1
|
Rudman Y, Fleseriu M, Dery L, Masri-Iraqi H, Sasson L, Shochat T, Kushnir S, Shimon I, Akirov A. Endogenous Cushing's syndrome and cancer risk. Eur J Endocrinol 2024; 191:223-231. [PMID: 39067000 DOI: 10.1093/ejendo/lvae098] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/02/2024] [Revised: 07/01/2024] [Accepted: 07/25/2024] [Indexed: 07/30/2024]
Abstract
OBJECTIVE Cancer incidence in patients with endogenous Cushing's syndrome (CS) has never been established. Here, we aimed to assess the cancer risk in patients with CS as compared with individually matched controls. DESIGN A nationwide retrospective matched cohort study of patients with endogenous CS diagnosed between 2000 and 2023 using the database of Clalit Health Services in Israel. METHODS Patients with adrenal carcinoma or ectopic CS were excluded. Patients with CS were matched in a 1:5 ratio, with controls individually matched for age, sex, socioeconomic status, and body mass index. The primary outcome was defined as the first diagnosis of any malignancy following a CS diagnosis. Risk of malignancy was calculated using the Cox proportional hazard model, with death as a competing event. RESULTS A total of 609 patients with CS and 3018 controls were included [mean age at diagnosis, 48.0 ± 17.2 years; 2371 (65.4%) women]. The median follow-up was 14.7 years (IQR, 9.9-20.2 years). Patients with CS had an increased cancer risk, with a hazard ratio (HR) of 1.78 (95% CI 1.44-2.20) compared with their matched controls. The risk of malignancy was elevated in patients with Cushing's disease (251 cases and 1246 controls; HR 1.65, 95% CI 1.15-2.36) and in patients with adrenal CS (200 cases and 991 controls; HR 2.36, 95% CI 1.70-3.29). The increased cancer risk in patients with CS persists after exclusion of thyroid malignancies. CONCLUSION Endogenous CS is associated with increased malignancy risk. These findings underscore the need for further research to establish recommendations for cancer screening in this population.
Collapse
Affiliation(s)
- Yaron Rudman
- Institute of Endocrinology, Beilinson Hospital, Rabin Medical Center, Petah Tikva, 4941492, Israel
- Faculty of Medicine, Tel Aviv University, Tel Aviv, 6927846, Israel
| | - Maria Fleseriu
- Pituitary Center, Departments of Medicine and Neurological Surgery, Oregon Health & Science University, Portland, OR, 97239-3011, United States
| | - Laura Dery
- Faculty of Medicine, Tel Aviv University, Tel Aviv, 6927846, Israel
| | - Hiba Masri-Iraqi
- Institute of Endocrinology, Beilinson Hospital, Rabin Medical Center, Petah Tikva, 4941492, Israel
- Faculty of Medicine, Tel Aviv University, Tel Aviv, 6927846, Israel
| | - Liat Sasson
- Institute of Endocrinology, Beilinson Hospital, Rabin Medical Center, Petah Tikva, 4941492, Israel
- Faculty of Medicine, Tel Aviv University, Tel Aviv, 6927846, Israel
| | - Tzipora Shochat
- Biostatistics Unit, Rabin Medical Center, Beilinson Hospital, Petah Tikva, 4941492, Israel
| | - Shiri Kushnir
- Research Authority, Rabin Medical Center, Beilinson Hospital, Petah Tikva, 4941492, Israel
| | - Ilan Shimon
- Institute of Endocrinology, Beilinson Hospital, Rabin Medical Center, Petah Tikva, 4941492, Israel
- Faculty of Medicine, Tel Aviv University, Tel Aviv, 6927846, Israel
| | - Amit Akirov
- Institute of Endocrinology, Beilinson Hospital, Rabin Medical Center, Petah Tikva, 4941492, Israel
- Faculty of Medicine, Tel Aviv University, Tel Aviv, 6927846, Israel
| |
Collapse
|
2
|
Liu C, Yuan YC, Guo MN, Xin Z, Chen GJ, Ding N, Zheng JP, Zang B, Yang JK. Rising incidence of obesity-related cancers among younger adults in China: A population-based analysis (2007-2021). MED 2024:S2666-6340(24)00294-0. [PMID: 39181132 DOI: 10.1016/j.medj.2024.07.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2023] [Revised: 05/12/2024] [Accepted: 07/11/2024] [Indexed: 08/27/2024]
Abstract
BACKGROUND Developing countries face an "obesity epidemic," particularly affecting children and younger adults. While obesity is a known risk factor for 12 types of cancer, primarily affecting older populations, its impact on younger generations is understudied. METHODS This study analyzed data from a population-based cancer registry covering 14.14 million individuals in China (2007-2021). We compared the incidence of obesity- and non-obesity-related cancers and applied an age-period-cohort model to estimate their impacts. FINDINGS Among 651,342 cancer cases, 48.47% were obesity related. The age-standardized incidence rates (ASRs) of the 12 obesity-related cancers increased annually by 3.6% (p < 0.001), while ASRs for non-obesity-related cancers remained stable. Obesity-related cancers surged among younger adults, with rates rising across successive generations. The annual percentage of change decreased with age, from 15.28% for ages 25-29 years to 1.55% for ages 60-64 years. The incidence rate ratio for obesity-related cancer was higher in younger generations compared to those born in 1962-1966. We predict that the ASR for obesity-related cancers will nearly double in the next decade. CONCLUSIONS The rising incidence of obesity-related cancers among young adults poses a significant public health concern. The increasing cancer burden underscores the need for targeted interventions to address the obesity epidemic. FUNDING This work was supported by the National Natural Science Foundation of China (81930019, 82341076) to J.-K.Y.
Collapse
Affiliation(s)
- Chang Liu
- Department of Endocrinology, Beijing Tongren Hospital, Capital Medical University, Beijing 100730, China; Beijing Diabetes Institute, Beijing 100730, China; Beijing Key Laboratory of Diabetes Research and Care, Laboratory for Clinical Medicine, Capital Medical University, Beijing 100069, China
| | - Ying-Chao Yuan
- Department of Endocrinology, Beijing Tongren Hospital, Capital Medical University, Beijing 100730, China; Beijing Diabetes Institute, Beijing 100730, China; Beijing Key Laboratory of Diabetes Research and Care, Laboratory for Clinical Medicine, Capital Medical University, Beijing 100069, China
| | - Mo-Ning Guo
- Beijing Municipal Health Big Data and Policy Research Center, Beijing 100034, China
| | - Zhong Xin
- Department of Endocrinology, Beijing Tongren Hospital, Capital Medical University, Beijing 100730, China; Beijing Diabetes Institute, Beijing 100730, China; Beijing Key Laboratory of Diabetes Research and Care, Laboratory for Clinical Medicine, Capital Medical University, Beijing 100069, China
| | - Guan-Jie Chen
- The Center for Research on Genomics and Global Health, National Human Genome Research Institute, National Institutes of Health, Bethesda, MD 20892, USA
| | - Nan Ding
- Department of Endocrinology, Beijing Tongren Hospital, Capital Medical University, Beijing 100730, China; Beijing Diabetes Institute, Beijing 100730, China; Beijing Key Laboratory of Diabetes Research and Care, Laboratory for Clinical Medicine, Capital Medical University, Beijing 100069, China
| | - Jian-Peng Zheng
- Beijing Municipal Health Big Data and Policy Research Center, Beijing 100034, China
| | - Bai Zang
- Beijing Municipal Health Big Data and Policy Research Center, Beijing 100034, China
| | - Jin-Kui Yang
- Department of Endocrinology, Beijing Tongren Hospital, Capital Medical University, Beijing 100730, China; Beijing Diabetes Institute, Beijing 100730, China; Beijing Key Laboratory of Diabetes Research and Care, Laboratory for Clinical Medicine, Capital Medical University, Beijing 100069, China.
| |
Collapse
|
3
|
Slighting SA, Rasmussen K, Dufur MJ, Jarvis JA, Pribesh SL, Alexander AJ, Otero C. Family Structure, Family Transitions, and Child Overweight and Obesity: Comparing Australia, the United Kingdom, and the United States. CHILDREN (BASEL, SWITZERLAND) 2024; 11:693. [PMID: 38929272 PMCID: PMC11201719 DOI: 10.3390/children11060693] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/25/2024] [Revised: 05/21/2024] [Accepted: 06/02/2024] [Indexed: 06/28/2024]
Abstract
Growing rates of childhood obesity globally create concern for individuals' health outcomes and demands on health systems. While many policy approaches focus on macro-level interventions, we examine how the type of stability of a family structure might provide opportunities for policy interventions at the micro level. We examine the association between family structure trajectories and childhood overweight and obesity across three Anglophone countries using an expanded set of eight family structure categories that capture biological relationships and instability, along with potential explanatory variables that might vary across family trajectories and provide opportunities for intervention, including access to resources, family stressors, family structure selectivity factors, and obesogenic correlates. We use three datasets that are representative of children born around the year 2000 and aged 11 years old in Australia (n = 3329), the United Kingdom (n = 11,542), and the United States (n = 8837) and nested multivariate multinomial logistic regression models. Our analyses find stronger relationships between child overweight and obesity and family structure trajectories than between child obesity and obesogenic factors. Children in all three countries are sensitive to living with cohabiting parents, although in Australia, this is limited to children whose parents have been cohabiting since before their birth. In the UK and US, parents starting their cohabitation after the child's birth are more likely to have children who experience obesity. Despite a few differences across cross-cultural contexts, most of the relationship between family structures and child overweight or obesity is connected to differences in families' access to resources and by the types of parents who enter into these family structures. These findings suggest policy interventions at the family level that focus on potential parents' education and career prospects and on income support rather than interventions like marriage incentives.
