Prospective Associations of Body Composition and Body Shape With the Risk of Developing Pancreatic Cancer in the UK Biobank Cohort

IF 3.1 2区医学 Q2 ONCOLOGY Cancer Medicine Pub Date : 2025-03-25 DOI:10.1002/cam4.70809

Sofia Christakoudi, Konstantinos K. Tsilidis, Marc J. Gunter, Elio Riboli

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Abstract

Background

Obesity and diabetes are positively associated with pancreatic cancer risk. It is unclear, however, whether fat or fat-free mass plays a role in these relationships, whether abdominal obesity is more important than general obesity or whether the associations with anthropometric indices and diabetes are independent of each other.

Methods

We used multivariable Cox proportional hazards models to examine the prospective associations of body composition (allometric fat-mass index (AFI) and allometric lean-mass index (ALI), based on bioelectrical impedance, uncorrelated with each other and with height), waist size (allometric waist-to-hip index (WHI), uncorrelated with weight and height) and diabetes with pancreatic cancer risk in UK Biobank. We tested heterogeneity by sex, age and follow-up time with the augmentation method (p_het).

Results

During a mean follow-up of 10.4 years, 999 pancreatic cancer cases were ascertained in 427,939 participants. AFI was positively associated with pancreatic cancer risk in participants overall, independent of ALI, WHI, diabetes and covariates (hazard ratio HR = 1.102; 95% confidence interval CI = 1.033–1.176 per 1 standard deviation (SD) increase), more strongly in women aged under 55 years at recruitment (HR = 1.457; 95% CI = 1.181–1.797; p_het = 0.007) and in men only for follow-up 6 years or longer (HR = 1.159; 95% CI = 1.037–1.295; p_het = 0.075). ALI was positively associated with pancreatic cancer risk in participants overall (HR = 1.072; 95% CI = 1.005–1.145), more specifically in men (HR = 1.132; 95% CI = 1.035–1.238; p_het = 0.091). A positive association of WHI with pancreatic cancer risk was observed only in unadjusted models but was lost after adjustment for smoking status and diabetes. Independent of anthropometric indices, diabetes was associated positively with pancreatic cancer risk in participants overall (HR = 1.688; 95% CI = 1.365–2.087), but in women only for follow-up under 6 years (HR = 2.467; 95% CI = 1.477–4.121; p_het = 0.042).

Conclusions

General obesity (reflected in AFI and ALI) and diabetes but not abdominal obesity were associated positively with pancreatic cancer risk, independent of each other and covariates.

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在英国生物银行队列中，身体组成和体型与患胰腺癌风险的前瞻性关联

背景肥胖和糖尿病与胰腺癌风险呈正相关。然而，目前还不清楚脂肪或无脂肪质量在这些关系中是否起作用，腹部肥胖是否比全身肥胖更重要，也不清楚人体测量指数与糖尿病的关系是否相互独立。方法我们使用多变量 Cox 比例危险模型研究了英国生物库中身体成分（基于生物电阻抗的异速脂肪-质量指数（AFI）和异速瘦肉-质量指数（ALI），两者之间和与身高无关）、腰围（异速腰臀指数（WHI），与体重和身高无关）和糖尿病与胰腺癌风险的前瞻性关联。我们采用增强法（p_het）测试了性别、年龄和随访时间的异质性。结果在平均 10.4 年的随访期间，在 427 939 名参与者中确定了 999 例胰腺癌病例。总体而言，AFI 与参与者的胰腺癌风险呈正相关，不受 ALI、WHI、糖尿病和协变量的影响（危险比 HR = 1.102；95% 置信区间 CI = 1.033-1.176 per 1 standard deviation (1)）。每增加 1 个标准差 (SD) 的危险比 HR = 1.102；95% 置信区间 CI = 1.033-1.176），55 岁以下女性在招募时的危险比更高（HR = 1.457；95% CI = 1.181-1.797；p_het = 0.007），而男性的危险比仅随访 6 年或更长时间（HR = 1.159；95% CI = 1.037-1.295；p_het = 0.075）。在总体参与者中，ALI与胰腺癌风险呈正相关（HR = 1.072; 95% CI = 1.005-1.145），尤其是男性（HR = 1.132; 95% CI = 1.035-1.238; p_het = 0.091）。仅在未调整模型中观察到 WHI 与胰腺癌风险呈正相关，但在调整吸烟状况和糖尿病因素后，这种正相关性消失了。与人体测量指数无关，糖尿病与总体参与者的胰腺癌风险呈正相关（HR = 1.688; 95% CI = 1.365-2.087），但仅女性随访 6 年以下的胰腺癌风险与糖尿病呈正相关（HR = 2.467; 95% CI = 1.477-4.121；p_het = 0.042）。结论全身性肥胖（反映在 AFI 和 ALI 中）和糖尿病与胰腺癌风险呈正相关，但腹部肥胖与胰腺癌风险无关，且与其他因素和协变量无关。

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来源期刊

Cancer Medicine ONCOLOGY-

CiteScore

5.50

自引率

2.50%

发文量

907

审稿时长

19 weeks

期刊介绍： Cancer Medicine is a peer-reviewed, open access, interdisciplinary journal providing rapid publication of research from global biomedical researchers across the cancer sciences. The journal will consider submissions from all oncologic specialties, including, but not limited to, the following areas: Clinical Cancer Research Translational research ∙ clinical trials ∙ chemotherapy ∙ radiation therapy ∙ surgical therapy ∙ clinical observations ∙ clinical guidelines ∙ genetic consultation ∙ ethical considerations Cancer Biology: Molecular biology ∙ cellular biology ∙ molecular genetics ∙ genomics ∙ immunology ∙ epigenetics ∙ metabolic studies ∙ proteomics ∙ cytopathology ∙ carcinogenesis ∙ drug discovery and delivery. Cancer Prevention: Behavioral science ∙ psychosocial studies ∙ screening ∙ nutrition ∙ epidemiology and prevention ∙ community outreach. Bioinformatics: Gene expressions profiles ∙ gene regulation networks ∙ genome bioinformatics ∙ pathwayanalysis ∙ prognostic biomarkers. Cancer Medicine publishes original research articles, systematic reviews, meta-analyses, and research methods papers, along with invited editorials and commentaries. Original research papers must report well-conducted research with conclusions supported by the data presented in the paper.