扬中市40~69岁居民人体测量指标与胃癌及癌前病变的关联分析  

Analysis of the association between anthropometric indicators and gastric cancer and precancerouslesions in residents aged 40-69 years,Yangzhong City

作　　者：印红军[1] 冯祥 华召来[2,3] 陈梦星 仝海员[4] 朱进华[2,3,5,6] YIN Hong-jun;FENG Xiang;HUA Zhao-lai;CHEN Meng-xing;TONG Hai-yuan;ZHU Jin-hua(Department of Gastroenterology,Yangzhong People's Hospital,Yangzhong,Jiangsu 212200,China;不详)

机构地区：[1]扬中市人民医院消化科,江苏扬中210009 [2]扬中市人民医院肿瘤防治研究所 [3]扬中市人民医院慢病筛查科 [4]扬中市疾病预防控制中心慢性病防制科 [5]东南大学附属中大医院消化科 [6]东南大学医学院

出　　处：《现代预防医学》2024年第16期3022-3028,3061,共8页Modern Preventive Medicine

基　　金：国家重点研发计划(2016YFC0901400,2016YFC1302800);中国消化道早癌医师共同成长计划(GTCZ-2021-JS-32-0001);镇江市重点研发计划-社会发展(SH2022051);2023年江苏省预防医学面上项目(Ym2023031)。

摘　　要：目的分析扬中市40~69岁人群11种人体测量指标(AIs)与胃癌及癌前病变的关联。方法采用整群抽样方法,选取2017年11月至2022年12月,扬中市10698名参与上消化癌筛查的40~69岁居民进行问卷调查、体格检查、内镜检查及病理学诊断。采用多因素logistics回归分别分析体质量指数(BMI)、腰围(WC)、腰臀比(WHR)、腰高比(WHtR)、体脂百分比(BF%)、锥度指数(CI)、身体肥胖估计量(BAE)、身体形态指数(ABSI)、身体肥胖指数(BAI)、身体圆度指数(BRI)和腹部容积指数(AVI)与胃癌及癌前病变的关联。结果10115名调查对象胃癌及癌前病变的患病率为39.37%。多因素logistics回归结果显示,与第1分位数(Q1)相比,BMI的Q3和Q4人群患胃癌及癌前病变风险分别降低11.1%(OR=0.889,0.791~0.999)和12.4%(OR=0.876,0.779~0.984)。BF%的Q2,Q3和Q4人群患胃癌及癌前病变风险分别降低14.2%(OR=0.858,0.756~0.974)、17.4%(OR=0.826,0.689~0.991)和26.6%(OR=0.734,0.603~0.893)。BAE的Q2和Q4人群患胃癌及癌前病变风险分别降低13.2%(OR=0.868,0.766~0.983)和21.3%(OR=0.787,0.648~0.957)。BAI的Q2和Q3人群患胃癌及癌前病变风险分别降低13.7%(OR=0.863,0.767~0.970)和13.1%(OR=0.869,0.769~0.983)。分层分析显示,BMI、BF%、BAE和BAI与非贲门胃癌及癌前病变风险降低有关(均P<0.05)。但与Q1相比,仅BAE的Q2水平与贲门胃癌及癌前病变的风险降低有关(P<0.05)。结论扬中市40~69岁人群BMI、BF%、BAE和BAI水平的增加与胃癌及癌前病变患病风险降低相关。这种关联大多适用于非贲门而不是贲门。Objective To analyze the association of 11 anthropometric indicators(AIs)with gastric cancer and precancerous lesions in people aged 40-69 years in Yangzhong City.Methods Using the cluster sampling method,10698 residents aged 40-69 years who participated in upper gastrointestinal cancer screening in Yangzhong City from November 2017 to December 2022 were selected for questionnaire survey,physical examination,endoscopy and pathological diagnosis.Multivariate logistic regression was used to analyze the association between AIs\[body mass index(BMI),waist circumference(WC),waist-to-hip ratio(WHR),waist-to-height ratio(WHtR),body fat percentage(BF%),conicity index(CI),body adiposity estimator(BAE),a body shape index(ABSI),body adiposity index(BAI),body roundness index(BRI)and abdominal volumetric index(AVI)\]and gastric cancer and precancerous lesions.Results The prevalence of gastric cancer and precancerous lesions was 39.37%among 10115 residents.The results of multivariate logistic regression showed that compared with those in quartile 1(Q1),the Q3 and Q4 populations of BMI had an 11.1%(OR=0.889,0.791-0.999)and 12.4%(OR=0.876,0.779-0.984)lower risk of gastric cancer and precancerous lesions,respectively.The Q2,Q3 and Q4 populations of BF%had 14.2%(OR=0.858,0.756-0.974),17.4%(OR=0.826,0.689-0.991)and 26.6%(OR=0.734,0.603-0.893)lower risk of gastric cancer and precancerous lesions risk,respectively.The Q2 and Q4 populations of the BAE had reduced the risk of gastric cancer and precancerous lesions by 13.2%(OR=0.868,0.766-0.983)and 21.3%(OR=0.787,0.648-0.957).The risk of gastric cancer and precancerous lesions in BAI’s Q2 and Q3 populations was reduced by 13.7%(OR=0.863,0.767-0.970)and 13.1%(OR=0.869,0.769-0.983),respectively.Stratified analysis showed that BMI,BF%,BAE and BAI were associated with a reduced risk of non-cardia gastric cancer and precancerous lesions(all P<0.05).However,only the Q2 level of BAE was associated with a reduced risk of cardia gastric cancer and precancerous lesions compared to the Q1(P<0.0

关 键 词：人体测量指标 胃癌 癌前病变 关联 筛查 

分 类 号：R735.2[医药卫生—肿瘤]