Collapse
Affiliation(s)
- Sadie A. Slighting
- Department of Sociology, Brigham Young University, 2008 JFSB, Provo, UT 84602, USA; (S.A.S.); (K.R.); (J.A.J.)
| | - Kirsten Rasmussen
- Department of Sociology, Brigham Young University, 2008 JFSB, Provo, UT 84602, USA; (S.A.S.); (K.R.); (J.A.J.)
| | - Mikaela J. Dufur
- Department of Sociology, Brigham Young University, 2008 JFSB, Provo, UT 84602, USA; (S.A.S.); (K.R.); (J.A.J.)
| | - Jonathan A. Jarvis
- Department of Sociology, Brigham Young University, 2008 JFSB, Provo, UT 84602, USA; (S.A.S.); (K.R.); (J.A.J.)
| | - Shana L. Pribesh
- Department of STEM Education & Professional Studies, Old Dominion University, 2300A Education Building, Norfolk, VA 23529, USA;
| | - Alyssa J. Alexander
- Department of Sociology, University of British Columbia, AnSo-2220, Vancouver, BC V6T 1Z2, Canada;
| | - Carolina Otero
- United Way of Salt Lake City, 257 E 200 S, Salt Lake City, UT 84111, USA;
| |
Collapse
|
4
|
Vabistsevits M, Davey Smith G, Richardson TG, Richmond RC, Sieh W, Rothstein JH, Habel LA, Alexeeff SE, Lloyd-Lewis B, Sanderson E. Mammographic density mediates the protective effect of early-life body size on breast cancer risk. Nat Commun 2024; 15:4021. [PMID: 38740751 DOI: 10.1038/s41467-024-48105-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2023] [Accepted: 04/17/2024] [Indexed: 05/16/2024] Open
Abstract
The unexplained protective effect of childhood adiposity on breast cancer risk may be mediated via mammographic density (MD). Here, we investigate a complex relationship between adiposity in childhood and adulthood, puberty onset, MD phenotypes (dense area (DA), non-dense area (NDA), percent density (PD)), and their effects on breast cancer. We use Mendelian randomization (MR) and multivariable MR to estimate the total and direct effects of adiposity and age at menarche on MD phenotypes. Childhood adiposity has a decreasing effect on DA, while adulthood adiposity increases NDA. Later menarche increases DA/PD, but when accounting for childhood adiposity, this effect is attenuated. Next, we examine the effect of MD on breast cancer risk. DA/PD have a risk-increasing effect on breast cancer across all subtypes. The MD SNPs estimates are heterogeneous, and additional analyses suggest that different mechanisms may be linking MD and breast cancer. Finally, we evaluate the role of MD in the protective effect of childhood adiposity on breast cancer. Mediation MR analysis shows that 56% (95% CIs [32%-79%]) of this effect is mediated via DA. Our finding suggests that higher childhood adiposity decreases mammographic DA, subsequently reducing breast cancer risk. Understanding this mechanism is important for identifying potential intervention targets.
Collapse
Affiliation(s)
- Marina Vabistsevits
- University of Bristol, MRC Integrative Epidemiology Unit, Bristol, UK.
- University of Bristol, Population Health Sciences, Bristol, UK.
| | - George Davey Smith
- University of Bristol, MRC Integrative Epidemiology Unit, Bristol, UK
- University of Bristol, Population Health Sciences, Bristol, UK
| | - Tom G Richardson
- University of Bristol, MRC Integrative Epidemiology Unit, Bristol, UK
- University of Bristol, Population Health Sciences, Bristol, UK
| | - Rebecca C Richmond
- University of Bristol, MRC Integrative Epidemiology Unit, Bristol, UK
- University of Bristol, Population Health Sciences, Bristol, UK
| | - Weiva Sieh
- Icahn School of Medicine at Mount Sinai, Department of Genetics and Genomic Sciences, Department of Population Health Science and Policy, New York, NY, USA
- University of Texas MD Anderson Cancer Center, Department of Epidemiology, Houston, TX, USA
| | - Joseph H Rothstein
- Icahn School of Medicine at Mount Sinai, Department of Genetics and Genomic Sciences, Department of Population Health Science and Policy, New York, NY, USA
- University of Texas MD Anderson Cancer Center, Department of Epidemiology, Houston, TX, USA
| | - Laurel A Habel
- Kaiser Permanente Northern California, Division of Research, Oakland, CA, USA
| | - Stacey E Alexeeff
- Kaiser Permanente Northern California, Division of Research, Oakland, CA, USA
| | - Bethan Lloyd-Lewis
- University of Bristol, School of Cellular and Molecular Medicine, Bristol, UK
| | - Eleanor Sanderson
- University of Bristol, MRC Integrative Epidemiology Unit, Bristol, UK
- University of Bristol, Population Health Sciences, Bristol, UK
| |
Collapse
|
5
|
Dikaiou P, Edqvist J, Lagergren J, Adiels M, Björck L, Rosengren A. Body mass index and risk of cancer in young women. Sci Rep 2024; 14:6245. [PMID: 38485791 PMCID: PMC10940279 DOI: 10.1038/s41598-024-56899-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2023] [Accepted: 03/12/2024] [Indexed: 03/18/2024] Open
Abstract
It is unclear how increasing body mass index (BMI) influences risk of cancer in young women. We used data from the Medical Birth, Patient and Cause of Death registers collected between 1982 and 2014 to determine the risk of obesity-related cancer types, breast cancer, all cancer and cancer-related death in relation to BMI in 1,386,725 women, aged between 18 and 45 years, in Sweden. During a median follow-up of 16.3 years (IQR 7.7-23.5), 9808 women developed cancer. The hazard ratio (HR) of endometrial and ovarian cancer increased with higher BMI from 1.08 (95% CI 0.93-1.24) and 1.08 (95% CI 0.96-1.21) among women with BMI 22.5-< 25 to 2.33 (95% CI 1.92-2.83) and 1.48 (95% CI 1.24-1.77), respectively, among women with BMI ≥ 30. There were linear and positive associations between BMI and incident cancer in the ovary, colon, endometrium, pancreas, rectum, gallbladder, esophageal cancer and renal cell carcinoma, as well as death from obesity-related cancer forms. In conclusion, we found that elevated BMI in young women linearly associated with several obesity-related cancer forms, including death from these cancers.
Collapse
Affiliation(s)
- Pigi Dikaiou
- Department of Molecular and Clinical Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.
- Sahlgrenska University Hospital/Sahlgrenska Hospital, Gothenburg, Sweden.
- Institute of Medicine, Department of Molecular and Clinical Medicine, Sahlgrenska Academy, University of Gothenburg Hospital/Östra, Diagnosvägen 11, 416 50, Gothenburg, Sweden.
| | - Jon Edqvist
- Department of Molecular and Clinical Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
- Sahlgrenska University Hospital/Sahlgrenska Hospital, Gothenburg, Sweden
| | - Jesper Lagergren
- Upper Gastrointestinal Surgery, Department of Molecular Medicine and Surgery, Karolinska Institutet, Karolinska University Hospital, Stockholm, Sweden
- School of Cancer and Pharmaceutical Sciences, King's College London, London, UK
| | - Martin Adiels
- Department of Molecular and Clinical Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
- Health Metrics Unit, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Lena Björck
- Department of Molecular and Clinical Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
- Sahlgrenska University Hospital/Östra Hospital, Gothenburg, Sweden
| | - Annika Rosengren
- Department of Molecular and Clinical Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
- Sahlgrenska University Hospital/Östra Hospital, Gothenburg, Sweden
| |
Collapse
|
6
|
Shapiro WL, Kunani P, Sidell MA, Li X, Anderson SR, Slezak JM, Koebnick C, Schwimmer JB. Prevalence of Adolescents Meeting Criteria for Metabolic and Bariatric Surgery. Pediatrics 2024; 153:e2023063916. [PMID: 38410833 DOI: 10.1542/peds.2023-063916] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 10/26/2023] [Indexed: 02/28/2024] Open
Abstract
BACKGROUND AND OBJECTIVES The American Academy of Pediatrics endorses metabolic and bariatric surgery (MBS) as a safe and effective treatment of severe obesity in children with class 3 obesity or with class 2 obesity and qualifying comorbidities. The study objective was to determine eligibility and characteristics of adolescents who qualify for MBS based on American Academy of Pediatrics guidelines. METHODS This retrospective cohort study analyzed electronic health record data of 603 051 adolescents aged 13 to 17 years between January 1, 2018, and December 31, 2021. Centers for Disease Control and Prevention criteria were used to define obesity classes 2 and 3. Multivariable logistic regression was used to evaluate the factors associated with meeting MBS eligibility criteria. RESULTS Of the 603 041 adolescents evaluated, 22.2% had obesity (12.9% class 1, 5.4% class 2, and 3.9% class 3). The most frequently diagnosed comorbid conditions were gastroesophageal reflux disease (3.2%), hypertension (0.5%), and nonalcoholic fatty liver disease (0.5%). Among adolescents with class 2 obesity, 9.1% had 1 or more comorbidities qualifying for MBS, and 4.4% of all adolescents met the eligibility criteria for MBS. In multivariable modeling, males, Black and Hispanic adolescents, and those living in more deprived neighborhoods were more likely to meet MBS eligibility criteria. CONCLUSIONS Overall, 1 in 23 adolescents met the eligibility criteria for MBS. Demographic and social determinants were associated with a higher risk for meeting these criteria. The study suggests that the health care system may face challenges in accommodating the demand for MBS among eligible adolescents.
Collapse
Affiliation(s)
- Warren L Shapiro
- Department of Pediatrics, Southern California Permanente Medical Group, San Diego, California
- Department of Pediatrics, Division of Gastroenterology, Hepatology, and Nutrition, University of California, San Diego School of Medicine, San Diego, California
- Department of Gastroenterology, Rady Children's Hospital, San Diego, California
| | - Poornima Kunani
- Department of Pediatrics, Kaiser Permanente South Bay Medical Center, Southern California Permanente Medical Group, Manhattan Beach, California
| | - Margo A Sidell
- Department of Research & Evaluation, Kaiser Permanente Southern California, Pasadena, California
| | - Xia Li
- Department of Research & Evaluation, Kaiser Permanente Southern California, Pasadena, California
| | - Sabina R Anderson
- Department of Pediatrics, Division of Gastroenterology, Hepatology, and Nutrition, University of California, San Diego School of Medicine, San Diego, California
- Amherst College, Amherst, Massachusetts
| | - Jeffrey M Slezak
- Department of Research & Evaluation, Kaiser Permanente Southern California, Pasadena, California
| | - Corinna Koebnick
- Department of Research & Evaluation, Kaiser Permanente Southern California, Pasadena, California
| | - Jeffrey B Schwimmer
- Department of Pediatrics, Division of Gastroenterology, Hepatology, and Nutrition, University of California, San Diego School of Medicine, San Diego, California
- Department of Gastroenterology, Rady Children's Hospital, San Diego, California
| |
Collapse
|
7
|
Onerup A, Mirzaei S, Bhatia S, Åberg M, Ware ME, Joffe L, Turcotte LM, Goodenough CG, Sapkota Y, Dixon SB, Wogksch MD, Ehrhardt MJ, Armstrong GT, Hudson MM, Ness KK. Lifestyle and Subsequent Malignant Neoplasms in Childhood Cancer Survivors: A Report from the St. Jude Lifetime Cohort Study. Cancers (Basel) 2024; 16:864. [PMID: 38473225 PMCID: PMC10930858 DOI: 10.3390/cancers16050864] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2024] [Revised: 02/17/2024] [Accepted: 02/19/2024] [Indexed: 03/14/2024] Open
Abstract
INTRODUCTION This study aimed to assess longitudinal associations between lifestyle and subsequent malignant neoplasms (SMNs) in young adult childhood cancer survivors. METHODS Members of the St. Jude Lifetime Cohort (SJLIFE) aged ≥18 years and surviving ≥5 years after childhood cancer diagnosis were queried and evaluated for physical activity, cardiorespiratory fitness (CRF), muscle strength, body mass index (BMI), smoking, risky drinking, and a combined lifestyle score. Time to first SMN, excluding nonmalignant neoplasms and nonmelanoma skin cancer, was the outcome of longitudinal analysis. RESULTS Survivors (n = 4072, 47% female, 29% smokers, 37% risky drinkers, 34% obese, and 48% physically inactive) had a mean (SD) time between baseline evaluation and follow-up of 7.0 (3.3) years, an age of 8.7 (5.7) years at diagnosis, and an age of 30 (8.4) years at baseline lifestyle assessment. Neither individual lifestyle factors nor a healthy lifestyle score (RR 0.8, 0.4-1.3, p = 0.36) were associated with the risk of developing an SMN. CONCLUSIONS We did not identify any association between lifestyle factors and the risk of SMN in young adult childhood cancer survivors.
