in female cases,and(0. 90 ± 0. 07)in female controls and the differences between the two groups were significant(p< 0. 05). Univariate Logistic regression showed the danger of occurrence of esophageal cancer in case patients whose BMI was 24. 00 ~ 27. 99 kg/ m2 ,≥28. 00 kg/ m2 was 1. 526 times and 1. 817 times respectively that in control patients whose BMI was 18. 50 ~ 23. 99 kg/ m2;the danger in case groups whose WHR was > 0. 95 was 1. 854 times that in control group whose WHR was< 0. 83. After adjusting many confounding factors such as age and gender,etc. ,multiple logistic regression analysis showed that compared with that in the patients in control whose BMI was 18. 50 ~ 23. 99 kg/ m2 ,the danger of the occurrence in case group patients whose BMI was 24. 00 ~ 27. 99 kg/ m2 ,≥28. 00 kg/ m2 was increased by 59. 4% and 78. 2% respectively;compared with that in the patients in control whose WHR was < 0. 83,the danger of the occurrence in case group patients whose WHR was 0. 83 ~ 0. 89,0. 90 ~ 0. 94, > 0. 94 was increased by 4. 8% ,32. 6% and 36. 5% respectively. ConClusion BMI and WHR are important risk factors for esophageal cancer. Overweight or obesity is associated with a significantly increased risk of esophageal cancer. So keeping normal weight may be a protective factor.