BMI与吸烟男性肺癌发病关系的前瞻性队列研究  

Body mass index and the risk of lung cancer incidence in smokers： a prospective cohort study

作　　者：李放[1] 谢双华 王刚[3] 苏凯[1] 冯小双 吕章艳 郭兰伟 陈朔华[4] 昌盛[1] 陈玉恒 任建松 石菊芳 杨文静 崔宏 吴寿岭[4] 代敏 李霓[4] 赫捷[1] 

机构地区：[1]中国医学科学院北京协和医学院肿瘤医院胸外科,100021 [2]全国肿瘤防治研究办公室城市癌症早诊早治项目办公室 [3]开滦总医院肿瘤科 [4]开滦总医院心内科

出　　处：《中华预防医学杂志》2016年第5期385-390,共6页Chinese Journal of Preventive Medicine

基　　金：国家自然科学基金（81172757、30901236、81373079）;2014年公益性行业科研专项（201402003）;北京市科技新星计划（xx2012067）

摘　　要：目的分析BMI与吸烟男性肺癌发病风险的关系。方法以开滦集团全体在职及离退休男性职工为调查对象，自2006年5月开始，按照统一标准，每2年对其进行健康检查。截至2011年12月3113，共完成3次健康检查。进入队列的时间为首次参加健康检查的时间，观察期截止时间为发生癌症时间、死亡时间或随访截止时间（2011年12月31日），最终进入研究队列的调查对象为42718名。收集基线调查时的社会人口学特征，吸烟、饮酒等生活方式信息，身高、体重等测量指标信息，肿瘤发病结局信息。采用多因素Cox比例风险回归模型分析调查对象基线BMI与肺癌发病风险的关系。结果42718名吸烟男性共随访181998．09人年，平均随访4．26年，共234例肺癌新发病例，粗发病密度为128．57／10万人年。调整年龄、文化程度、饮酒、体育锻炼、工作环境和累计吸烟量（包年）等因素后，与正常体重者相比，低体重组、超重组、肥胖组肺癌发病的HR（95％CI）值分别为1．63（0．79～3．37）、0．79（0．57～1．09）、0．50（0．27～0．91）。调整年龄、文化程度、饮酒、体育锻炼、工作环境和累计吸烟量（包年）等因素后，与正常体重者相比：t〉50岁组中，肥胖者肺癌发病的删2（95％讲）值为0．33（0．15～0．71）；累计吸烟量t〉20包年组中，肥胖者肺癌发病的上限（95％c，）值为0．27（0．10～0．75）；体育锻炼频率〈4次／周组中，肥胖者肺癌发病的HR（95％CI）值为0．44（0．20～0．96）；井上工作组中，肥胖者肺癌发病的HR（95％CI）值为0．38（0．15～0．96）。结论BMI与吸烟男性肺癌的发生呈负相关，对于吸烟男性，戒烟和保持适当的体重可能是预防和控制肺癌的有效措施之一。Objective To investigate the effect of baseline body mass index （BMI） on the risk of lung cancer incidence in male smokers. Methods All the male employees and retirees of the Kailuan Group were recruited in the Chinese Kailuan Male Cohort Study, and they had been experienced routine physical examinations every two years since May, 2006. Up to 31st December 2011, a total of 3 rounds physical examinations bad been completed. A total of 42 718 male smokers candidates from the Chinese Kailuan Male Cohort Study were enrolled in the present study. The date of entering this study was defined as that of taking first check-up, and the date of end-of-observation was defined as that of cancer diagnosis, death or end of follow-up （31 December 2011）. Information on demographics, lifestyle such as smoking, alcohol consumption, anthropometries such as height and weight, as well as the information of newly-diagnosed cancer cases, were collected at the baseline investigation. Multivariable Cox proportional hazards regression models were used to investigate the association between levels of the baseline BMI and risk of lung cancer. Results Of the 42 718 male smokers, there were 181 998.09 person-years of follow-up, taking 4.26 years of average follow-up period. During follow-up, 234 new lung cancer cases were identified among the 42 718 male smokers and the crude incidence density was 128.57/100 000. After the factors adjustment for age, education level, alcohol consumption, physical activity, work environment and cumulative smoking levels （pack-years）, compared with subjects of normal BMI group, hazard ratio and 95% confidence intervals of lung cancer for subjects of under^eight, overweight, and obesity were 1.63 （0.79- 3.37）, 0.79 （0.57-1.09） and 0.50 （0.27-0.91）, respectively. After the facotors adjustment for age, education level, alcohol consumption, physical activity, work environment and cumulative smoking levels （pack-years）, compared with subjects of normal BMI, hazard ratio and 95% confidence

关 键 词：肺肿瘤 吸烟 前瞻性研究 

分 类 号：R734.2[医药卫生—肿瘤]