Collapse
Affiliation(s)
- Aron Onerup
- Department of Epidemiology and Cancer Control, St. Jude Children’s Research Hospital, Memphis, TN 38105, USA (Y.S.); (M.M.H.); (K.K.N.)
- Department of Pediatrics, Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, 405 30 Gothenburg, Sweden
| | - Sedigheh Mirzaei
- Department of Biostatistics, St. Jude Children’s Research Hospital, Memphis, TN 38105, USA
| | - Shalini Bhatia
- Department of Biostatistics, St. Jude Children’s Research Hospital, Memphis, TN 38105, USA
| | - Maria Åberg
- School of Public Health and Community Medicine, Institute of Medicine, University of Gothenburg, 405 30 Gothenburg, Sweden;
- Region Västra Götaland, Regionhälsan, 413 45 Gothenburg, Sweden
| | - Megan E. Ware
- Department of Epidemiology and Cancer Control, St. Jude Children’s Research Hospital, Memphis, TN 38105, USA (Y.S.); (M.M.H.); (K.K.N.)
| | - Lenat Joffe
- Department of Pediatrics, Zucker School of Medicine at Hofstra/Northwell, Hempstead, NY 11549, USA
| | - Lucie M. Turcotte
- Department of Pediatrics, University of Minnesota, Minneapolis, MN 55455, USA
| | - Chelsea G. Goodenough
- Department of Epidemiology and Cancer Control, St. Jude Children’s Research Hospital, Memphis, TN 38105, USA (Y.S.); (M.M.H.); (K.K.N.)
| | - Yadav Sapkota
- Department of Epidemiology and Cancer Control, St. Jude Children’s Research Hospital, Memphis, TN 38105, USA (Y.S.); (M.M.H.); (K.K.N.)
| | - Stephanie B. Dixon
- Department of Epidemiology and Cancer Control, St. Jude Children’s Research Hospital, Memphis, TN 38105, USA (Y.S.); (M.M.H.); (K.K.N.)
- Department of Oncology, St. Jude Children’s Research Hospital, Memphis, TN 38105, USA
| | - Matthew D. Wogksch
- Department of Epidemiology and Cancer Control, St. Jude Children’s Research Hospital, Memphis, TN 38105, USA (Y.S.); (M.M.H.); (K.K.N.)
| | - Matthew J. Ehrhardt
- Department of Epidemiology and Cancer Control, St. Jude Children’s Research Hospital, Memphis, TN 38105, USA (Y.S.); (M.M.H.); (K.K.N.)
- Department of Oncology, St. Jude Children’s Research Hospital, Memphis, TN 38105, USA
| | - Gregory T. Armstrong
- Department of Epidemiology and Cancer Control, St. Jude Children’s Research Hospital, Memphis, TN 38105, USA (Y.S.); (M.M.H.); (K.K.N.)
| | - Melissa M. Hudson
- Department of Epidemiology and Cancer Control, St. Jude Children’s Research Hospital, Memphis, TN 38105, USA (Y.S.); (M.M.H.); (K.K.N.)
| | - Kirsten K. Ness
- Department of Epidemiology and Cancer Control, St. Jude Children’s Research Hospital, Memphis, TN 38105, USA (Y.S.); (M.M.H.); (K.K.N.)
| |
Collapse
|
8
|
Hussan H, Patel A, Ma J, Hinton A, Clinton SK. Historical Obesity and Early-Onset Cancers: A Propensity-Weighted Analysis of the National Health and Nutrition Examination Survey. Dig Dis Sci 2024; 69:419-425. [PMID: 38030832 DOI: 10.1007/s10620-023-08194-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/14/2023] [Accepted: 11/09/2023] [Indexed: 12/01/2023]
Abstract
BACKGROUND The incidence of early-onset obesity-related cancers (diagnosed < 50 years) is increasing in the U.S. We examined the reported historical body mass index (BMI) of adults with early and later-onset cancers to explore relation to obesity. METHODS We queried the 1999-2018 NHANES database for adults diagnosed with obesity-related cancers (colorectal, non-colorectal gastrointestinal, uterine, breast). We classified early and late-onset cancer based on a diagnosis age of < 50 and ≥ 50 years, respectively. Propensity-weighted analysis was used to compare prior historical BMIs between the matched groups. RESULTS After weighing, we included 2,966,528 patients with obesity-related cancers, 846,211 (28%) of which were < 50 years. In the matched analysis, 69.1% of early-onset CRC cases were diagnosed as obese (BMI ≥ 30 kg/m2) before cancer diagnosis, compared to 47.2% of late-onset cases (p < 0.03). Similarly, a higher percentage of adults with other early-onset gastrointestinal cancers had prior obesity as compared to the late-onset cohort (70.3% vs. 40.5%, p = 0.0002). BMI showed a trend toward higher values at ages 20-24 for early-onset CRC and 30-34 for other gastrointestinal cancers. In contrast, later-onset CRC and other gastrointestinal cancers exhibited higher BMI values at later ages (30-34 and 35-39, respectively). Early-onset uterine cancer was linked to a higher BMI compared to later-onset cancer (34.0 vs. 31.1 kg/m2, p < 0.0001), with a trend towards a higher BMI before 19 years old. CONCLUSIONS Our nationally representative data reveal that higher and earlier body fatness in adulthood associates with early-onset gastrointestinal and uterine cancers. These findings underscore the importance of intensifying efforts to combat early-life obesity.
Collapse
Affiliation(s)
- Hisham Hussan
- Division of Gastroenterology, Department of Internal Medicine, University of California, Davis, Sacramento, CA, USA.
- Comprehensive Cancer Center, University of California, Davis, Sacramento, CA, USA.
- Division of Gastroenterology, Department of Internal Medicine, UC Davis Medical Center, 4150 V Street, Suite 3500, Sacramento, CA, 95817, USA.
| | - Arsheya Patel
- Division of Gastroenterology, Hepatology, and Nutrition, Department of Internal Medicine, The Ohio State University, Columbus, OH, USA
| | - Jianing Ma
- Center for Biostatistics, Department of Biomedical Informatics, The Ohio State University, Columbus, OH, USA
| | - Alice Hinton
- Division of Biostatistics, College of Public Health, The Ohio State University, Columbus, OH, USA
| | - Steven K Clinton
- Division of Medical Oncology, Department of Internal Medicine, College of Medicine, The Ohio State University, Columbus, OH, USA
- Comprehensive Cancer Center, The Ohio State University, Columbus, OH, USA
| |
Collapse
|
9
|
Onerup A, Mehlig K, Af Geijerstam A, Ekblom-Bak E, Kuhn HG, Lissner L, Rosengren A, Börjesson M, Åberg M. Associations between BMI in youth and site-specific cancer in men-A cohort study with register linkage. Obesity (Silver Spring) 2024; 32:376-389. [PMID: 37927128 DOI: 10.1002/oby.23942] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/12/2023] [Revised: 09/04/2023] [Accepted: 09/26/2023] [Indexed: 11/07/2023]
Abstract
OBJECTIVE This study examined BMI in young men and incident site-specific cancer to estimate population attributable fractions due to BMI based on projected obesity prevalence. METHODS A population-based cohort study with measured height and weight at age 18. Cox regression models assessed linear associations for BMI and included age, year, and site of conscription as well as parental level of education as covariates. RESULTS Primary analyses were performed in 1,489,115 men, of whom 78,217 subsequently developed cancer during a mean follow-up of 31 years. BMI was linearly associated with risk of developing all 18 site-specific cancers assessed (malignant melanoma; leukemia; myeloma; Hodgkin lymphoma; non-Hodgkin lymphoma; and cancer in the lungs, head and neck, central nervous system, thyroid, esophagus, stomach, pancreas, liver and gallbladder, colon, rectum, kidney, and bladder), in some instances evident at BMI levels usually defined as normal (20-25 kg/m2 ). Higher BMI was associated with lower risk of prostate cancer. The highest hazard ratios and population attributable fractions were seen for some gastrointestinal cancers. CONCLUSIONS This study reports linear associations between BMI at age 18 and subsequent site-specific cancers, calling for rapid action to stem the obesity epidemic and to prepare the health care system for steep increases in cancer cases.
