CAJ | 학술논문

目的：探讨肥胖与中国人群肺癌发病风险的关系，分析BMI与肺癌发病风险的剂量-反应关系。方法系统性检索国内外公开发表的有关中国人群BMI与肺癌发病关系的文献，并辅以文献追溯等方法，检索数据库包括中国知网、万方数据知识服务平台、PubMed、Embase和Google Scholar，时间范围从各数据库建库至2014年9月，共检索到93篇文献。采用Meta分析方法计算肥胖与肺癌发病风险的合并OR（95%CI）值，运用广义最小二乘估计方法（GLST）估计BMI与肺癌发病风险的剂量-反应关系。结果最终纳入文献7篇，纳入肺癌病例2351例。Meta分析结果表明，肥胖与肺癌发病风险呈负相关（OR=0.68，95%CI：0.59～0.79），并且这种负相关不受研究类型、性别、吸烟状况、BMI获取方式和病例来源的影响，异质性检验结果I2=0，P=0.594。BMI与肺癌发病风险呈线性剂量-反应关系，BMI每增加5 kg/m2，肺癌发病风险降低21%（OR=0.79,95%CI：0.71～0.89），异质性检验结果q=22.43，P=0.002。结论 BMI较高是中国人群肺癌发病的一个保护性因素，由于吸烟是肺癌最重要的危险因素，可能有一定的混杂作用。
목적：탐토비반여중국인군폐암발병풍험적관계，분석BMI여폐암발병풍험적제량-반응관계。방법계통성검색국내외공개발표적유관중국인군BMI여폐암발병관계적문헌，병보이문헌추소등방법，검색수거고포괄중국지망、만방수거지식복무평태、PubMed、Embase화Google Scholar，시간범위종각수거고건고지2014년9월，공검색도93편문헌。채용Meta분석방법계산비반여폐암발병풍험적합병OR（95%CI）치，운용엄의최소이승고계방법（GLST）고계BMI여폐암발병풍험적제량-반응관계。결과최종납입문헌7편，납입폐암병례2351례。Meta분석결과표명，비반여폐암발병풍험정부상관（OR=0.68，95%CI：0.59～0.79），병차저충부상관불수연구류형、성별、흡연상황、BMI획취방식화병례래원적영향，이질성검험결과I2=0，P=0.594。BMI여폐암발병풍험정선성제량-반응관계，BMI매증가5 kg/m2，폐암발병풍험강저21%（OR=0.79,95%CI：0.71～0.89），이질성검험결과q=22.43，P=0.002。결론 BMI교고시중국인군폐암발병적일개보호성인소，유우흡연시폐암최중요적위험인소，가능유일정적혼잡작용。
Objective To investigate the association between obesity and the risk of lung cancer and evaluate a dose-response relationship between body mass index (BMI) and incidence risk of lung cancer in the Chinese population. Methods A systematic literature search for BMI and incidence risk of lung cancer in the Chinese population, as well as through the reference lists of retrieved articles. The literature databases including Chinese National Knowledge Infrastructure, Wanfang, PubMed, Embase and Google Scholar. Time range was from the founding of each database to September 2014 and a total of 93 research papers were collected. Meta-analysis was conducted to calculate pooled odds ratio and corresponding 95%CI. Generalized least-squares regression methods were used to make a dose-response meta-analysis between BMI and incidence risk of lung cancer. Results Seven studies were included in the meta-analysis, with a number of 2 351 lung cancer cases. Results showed that obesity was inversely associated with lung cancer incidence (OR=0.68, 95%CI:0.59-0.79) (heterogeneity test:I2=0,P=0.594). The association did not change with stratification by study design, sex, smoking status, BMI measurement method and study population. A linear dose-response association between BMI and risk of lung cancer was visually significant, and lung cancer risk would be reduced 21% for per 5 kg/m2 BMI increase (OR=0.79, 95% CI: 0.71- 0.89) (heterogeneity test:q=22.43,P=0.002). Conclusion The results of this meta-analysis indicated that higher BMI was a protective factor against lung cancer, but smoking may play a stronger role as a confounding factor for the most important role with lung cancer incidence.