Collapse
Affiliation(s)
- Aron Onerup
- Department of Pediatrics, Institute of Clinical Sciences, University of Gothenburg, Gothenburg, Sweden
| | - Kirsten Mehlig
- School of Public Health and Community Medicine, Institute of Medicine, University of Gothenburg, Gothenburg, Sweden
| | - Agnes Af Geijerstam
- School of Public Health and Community Medicine, Institute of Medicine, University of Gothenburg, Gothenburg, Sweden
| | - Elin Ekblom-Bak
- Department of Physical Activity and Health, The Swedish School of Sport and Health Sciences, Stockholm, Sweden
| | - Hans-Georg Kuhn
- Department of Clinical Neuroscience, Institute of Neuroscience and Physiology, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
- Institute of Public Health, Charité-Universitätsmedizin Berlin, Berlin, Germany
| | - Lauren Lissner
- School of Public Health and Community Medicine, Institute of Medicine, University of Gothenburg, Gothenburg, Sweden
| | - Annika Rosengren
- Department of Molecular and Clinical Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
- Sahlgrenska University Hospital/Östra, Region Västra Götaland, Gothenburg, Sweden
| | - Mats Börjesson
- Department of Molecular and Clinical Medicine, Center for Lifestyle Intervention, Sahlgrenska Academy, University of Gothenburg and Sahlgrenska University Hospital, Region Västra Götaland, Gothenburg, Sweden
| | - Maria Åberg
- School of Public Health and Community Medicine, Institute of Medicine, University of Gothenburg, Gothenburg, Sweden
- Region Västra Götaland, Gothenburg, Sweden
| |
Collapse
|
10
|
Tsur AM, Akavian I, Landau R, Derazne E, Tzur D, Vivante A, Grossman E, Rotem RS, Fishman B, Pinhas-Hamiel O, Afek A, Coresh J, Chodick G, Twig G. Adolescent Body Mass Index and Early Chronic Kidney Disease in Young Adulthood. JAMA Pediatr 2024; 178:142-150. [PMID: 38079159 PMCID: PMC10714283 DOI: 10.1001/jamapediatrics.2023.5420] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/23/2023] [Accepted: 10/03/2023] [Indexed: 02/06/2024]
Abstract
Importance Despite increasing obesity rates in adolescents, data regarding early kidney sequelae are lacking. Objective To assess the association between adolescent body mass index (BMI) and early chronic kidney disease (CKD) in young adulthood (<45 years of age). Design, Setting, and Participants This cohort study linked screening data of mandatory medical assessments of Israeli adolescents to data from a CKD registry of a national health care system. Adolescents who were aged 16 to 20 years; born since January 1, 1975; medically evaluated for mandatory military service through December 31, 2019; and insured by Maccabi Healthcare Services were assessed. Individuals with kidney pathology, albuminuria, hypertension, dysglycemia, or missing blood pressure or BMI data were excluded. Body mass index was calculated as weight in kilograms divided by height in meters squared and categorized by age- and sex-matched percentiles according to the US Centers for Disease Control and Prevention. Follow-up started at the time of medical evaluation or January 1, 2000 (whichever came last), and ended at early CKD onset, death, the last day insured, or August 23, 2020 (whichever came first). Data analysis was performed from December 19, 2021, to September 11, 2023. Main Outcomes and Measures Early CKD, defined as stage 1 to 2 CKD by moderately or severely increased albuminuria, with an estimated glomerular filtration rate of 60 mL/min/1.73 m2 or higher. Results Of 629 168 adolescents evaluated, 593 660 (mean [SD] age at study entry, 17.2 [0.5] years; 323 293 [54.5%] male, 270 367 [45.5%] female) were included in the analysis. During a mean (SD) follow-up of 13.4 (5.5) years for males and 13.4 (5.6) years for females, 1963 adolescents (0.3%) developed early CKD. Among males, the adjusted hazard ratios were 1.8 (95% CI, 1.5-2.2) for adolescents with high-normal BMI, 4.0 (95% CI, 3.3-5.0) for those with overweight, 6.7 (95% CI, 5.4-8.4) for those with mild obesity, and 9.4 (95% CI, 6.6-13.5) for those with severe obesity. Among females, the hazard ratios were 1.4 (95% CI, 1.2-1.6) for those with high-normal BMI, 2.3 (95% CI, 1.9-2.8) for those with overweight, 2.7 (95% CI, 2.1-3.6) for those with mild obesity, and 4.3 (95% CI, 2.8-6.5) for those with severe obesity. The results were similar when the cohort was limited to individuals who were seemingly healthy as adolescents, individuals surveyed up to 30 years of age, or those free of diabetes and hypertension at the end of the follow-up. Conclusions and Relevance In this cohort study, high BMI in late adolescence was associated with early CKD in young adulthood. The risk was also present in seemingly healthy individuals with high-normal BMI and before 30 years of age, and a greater risk was seen among those with severe obesity. These findings underscore the importance of mitigating adolescent obesity rates and managing risk factors for kidney disease in adolescents with high BMI.
Collapse
Affiliation(s)
- Avishai M. Tsur
- Israel Defense Forces, Medical Corps, Tel Hashomer, Ramat Gan, Israel
- Department of Military Medicine, Hebrew University of Jerusalem Faculty of Medicine, Jerusalem, Israel
- Department of Medicine, Sheba Medical Center, Tel HaShomer, Israel
- Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Inbal Akavian
- Israel Defense Forces, Medical Corps, Tel Hashomer, Ramat Gan, Israel
- Department of Military Medicine, Hebrew University of Jerusalem Faculty of Medicine, Jerusalem, Israel
| | - Regev Landau
- Israel Defense Forces, Medical Corps, Tel Hashomer, Ramat Gan, Israel
- Department of Military Medicine, Hebrew University of Jerusalem Faculty of Medicine, Jerusalem, Israel
- Department of Medicine, Sheba Medical Center, Tel HaShomer, Israel
- Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Estela Derazne
- Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Dorit Tzur
- Israel Defense Forces, Medical Corps, Tel Hashomer, Ramat Gan, Israel
| | - Asaf Vivante
- Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
- Department of Pediatrics B and Pediatric Nephrology Unit, Edmond and Lily Safra Children’s Hospital, Sheba Medical Center, Tel Hashomer, Israel
| | - Ehud Grossman
- Department of Medicine, Sheba Medical Center, Tel HaShomer, Israel
- Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Ran S. Rotem
- Maccabitech Institute for Research and Innovation, Maccabi Healthcare Services, Tel Aviv, Israel
- Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, Massachusetts
| | - Boris Fishman
- Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
- Division of Cardiology, Sheba Medical Center, Tel HaShomer, Israel
| | - Orit Pinhas-Hamiel
- Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
- Pediatric Endocrine and Diabetes Unit, Edmond and Lily Safra Children’s Hospital, Sheba Medical Center, Tel Hashomer, Israel
| | - Arnon Afek
- Central Management, Sheba Medical Center, Tel Hashomer, Ramat Gan, Israel
| | - Josef Coresh
- Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland
| | - Gabriel Chodick
- Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
- Maccabitech Institute for Research and Innovation, Maccabi Healthcare Services, Tel Aviv, Israel
| | - Gilad Twig
- Israel Defense Forces, Medical Corps, Tel Hashomer, Ramat Gan, Israel
- Department of Military Medicine, Hebrew University of Jerusalem Faculty of Medicine, Jerusalem, Israel
- Division of Endocrinology, Diabetes and Metabolism, Sheba Medical Center, Tel Hashomer, Ramat Gan, Israel
- Department of Preventive Medicine, School of Public Health, Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
- The Gertner Institute for Epidemiology & Health Policy Research, Sheba Medical Center, Ramat Gan, Israel
| |
Collapse
|
11
|
Newson L, Abayomi J. Reframing interventions for optimal child nutrition and childhood obesity: the importance of considering psychological factors. Proc Nutr Soc 2024:1-12. [PMID: 38205619 DOI: 10.1017/s0029665124000028] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/12/2024]
Abstract
This review aims to emphasise the impact of poor nutrition on children's health and psychological well-being, urging those involved in childhood obesity or nutrition services to broaden their intervention approach. Poor nutrition and childhood obesity affect physical and psychological health. The stress of living with obesity further impacts quality of life, well-being and self-esteem. Children living with obesity may experience adverse childhood events and stress, and young people are able to recall the impact of psychosocial issues such as experiencing stigma and discrimination. Food is often a coping mechanism for managing negative emotions, perpetuating cycles of emotional coping and unhealthy eating behaviours. UK guidelines recommend family-based, multi-component weight management interventions for children living with obesity. Interventions mainly target health behaviours and utilise behaviour change techniques attempting to directly improve diet and physical activity as behavioural outcomes. Whilst these interventions may show some improvements in psychological well-being, there is limited consideration or understanding of the underlying mechanisms of action which indirectly influence engagement and the sustainability of the behaviour change. Lack of attention and inclusion of psychosocial variables in intervention implementation may help explain the variable effectiveness reported across childhood obesity interventions. In conclusion, enhancing the effectiveness of childhood obesity interventions requires a broader approach that fully incorporates psychosocial factors. Those responsible for commissioning, designing and implementing these interventions should adopt a holistic approach that addresses psychological and emotional needs while incorporating underlying mechanisms of action. This shift in focus could result in more sustainable and comprehensive treatment for childhood obesity.
Collapse
Affiliation(s)
- Lisa Newson
- School of Psychology, Research Centre for Brain and Behaviour, Faculty of Health, Liverpool John Moores University, Liverpool, UK
- Liverpool Centre for Cardiovascular Science, Liverpool, UK
| | - Julie Abayomi
- Faculty of Health, Social Care and Medicine, Edgehill University, Liverpool, UK
| |
Collapse
|
12
|
Khalooeifard R, Rahmani J, Ghoreishy SM, Tavakoli A, Najjari K, Talebpour M. Evaluate the Effects of Different Types of Preoperative Restricted Calorie Diets on Weight, Body Mass Index, Operation Time and Hospital Stay in Patients Undergoing Bariatric Surgery: a Systematic Review and Meta Analysis Study. Obes Surg 2024; 34:236-249. [PMID: 38052747 DOI: 10.1007/s11695-023-06973-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2023] [Revised: 11/15/2023] [Accepted: 11/26/2023] [Indexed: 12/07/2023]
Abstract
Previous studies investigated low-calorie diets (LCD), very-low-calorie diets (VLCD), and very-low-calorie ketogenic diets (VLCKD) in relation to weight loss and outcomes for bariatric surgery patients. However, the overall effects of these diets on various outcomes remain unclear. This study aimed to assess the impact of preoperative restricted calorie diets on weight, body mass index (BMI), operation time (OT), and hospital stay (HS) in bariatric surgery patients. Seventeen articles were analyzed, revealing the highest weight loss (-8.62) and BMI reduction (-5.75) with VLCKD. Due to insufficient data, the impact of these diets on OT and HS could not be determined. Further interventional studies are required to determine the ideal preoperative diet that achieves optimal weight loss, patient compliance, tolerance, acceptance, and surgical outcomes.
Collapse
Affiliation(s)
- Razieh Khalooeifard
- Department of Clinical Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences, Tehran, Iran.
| | - Jamal Rahmani
- Cancer Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Seyed Mojtaba Ghoreishy
- Department of Nutrition, School of Public Health, Iran University of Medical Sciences, Tehran, Iran
| | - Aryan Tavakoli
- School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences, Tehran, Iran
| | - Khosrow Najjari
- Advanced Minimally Invasive Surgery Fellowship, Department of General Surgery, Sina Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Mohammad Talebpour
- Advanced Minimally Invasive Surgery Fellowship, Department of General Surgery, Sina Hospital, Tehran University of Medical Sciences, Tehran, Iran
| |
Collapse
|
13
|
Wu N, Chen Y, Li G. Association of High Body Mass Index in Early Life With the Development of Colorectal Cancer. Cancer Control 2024; 31:10732748241270582. [PMID: 39109953 PMCID: PMC11307362 DOI: 10.1177/10732748241270582] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2024] [Revised: 06/16/2024] [Accepted: 06/26/2024] [Indexed: 08/10/2024] Open
Abstract
SIGNIFICANCE This study on the relationship between early life high BMI and the development of CRC reveals the role of high BMI during childhood and adolescence in the occurrence and progression of CRC. It suggests the importance of restoring normal weight or reducing weight in individuals with high BMI early in life for the prevention of colorectal cancer.
Collapse
Affiliation(s)
- Nian Wu
- School of Clinical Medicine, Guizhou Medical University, Guizhou, China
| | - Yangyang Chen
- School of Clinical Medicine, Guizhou Medical University, Guizhou, China
| | - Guosheng Li
- Department of anorectal surgery, Affiliated Hospital of Guizhou Medical University, Guizhou, China
| |
Collapse
|
14
|
Schooling CM, Fei K, Zhao JV. Selection bias as an explanation for the observed protective association of childhood adiposity with breast cancer. J Clin Epidemiol 2023; 164:104-111. [PMID: 37783402 DOI: 10.1016/j.jclinepi.2023.09.015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2022] [Revised: 09/09/2023] [Accepted: 09/26/2023] [Indexed: 10/04/2023]
Abstract
OBJECTIVES Recalled childhood adiposity is inversely associated with breast cancer observationally, including in Mendelian randomization (MR) studies. Breast cancer studies recruited in adulthood only include survivors of childhood adiposity and breast cancer or a competing risk. We assessed recalled childhood adiposity on participant reported sibling and maternal breast cancer to ensure ascertainment of nonsurvivors. STUDY DESIGN AND SETTING We obtained independent strong genetic predictors of recalled childhood adiposity for women and their associations with participant reported own, sibling and maternal breast cancer from UK Biobank genome wide association studies. RESULTS Recalled childhood adiposity in women was inversely associated with own breast cancer using Mendelian randomization inverse variance weighting (odds ratio (OR) 0.66, 95% confidence interval (CI) 0.52-0.84) but less clearly related to participant reported sibling (OR 0.89, 95% CI 0.69-1.14) or maternal breast cancer (OR 0.84, 95% CI 0.67-1.05). CONCLUSION Weaker inverse associations of recalled childhood adiposity with breast cancer with more comprehensive ascertainment of cases before recruitment suggests the inverse association of recalled childhood adiposity with breast cancer could be partly selection bias from preferential selection of survivors. Greater consideration of survival bias in public health relevant causal inferences would be helpful.
Collapse
Affiliation(s)
- C Mary Schooling
- Environmental, Occupational, and Geospatial Health Sciences, CUNY School of Public Health, 55 West 125th St, New York, NY 10027, USA; School of Public Health, The University of Hong Kong, 7 Sassoon Road, Pokfulam, Hong Kong, China.
| | - Kezhen Fei
- Environmental, Occupational, and Geospatial Health Sciences, CUNY School of Public Health, 55 West 125th St, New York, NY 10027, USA
| | - Jie V Zhao
- School of Public Health, The University of Hong Kong, 7 Sassoon Road, Pokfulam, Hong Kong, China
| |
Collapse
|
15
|
Wang X, Wu Z, Lv J, Yu C, Sun D, Pei P, Yang L, Millwood IY, Walters R, Chen Y, Du H, Yuan M, Schmidt D, Barnard M, Chen J, Chen Z, Li L, Pang Y. Life-course adiposity and severe liver disease: a Mendelian randomization analysis. Obesity (Silver Spring) 2023; 31:3077-3085. [PMID: 37869961 DOI: 10.1002/oby.23913] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/29/2023] [Revised: 07/21/2023] [Accepted: 08/04/2023] [Indexed: 10/24/2023]
Abstract
OBJECTIVE There is little evidence on the genetic associations between life-course adiposity (including birth weight, childhood BMI, and adulthood BMI) and severe liver disease (SLD; including cirrhosis and liver cancer). The current study aimed to examine and contrast these associations. METHODS Genetic variants were obtained from genome-wide association studies. Two-sample Mendelian randomization (MR) analyses were performed to assess the genetic associations of life-course adiposity with SLD and liver biomarkers. Cox regression was used to estimate adjusted hazard ratios for SLD associated with genetic risk scores of life-course adiposity and adulthood weight change in the China Kadoorie Biobank. RESULTS In observational analyses, genetic predispositions to childhood adiposity and adulthood adiposity were each associated with SLD. There was a U-shaped association between adulthood weight change and risk of SLD. In meta-analyses of MR results, genetically predicted 1-standard deviation increase in birth weight was inversely associated with SLD at a marginal significance (odds ratio: 0.81 [95% CI: 0.65-1.00]), whereas genetically predicted 1-standard deviation higher childhood BMI and adulthood BMI were positively associated with SLD (odds ratio: 1.27 [95% CI: 1.05-1.55] and 1.79 [95% CI: 1.59-2.01], respectively). The results of liver biomarkers mirrored those of SLD. CONCLUSIONS The current study provided genetic evidence on the associations between life-course adiposity and SLD.
Collapse
Affiliation(s)
- Xinyu Wang
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University, Beijing, China
| | - Zhiyu Wu
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University, Beijing, China
| | - Jun Lv
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University, Beijing, China
- Peking University Center for Public Health and Epidemic Preparedness & Response, Beijing, China
- Key Laboratory of Epidemiology of Major Diseases, Peking University, Ministry of Education, Beijing, China
| | - Canqing Yu
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University, Beijing, China
- Peking University Center for Public Health and Epidemic Preparedness & Response, Beijing, China
- Key Laboratory of Epidemiology of Major Diseases, Peking University, Ministry of Education, Beijing, China
| | - Dianjianyi Sun
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University, Beijing, China
- Peking University Center for Public Health and Epidemic Preparedness & Response, Beijing, China
- Key Laboratory of Epidemiology of Major Diseases, Peking University, Ministry of Education, Beijing, China
| | - Pei Pei
- Peking University Center for Public Health and Epidemic Preparedness & Response, Beijing, China
| | - Ling Yang
- Medical Research Council Population Health Research Unit at the University of Oxford, Oxford, UK
- Clinical Trial Service Unit & Epidemiological Studies Unit (CTSU), Nuffield Department of Population Health, University of Oxford, Oxford, UK
| | - Iona Y Millwood
- Medical Research Council Population Health Research Unit at the University of Oxford, Oxford, UK
- Clinical Trial Service Unit & Epidemiological Studies Unit (CTSU), Nuffield Department of Population Health, University of Oxford, Oxford, UK
| | - Robin Walters
- Medical Research Council Population Health Research Unit at the University of Oxford, Oxford, UK
- Clinical Trial Service Unit & Epidemiological Studies Unit (CTSU), Nuffield Department of Population Health, University of Oxford, Oxford, UK
| | - Yiping Chen
- Medical Research Council Population Health Research Unit at the University of Oxford, Oxford, UK
- Clinical Trial Service Unit & Epidemiological Studies Unit (CTSU), Nuffield Department of Population Health, University of Oxford, Oxford, UK
| | - Huaidong Du
- Medical Research Council Population Health Research Unit at the University of Oxford, Oxford, UK
- Clinical Trial Service Unit & Epidemiological Studies Unit (CTSU), Nuffield Department of Population Health, University of Oxford, Oxford, UK
| | - Mingqiang Yuan
- Pengzhou Center for Disease Control and Prevention, Pengzhou, China
| | - Dan Schmidt
- Clinical Trial Service Unit & Epidemiological Studies Unit (CTSU), Nuffield Department of Population Health, University of Oxford, Oxford, UK
| | - Maxim Barnard
- Clinical Trial Service Unit & Epidemiological Studies Unit (CTSU), Nuffield Department of Population Health, University of Oxford, Oxford, UK
| | - Junshi Chen
- China National Center for Food Safety Risk Assessment, Beijing, China
| | - Zhengming Chen
- Clinical Trial Service Unit & Epidemiological Studies Unit (CTSU), Nuffield Department of Population Health, University of Oxford, Oxford, UK
| | - Liming Li
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University, Beijing, China
- Peking University Center for Public Health and Epidemic Preparedness & Response, Beijing, China
- Key Laboratory of Epidemiology of Major Diseases, Peking University, Ministry of Education, Beijing, China
| | - Yuanjie Pang
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University, Beijing, China
- Key Laboratory of Epidemiology of Major Diseases, Peking University, Ministry of Education, Beijing, China
| |
Collapse
|
16
|
Aburto TC, Romieu I, Stern MC, Barquera S, Corvalán C, Hallal PC, Reynales-Shigematsu LM, Barnoya J, Cavalcante TM, Canelo-Aybar C, Santero M, Feliu A, Espina C, Rivera JA. Latin American and the Caribbean Code Against Cancer 1st edition: Weight, physical activity, diet, breastfeeding, and cancer. Cancer Epidemiol 2023; 86 Suppl 1:102436. [PMID: 37852731 DOI: 10.1016/j.canep.2023.102436] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2023] [Revised: 07/06/2023] [Accepted: 07/13/2023] [Indexed: 10/20/2023]
Abstract
In Latin America and the Caribbean a considerable proportion of the population have excess body weight, do not meet the recommendations of physical activity and healthy diet, and have suboptimal rates of breastfeeding. Excess body weight is associated with at least 15 cancer sites, physical activity protects against three cancers, with some evidence suggesting a protective effect for eight more cancer sites, and sedentary behavior probably increases the risk of five cancer sites. Fiber and wholegrains protect against colorectal cancer, high intake of fruits and vegetables could reduce the risk of aerodigestive cancers; processed and red meat increase the risk of colorectal cancer; and very hot beverages are associated with esophageal cancer. Moreover, sugar-sweetened beverages and ultra-processed foods are a convincing cause for excess body weight, increasing cancer risk through this pathway, with some emerging evidence suggesting also direct pathways. Breastfeeding protects against breast cancer, and could protect against ovarian cancer. Taking this evidence into account, the Latin America and the Caribbean Code Against Cancer recommends the general public to maintain a healthy body weight, be physically active and limit sedentary behavior, eat a healthy diet (eat plenty of vegetables, fruits, wholegrains and legumes; avoid sugar-sweetened beverages and processed meat; and limit ultra-processed foods, red meat and very hot beverages), and breastfeed. Moreover, the Latin America and the Caribbean Code Against Cancer also includes a set of public policy recommendations for cancer prevention to inform policy makers and civil society about the need of policies to shape healthy environments and create opportunities to facilitate the adoption of the recommendations directed to the public.
Collapse
Affiliation(s)
- Tania C Aburto
- Center for Research on Nutrition and Health, National Institute of Public Health, 62100 Cuernavaca, Mexico
| | - Isabelle Romieu
- Center for Population Health Research, National Institute of Public Health, 62100 Cuernavaca, Mexico
| | - Mariana C Stern
- Department of Preventive Medicine and Urology, Keck School of Medicine of USC, 90033 Los Angeles, United States
| | - Simón Barquera
- Center for Research on Nutrition and Health, National Institute of Public Health, 62100 Cuernavaca, Mexico
| | - Camila Corvalán
- Institute of Nutrition and Food Technology (INTA), University of Chile, Santiago, Chile
| | - Pedro C Hallal
- Department of Kinesiology and Community Health, University of Illinois Champaign-Urbana, Illinois, United States
| | - Luz M Reynales-Shigematsu
- Center for Population Health Research, National Institute of Public Health, 62100 Cuernavaca, Mexico
| | - Joaquín Barnoya
- Research Department, Integra Cancer Institute, Guatemala City, Guatemala; Department of Environmental and Occupational Health, Colorado School of Public Health, CU Anschutz, United States
| | - Tania M Cavalcante
- Instituto Nacional de Câncer José de Alencar Gomes da Silva, Secretaria Executiva da Comissão Nacional para a Implementação da Convenção-Quadro para o Controle do Tabaco, Rio de Janeiro, RJ, Brasil
| | - Carlos Canelo-Aybar
- Department of Clinical Epidemiology and Public Health, Iberoamerican Cochrane Centre, Biomedical Research Institute Sant Pau (IIB Sant Pau), Barcelona, Spain
| | - Marilina Santero
- Department of Clinical Epidemiology and Public Health, Iberoamerican Cochrane Centre, Biomedical Research Institute Sant Pau (IIB Sant Pau), Barcelona, Spain
| | - Ariadna Feliu
- International Agency for Research on Cancer (IARC/WHO), Environment and Lifestyle Epidemiology Branch, 25 avenue Tony Garnier CS 90627, 69366 Lyon CEDEX 07 France
| | - Carolina Espina
- International Agency for Research on Cancer (IARC/WHO), Environment and Lifestyle Epidemiology Branch, 25 avenue Tony Garnier CS 90627, 69366 Lyon CEDEX 07 France
| | - Juan A Rivera
- Center for Population Health Research, National Institute of Public Health, 62100 Cuernavaca, Mexico.
| |
Collapse
|
17
|
Wiebe N, Lloyd A, Crumley ET, Tonelli M. Associations between body mass index and all-cause mortality: A systematic review and meta-analysis. Obes Rev 2023; 24:e13588. [PMID: 37309266 DOI: 10.1111/obr.13588] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/06/2023] [Revised: 04/12/2023] [Accepted: 05/22/2023] [Indexed: 06/14/2023]
Abstract
Fasting insulin and c-reactive protein confound the association between mortality and body mass index. An increase in fat mass may mediate the associations between hyperinsulinemia, hyperinflammation, and mortality. The objective of this study was to describe the "average" associations between body mass index and the risk of mortality and to explore how adjusting for fasting insulin and markers of inflammation might modify the association of BMI with mortality. MEDLINE and EMBASE were searched for studies published in 2020. Studies with adult participants where BMI and vital status was assessed were included. BMI was required to be categorized into groups or parametrized as non-first order polynomials or splines. All-cause mortality was regressed against mean BMI squared within seven broad clinical populations. Study was modeled as a random intercept. β coefficients and 95% confidence intervals are reported along with estimates of mortality risk by BMIs of 20, 30, and 40 kg/m2 . Bubble plots with regression lines are drawn, showing the associations between mortality and BMI. Splines results were summarized. There were 154 included studies with 6,685,979 participants. Only five (3.2%) studies adjusted for a marker of inflammation, and no studies adjusted for fasting insulin. There were significant associations between higher BMIs and lower mortality risk in cardiovascular (unadjusted β -0.829 [95% CI -1.313, -0.345] and adjusted β -0.746 [95% CI -1.471, -0.021]), Covid-19 (unadjusted β -0.333 [95% CI -0.650, -0.015]), critically ill (adjusted β -0.550 [95% CI -1.091, -0.010]), and surgical (unadjusted β -0.415 [95% CI -0.824, -0.006]) populations. The associations for general, cancer, and non-communicable disease populations were not significant. Heterogeneity was very large (I2 ≥ 97%). The role of obesity as a driver of excess mortality should be critically re-examined, in parallel with increased efforts to determine the harms of hyperinsulinemia and chronic inflammation.
Collapse
Affiliation(s)
- Natasha Wiebe
- Department of Medicine, University of Alberta, Edmonton, Canada
| | - Anita Lloyd
- Department of Medicine, University of Alberta, Edmonton, Canada
| | - Ellen T Crumley
- Rowe School of Business, Dalhousie University, Halifax, Nova Scotia, Canada
| | | |
Collapse
|
18
|
Zloof Y, Tsur AM, Simchoni M, Derazne E, Tzur D, Honig A, Braun M, Ganelin-Cohen E, Amarilyo G, Pinhas-Hamiel O, Afek A, Twig G. Body mass index and migraine in adolescence: A nationwide study. Cephalalgia 2023; 43:3331024231209309. [PMID: 37882650 DOI: 10.1177/03331024231209309] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2023]
Abstract
BACKGROUND The association between body mass index (BMI) and migraine in adults has been well established. However, studies in children and adolescents are inconclusive. We aimed to study the association between BMI and migraine using a national dataset that comprises the electronic medical records of more than two million adolescents. METHODS This study included all Israeli adolescents (57.7% males, 42.3% females; mean age 17 years) who were medically assessed before mandatory military service during 1990-2020. As part of the pre-recruitment medical assessment, all the adolescents were screened for migraine and their height and weight were measured. Diagnoses of migraine were confirmed by board-certified neurologists. Prevalences and odds ratios (ORs) for migraine were computed across BMI subgroups. Spline models were applied. RESULTS A total of 2,094,862 adolescents were included, of whom 57,385 (2.8%) had active migraine. Among males, the adjusted ORs for migraine were 1.11 (95% confidence interval, 1.06-1.16), 1.13 (1.08-1.17), and 1.24 (1.19-1.30), for the underweight, overweight, and obesity subgroups, respectively, compared to the reference group of low-normal BMI (5th-49th percentile). Among females, the respective adjusted ORs were 1.12 (1.05-1.19), 1.23 (1.19-1.28), and 1.38 (1.31-1.46). Results persisted in sensitivity analyses accounting for other medical and psychiatric comorbidities and parental history of migraine. Spline models demonstrated a J-shaped relation between BMI and migraine. CONCLUSIONS Both adolescent obesity and underweight were associated with migraine in a sex-dependent manner. This association peaked in female adolescents with overweight and obesity.
Collapse
Affiliation(s)
- Yair Zloof
- Israel Defense Forces Medical Corps, Ramat Gan, Israel
- Department of Preventive Medicine and Epidemiology, School of Public Health, Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
- Schneider Children's Medical Center of Israel, Petach Tikva, Israel
| | - Avishai M Tsur
- Israel Defense Forces Medical Corps, Ramat Gan, Israel
- Department of Preventive Medicine and Epidemiology, School of Public Health, Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
- Department of Medicine, Sheba Medical Center, Tel Hashomer, Ramat Gan, Israel
- Department of Military Medicine, Hebrew University, Jerusalem, Israel
| | - Maya Simchoni
- Israel Defense Forces Medical Corps, Ramat Gan, Israel
- Department of Military Medicine, Hebrew University, Jerusalem, Israel
| | - Estela Derazne
- Faculty of Medicine, Tel-Aviv University, Tel-Aviv, Israel
| | - Dorit Tzur
- Israel Defense Forces Medical Corps, Ramat Gan, Israel
| | - Asaf Honig
- Department of Neurology, Hadassah-Hebrew University Medical Center, Jerusalem, Israel
| | - Maya Braun
- Israel Defense Forces Medical Corps, Ramat Gan, Israel
| | - Esther Ganelin-Cohen
- Faculty of Medicine, Tel-Aviv University, Tel-Aviv, Israel
- Institute of Pediatric Neurology, Schneider Children's Medical Center of Israel, Petach Tikva, Israel
| | - Gil Amarilyo
- Institute of Pediatric Neurology, Schneider Children's Medical Center of Israel, Petach Tikva, Israel
- Pediatric Rheumatology Unit, Schneider Children's Medical Center of Israel, Petach Tikva, Israel
| | - Orit Pinhas-Hamiel
- Institute of Pediatric Neurology, Schneider Children's Medical Center of Israel, Petach Tikva, Israel
- Pediatric Endocrinology and Diabetes Unit, Edmond and Lili Safra Children's Hospital, Sheba Medical Center, Tel Hashomer, Ramat Gan, Israel
| | - Arnon Afek
- Institute of Pediatric Neurology, Schneider Children's Medical Center of Israel, Petach Tikva, Israel
- Central Management Sheba Medical Center, Tel Hashomer, Ramat Gan, Israel
| | - Gilad Twig
- Israel Defense Forces Medical Corps, Ramat Gan, Israel
- Department of Preventive Medicine and Epidemiology, School of Public Health, Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
- Schneider Children's Medical Center of Israel, Petach Tikva, Israel
- Division of Endocrinology, Diabetes and Metabolism, Sheba Medical Center, Tel Hashomer, Ramat Gan, Israel
- Gertner Institute for Epidemiology and Health Policy Research, Sheba Medical Center, Tel Hashomer, Ramat Gan, Israel
| |
Collapse
|
19
|
Zhang X, Huangfu Z, Wang S. Review of mendelian randomization studies on age at natural menopause. Front Endocrinol (Lausanne) 2023; 14:1234324. [PMID: 37766689 PMCID: PMC10520463 DOI: 10.3389/fendo.2023.1234324] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/04/2023] [Accepted: 08/18/2023] [Indexed: 09/29/2023] Open
Abstract
Menopause marks the end of the reproductive phase of life. Based on epidemiological studies, abnormal age at natural menopause (ANM) is thought to contribute to a number of adverse outcomes, such as osteoporosis, cardiovascular disease, and cancer. However, the causality of these associations remains unclear. A powerful epidemiological method known as Mendelian randomization (MR) can be used to clarify the causality between ANM and other diseases or traits. The present review describes MR studies that included ANM as an exposure, outcome and mediator. The findings of MR analyses on ANM have revealed that higher body mass index, poor educational level, early age at menarche, early age at first live birth, early age at first sexual intercourse, and autoimmune thyroid disease appear to be involved in early ANM etiology. The etiology of late ANM appears to be influenced by higher free thyroxine 4 and methylene tetrahydrofolate reductase gene mutations. Furthermore, early ANM has been found to be causally associated with an increased risk of osteoporosis, fracture, type 2 diabetes mellitus, glycosylated hemoglobin, and the homeostasis model of insulin resistance level. In addition, late ANM has been found to be causally associated with an increased systolic blood pressure, higher risk of breast cancer, endometrial cancer, endometrioid ovarian carcinoma, lung cancer, longevity, airflow obstruction, and lower risk of Parkinson's disease. ANM is also a mediator for breast cancer caused by birth weight and childhood body size. However, due to the different instrumental variables used, some results of studies are inconsistent. Future studies with more valid genetic variants are needed for traits with discrepancies between MRs or between MR and other types of epidemiological studies.
Collapse
Affiliation(s)
- Xiao Zhang
- Department of Obstetrics and Gynecology, Beijing Hospital, National Center of Gerontology, Beijing, China
- Institute of Geriatric Medicine, Chinese Academy of Medical Science, Beijing, China
- Graduate School of Peking Union Medical College, Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing, China
| | - Zhao Huangfu
- Department of Urology, Changhai Hospital, Naval Medical University, Shanghai, China
| | - Shaowei Wang
- Department of Obstetrics and Gynecology, Beijing Hospital, National Center of Gerontology, Beijing, China
- Institute of Geriatric Medicine, Chinese Academy of Medical Science, Beijing, China
- Graduate School of Peking Union Medical College, Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing, China
| |
Collapse
|
20
|
Vabistsevits M, Smith GD, Richardson TG, Richmond RC, Sieh W, Rothstein JH, Habel LA, Alexeeff SE, Lloyd-Lewis B, Sanderson E. The mediating role of mammographic density in the protective effect of early-life adiposity on breast cancer risk: a multivariable Mendelian randomization study. MEDRXIV : THE PREPRINT SERVER FOR HEALTH SCIENCES 2023:2023.09.01.23294765. [PMID: 37693539 PMCID: PMC10491349 DOI: 10.1101/2023.09.01.23294765] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 09/12/2023]
Abstract
Observational studies suggest that mammographic density (MD) may have a role in the unexplained protective effect of childhood adiposity on breast cancer risk. Here, we investigated a complex and interlinked relationship between puberty onset, adiposity, MD, and their effects on breast cancer using Mendelian randomization (MR). We estimated the effects of childhood and adulthood adiposity, and age at menarche on MD phenotypes (dense area (DA), non-dense area (NDA), percent density (PD)) using MR and multivariable MR (MVMR), allowing us to disentangle their total and direct effects. Next, we examined the effect of MD on breast cancer risk, including risk of molecular subtypes, and accounting for genetic pleiotropy. Finally, we used MVMR to evaluate whether the protective effect of childhood adiposity on breast cancer was mediated by MD. Childhood adiposity had a strong inverse effect on mammographic DA, while adulthood adiposity increased NDA. Later menarche had an effect of increasing DA and PD, but when accounting for childhood adiposity, this effect attenuated to the null. DA and PD had a risk-increasing effect on breast cancer across all subtypes. The MD single-nucleotide polymorphism (SNP) estimates were extremely heterogeneous, and examination of the SNPs suggested different mechanisms may be linking MD and breast cancer. Finally, MR mediation analysis estimated that 56% (95% CIs [32% - 79%]) of the childhood adiposity effect on breast cancer risk was mediated via DA. In this work, we sought to disentangle the relationship between factors affecting MD and breast cancer. We showed that higher childhood adiposity decreases mammographic DA, which subsequently leads to reduced breast cancer risk. Understanding this mechanism is of great importance for identifying potential targets of intervention, since advocating weight gain in childhood would not be recommended.
Collapse
Affiliation(s)
- Marina Vabistsevits
- University of Bristol, MRC Integrative Epidemiology Unit, Bristol, United Kingdom
- University of Bristol, Population Health Sciences, Bristol, United Kingdom
| | - George Davey Smith
- University of Bristol, MRC Integrative Epidemiology Unit, Bristol, United Kingdom
- University of Bristol, Population Health Sciences, Bristol, United Kingdom
| | - Tom G. Richardson
- University of Bristol, MRC Integrative Epidemiology Unit, Bristol, United Kingdom
- University of Bristol, Population Health Sciences, Bristol, United Kingdom
| | - Rebecca C. Richmond
- University of Bristol, MRC Integrative Epidemiology Unit, Bristol, United Kingdom
- University of Bristol, Population Health Sciences, Bristol, United Kingdom
| | - Weiva Sieh
- Icahn School of Medicine at Mount Sinai, Department of Genetics and Genomic Sciences, Department of Population Health Science and Policy, New York, NY, United States
- University of Texas MD Anderson Cancer Center, Department of Epidemiology, Houston, TX, United States
| | - Joseph H. Rothstein
- Icahn School of Medicine at Mount Sinai, Department of Genetics and Genomic Sciences, Department of Population Health Science and Policy, New York, NY, United States
- University of Texas MD Anderson Cancer Center, Department of Epidemiology, Houston, TX, United States
| | - Laurel A. Habel
- Kaiser Permanente Northern California, Division of Research, Oakland, CA, United States
| | - Stacey E. Alexeeff
- Kaiser Permanente Northern California, Division of Research, Oakland, CA, United States
| | - Bethan Lloyd-Lewis
- University of Bristol, School of Cellular and Molecular Medicine, Bristol, United Kingdom
| | - Eleanor Sanderson
- University of Bristol, MRC Integrative Epidemiology Unit, Bristol, United Kingdom
- University of Bristol, Population Health Sciences, Bristol, United Kingdom
| |
Collapse
|
21
|
Cuttica CM, Briata IM, DeCensi A. Novel Treatments for Obesity: Implications for Cancer Prevention and Treatment. Nutrients 2023; 15:3737. [PMID: 37686769 PMCID: PMC10490004 DOI: 10.3390/nu15173737] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2023] [Revised: 08/23/2023] [Accepted: 08/24/2023] [Indexed: 09/10/2023] Open
Abstract
It is now established that obesity is related to a higher incidence of cancer during a lifespan. The effective treatment of obesity opens up new perspectives in the treatment of a relevant modifiable cancer risk factor. The present narrative review summarizes the correlations between weight loss in obesity and cancer. The current knowledge between obesity treatment and cancer was explored, highlighting the greatest potential for its use in the treatment of cancer in the clinical setting. Evidence for the effects of obesity therapy on proliferation, apoptosis, and response to chemotherapy is summarized. While more studies, including large, long-term clinical trials, are needed to adequately evaluate the relationship and durability between anti-obesity treatment and cancer, collaboration between oncologists and obesity treatment experts is increasingly important.
Collapse
Affiliation(s)
| | - Irene Maria Briata
- Division of Medical Oncology, E.O. Ospedali Galliera, 16128 Genoa, Italy; (I.M.B.); (A.D.)
| | - Andrea DeCensi
- Division of Medical Oncology, E.O. Ospedali Galliera, 16128 Genoa, Italy; (I.M.B.); (A.D.)
- Wolfson Institute of Population Health, Barts and the London School of Medicine and Dentistry, Queen Mary University of London, London E1 2AD, UK
| |
Collapse
|
22
|
Nitecki M, Shapiro G, Orr O, Levitin E, Sharshevsky H, Tzur D, Twig G, Shapira S. Association Between Body Mass Index and Nonspecific Recurrent Low Back Pain in Over 600,000 Healthy Young Adults. Am J Epidemiol 2023; 192:1371-1378. [PMID: 37083852 DOI: 10.1093/aje/kwad102] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2022] [Revised: 01/07/2023] [Accepted: 04/17/2023] [Indexed: 04/22/2023] Open
Abstract
An association between body mass index (BMI; weight (kg)/height (m)2) and low back pain (LBP) has long been debated, but inconsistent measurements of BMI and varying definitions of LBP have produced conflicting findings. We explored this association using measured BMI and physician documentation of recurrent LBP among healthy young adults. Data were extracted from the Israel Defense Forces electronic medical record system. All Israeli citizens with compulsory military service during January 2008-March 2019 were included (n = 705,840). Exclusion criteria were spine deformities, disc pathologies, spinal surgeries, arthropathies, connective tissue diseases, pain syndromes, low bone density disorders, cancers, and psychiatric illnesses. LBP was defined as electronic medical record system documentation of 1) 2 medical visits at least 6 weeks apart with a diagnosis of LBP or "LBP with radiation" or 2) 1 medical visit resulting in referral to an orthopedic surgeon. Logistic regression models were used to explore the association between BMI category and LBP; 619,969 (87.8%) individuals (mean age = 18.9 (standard deviation, 0.97) years; 56.9% male) were included. LBP prevalence was 9.2% (n = 56,918) and higher among males (9.7%) than females (8.5%). Overweight (odds ratio = 1.123, 95% confidence interval: 1.096, 1.151) and obesity (odds ratio = 1.137, 95% confidence interval: 1.096, 1.179) were associated with LBP. The association remained significant after accounting for various sociodemographic factors. Maintaining a healthy BMI may aid in the prevention of LBP in young adults.
Collapse
|
23
|
Tirani SA, Lotfi K, Mirzaei S, Asadi A, Akhlaghi M, Saneei P. The relation between dietary phytochemical index and metabolic health status in overweight and obese adolescents. Sci Rep 2023; 13:12059. [PMID: 37491451 PMCID: PMC10368731 DOI: 10.1038/s41598-023-39314-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2023] [Accepted: 07/23/2023] [Indexed: 07/27/2023] Open
Abstract
Previous studies have rarely investigated dietary phytochemicals consumption in relation to metabolic health of adolescents. The current study was performed to investigate dietary phytochemical index (DPI) in relation to metabolic health status in overweight and obese adolescents. This cross-sectional study was conducted among 203 adolescents with overweight or obesity. Dietary intakes of participants were obtained through a validated 147-item food frequency questionnaire. DPI was calculated [(dietary energy derived from phytochemical-rich foods (kcal)/total daily energy intake (kcal)) ⨯100]. Glycemic and lipid profiles, blood pressure, and anthropometric indices were also measured. A metabolically unhealthy overweight/obesity (MUO) profile was determined based on the International Diabetes Federation (IDF) and IDF/Homeostasis Model Assessment Insulin Resistance (HOMA-IR) definitions. Study subjects had a mean age of 13.98 years and 50.2% of them were girls. According to IDF and IDF/HOMA-IR criteria, 38.9% (37 boys, and 42 girls) and 33% (35 boys, and 32 girls) of the study participants were respectively MUO. According to IDF and IDF/HOMA-IR definitions, adolescents in the third DPI tertile had respectively 61% (maximally-adjusted OR = 0.39, 95%CI 0.16-0.91) and 67% (maximally-adjusted OR = 0.33, 95%CI 0.13-0.83) lower odds of being MUO, compared to the first tertile. Stratified analysis by sex indicated that DPI was inversely related to MUO phenotype based on IDF criteria in girls (maximally-adjusted OR = 0.25, 95%CI 0.06-0.98), but not in boys. The current study found that adolescents with a higher dietary intake of phytochemicals have lower odds of being MUO, particularly among girls. However, further large-scale prospective cohort studies are required to confirm this finding.
Collapse
Affiliation(s)
- Shahnaz Amani Tirani
- Department of Community Nutrition, School of Nutrition and Food Science, Nutrition and Food Security Research Center, Students' Research Committee, Isfahan University of Medical Sciences, PO Box 81745-151, Isfahan, Iran
| | - Keyhan Lotfi
- Department of Community Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences, Tehran, Iran
- Students' Scientific Research Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Saeideh Mirzaei
- Department of Community Nutrition, School of Nutrition and Food Science, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Ali Asadi
- Department of Exercise Physiology, School of Physical Education and Sport Sciences, University of Tehran, Tehran, Iran
| | - Masoumeh Akhlaghi
- Department of Community Nutrition, School of Nutrition and Food Science, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Parvane Saneei
- Department of Community Nutrition, School of Nutrition and Food Science, Nutrition and Food Security Research Center, Isfahan University of Medical Sciences, PO Box 81745-151, Isfahan, Iran.
| |
Collapse
|
24
|
de Andrade Mesquita L, Wayerbacher LF, Schwartsmann G, Gerchman F. Obesity, diabetes, and cancer: epidemiology, pathophysiology, and potential interventions. ARCHIVES OF ENDOCRINOLOGY AND METABOLISM 2023; 67:e000647. [PMID: 37364149 PMCID: PMC10660996 DOI: 10.20945/2359-3997000000647] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/08/2022] [Accepted: 02/22/2023] [Indexed: 06/28/2023]
Abstract
The proportion of deaths attributable to cancer is rising, and malignant neoplasms have become the leading cause of death in high-income countries. Obesity and diabetes are now recognized as risk factors for several types of malignancies, especially endometrial, colorectal, and postmenopausal breast cancers. Mechanisms implicated include disturbances in lipid-derived hormone secretion, sex steroids biosynthesis, hyperinsulinemia, and chronic inflammation. Intentional weight loss is associated with a mitigation of risk for obesity-related cancers, a phenomenon observed specially with bariatric surgery. The impact of pharmacological interventions for obesity and diabetes is not uniform: while metformin seems to protect against cancer, other agents such as lorcaserin may increase the risk of malignancies. However, these interpretations must be carefully considered, since most data stem from bias-prone observational studies, and high-quality randomized controlled trials with appropriate sample size and duration are needed to achieve definite conclusions. In this review, we outline epidemiological and pathophysiological aspects of the relationship between obesity, diabetes, and malignancies. We also highlight pieces of evidence regarding treatment effects on cancer incidence in these populations.
Collapse
Affiliation(s)
- Leonardo de Andrade Mesquita
- Programa de Pós-graduação em Ciências Médicas: Endocrinologia, Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brasil
- Hospital de Clínicas de Porto Alegre, Porto Alegre, Brasil, Porto Alegre, RS, Brasil
| | - Laura Fink Wayerbacher
- Faculdade de Medicina, Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brasil
| | - Gilberto Schwartsmann
- Hospital de Clínicas de Porto Alegre, Porto Alegre, Brasil, Porto Alegre, RS, Brasil
- Faculdade de Medicina, Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brasil
| | - Fernando Gerchman
- Programa de Pós-graduação em Ciências Médicas: Endocrinologia, Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brasil
- Hospital de Clínicas de Porto Alegre, Porto Alegre, Brasil, Porto Alegre, RS, Brasil,
| |
Collapse
|
25
|
Encarnação S, Rodrigues F, Monteiro AM, Gouili H, Hattabi S, Sortwell A, Branquinho L, Teixeira JE, Ferraz R, Flores P, Silva-Santos S, Ribeiro J, Batista A, Forte PM. Obesity Status and Physical Fitness Levels in Male and Female Portuguese Adolescents: A Two-Way Multivariate Analysis. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:6115. [PMID: 37372702 PMCID: PMC10298555 DOI: 10.3390/ijerph20126115] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/27/2023] [Revised: 04/26/2023] [Accepted: 06/09/2023] [Indexed: 06/29/2023]
Abstract
Obesity and decreasing fitness levels among the youth are growing concerns in Portugal, similar to other developed countries, with implications for health and psychomotor development. Understanding the influence of health determinants such as sex and age are crucial for developing effective public health strategies. This study aimed to analyze the association between sex and chronological age with obesity status and physical fitness in Portuguese adolescents. A total of 170 adolescents (85 males and 85 females) were evaluated for body mass index, abdominal adiposity, aerobic fitness, abdominal resistance, upper limb resistance, lower limb power, and maximal running speed in a 40 m sprint using the FITescola® physical fitness battery, a Portuguese government initiative. The general model, analyzed using Pillai's trace, showed a significant effect of age and sex on body mass index, abdominal circumference, aerobic fitness, abdominal resistance, upper limb resistance, lower limb power, and maximal running speed (V = 0.99, F (7) = 10,916.4, p < 0.001, partial η2, sex = 0.22; age = 0.43, sex and age interaction = 0.10). Boys had higher physical fitness levels than girls in most tests, but both sex groups had a significantly higher proportion of non-fit adolescents, with boys showing the highest number of participants classified as non-fit.
Collapse
Affiliation(s)
- Samuel Encarnação
- Department of Sports Sciences, Universidad Autónoma de Madrid (UAM), 28049 Madrid, Spain
- Department of Sport Sciences, Instituto Politécnico de Bragança (IPB), 5300-253 Bragança, Portugal
- Research Centre in Sports Sciences, Health Sciences and Human Development (CIDESD), 5001-801 Vila Real, Portugal
- Research Center of the Higher Institute of Educational Sciences of the Douro, (CI-ISCE), 4560-447 Penafiel, Portugal
| | - Filipe Rodrigues
- ESECS—Polytechnic of Leiria, 2411-901 Leiria, Portugal
- Life Quality Research Center (CIEQV), 2040-413 Leiria, Portugal
| | - António Miguel Monteiro
- Department of Sport Sciences, Instituto Politécnico de Bragança (IPB), 5300-253 Bragança, Portugal
- Research Centre in Sports Sciences, Health Sciences and Human Development (CIDESD), 5001-801 Vila Real, Portugal
| | - Hatem Gouili
- High Institute of Sports and Physical Education of Elkef, University of Jendouba, Jendouba Kef 7100, Tunisia
| | - Soukaina Hattabi
- Research Center of the Higher Institute of Educational Sciences of the Douro, (CI-ISCE), 4560-447 Penafiel, Portugal
- High Institute of Sports and Physical Education of Elkef, University of Jendouba, Jendouba Kef 7100, Tunisia
- Higher Institute of Educational Sciences of the Douro, 4560-447 Penafiel, Portugal
| | - Andrew Sortwell
- Research Centre in Sports Sciences, Health Sciences and Human Development (CIDESD), 5001-801 Vila Real, Portugal
- School of Nursing, Midwifery, Health Sciences and Physiotherapy, University of Notre Dame, Sydney 2007, Australia
| | - Luís Branquinho
- Research Centre in Sports Sciences, Health Sciences and Human Development (CIDESD), 5001-801 Vila Real, Portugal
- Research Center of the Higher Institute of Educational Sciences of the Douro, (CI-ISCE), 4560-447 Penafiel, Portugal
- Higher Institute of Educational Sciences of the Douro, 4560-447 Penafiel, Portugal
| | - José Eduardo Teixeira
- Department of Sport Sciences, Instituto Politécnico de Bragança (IPB), 5300-253 Bragança, Portugal
- Research Centre in Sports Sciences, Health Sciences and Human Development (CIDESD), 5001-801 Vila Real, Portugal
- Department of Sport Sciences, Polytechnic Institute of Guarda, 6300-559 Guarda, Portugal
| | - Ricardo Ferraz
- Research Centre in Sports Sciences, Health Sciences and Human Development (CIDESD), 5001-801 Vila Real, Portugal
- Department of Sports Sciences, University of Beria Interior, 6201-001 Covilhã, Portugal
| | - Pedro Flores
- Research Centre in Sports Sciences, Health Sciences and Human Development (CIDESD), 5001-801 Vila Real, Portugal
- Research Center of the Higher Institute of Educational Sciences of the Douro, (CI-ISCE), 4560-447 Penafiel, Portugal
- Higher Institute of Educational Sciences of the Douro, 4560-447 Penafiel, Portugal
| | - Sandra Silva-Santos
- Research Centre in Sports Sciences, Health Sciences and Human Development (CIDESD), 5001-801 Vila Real, Portugal
- Research Center of the Higher Institute of Educational Sciences of the Douro, (CI-ISCE), 4560-447 Penafiel, Portugal
- Higher Institute of Educational Sciences of the Douro, 4560-447 Penafiel, Portugal
- Research Center in Sports Performance, Recreation, Innovation and Technology (SPRINT -IPVC), 4900-347 Viana do Castelo, Portugal
- Instituto Politécnico de Viana do Castelo (IPVC), 4900-347 Viana do Castelo, Portugal
| | - Joana Ribeiro
- Research Centre in Sports Sciences, Health Sciences and Human Development (CIDESD), 5001-801 Vila Real, Portugal
- Research Center of the Higher Institute of Educational Sciences of the Douro, (CI-ISCE), 4560-447 Penafiel, Portugal
- Higher Institute of Educational Sciences of the Douro, 4560-447 Penafiel, Portugal
| | - Amanda Batista
- Research Center of the Higher Institute of Educational Sciences of the Douro, (CI-ISCE), 4560-447 Penafiel, Portugal
- Higher Institute of Educational Sciences of the Douro, 4560-447 Penafiel, Portugal
| | - Pedro Miguel Forte
- Department of Sport Sciences, Instituto Politécnico de Bragança (IPB), 5300-253 Bragança, Portugal
- Research Centre in Sports Sciences, Health Sciences and Human Development (CIDESD), 5001-801 Vila Real, Portugal
- Research Center of the Higher Institute of Educational Sciences of the Douro, (CI-ISCE), 4560-447 Penafiel, Portugal
- Higher Institute of Educational Sciences of the Douro, 4560-447 Penafiel, Portugal
| |
Collapse
|
26
|
Bleyer A. Increasing Cancer in Adolescents and Young Adults: Cancer Types and Causation Implications. J Adolesc Young Adult Oncol 2023; 12:285-296. [PMID: 37074337 DOI: 10.1089/jayao.2022.0134] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/20/2023] Open
Abstract
Purpose: This study aimed to identify cancer incidence trends in the United States and globally in adolescents and young adults (AYAs) 15-39 years of age, by sex, and to speculate on causes for trend changes. Methods: For the United States, SEER*Stat was used to obtain average annual percent change (AAPC) trends in cancer incidence during the period 2000-2019 among 395,163 AYAs. For global data, the source was the Institute of Health Metrics and Evaluation and its sociodemographic index (SDI) classification system. Results: In the United States, the invasive cancer incidence increased during the period 2000-2019 in both females (AAPC: 1.05, 95% CI: 0.90-1.20, p << 0.001) and males (AAPC: 0.56, 95% CI: 0.43-0.69, p << 0.001). A total of 25 and 20 types of cancers increased statistically significantly in female and male AYAs, respectively. Among potential causes for the increases, the obesity epidemic in the United States strongly correlates with the overall cancer increase in both its female (Pearson correlation coefficient R2 = 0.88, p = 0.0007) and male (R2 = 0.83, p = 0.003) AYAs, as does the most common malignancy in American AYAs, breast cancer (R2 = 0.83, p = 0.003). Worldwide, cancer incidence in the age group increased steadily during the period 2000-2019 among high-middle, middle, and low-middle SDI countries, but not in low SDI countries and with slowing of increase in high SDI countries. Conclusions: The increases and their age-dependent profiles implicate several causations that are preventable, including obesity, overdiagnosis, unnecessary diagnostic radiation, human papilloma virus infection, and cannabis avoidance. The United States is beginning to reverse the increasing incidence, and prevention efforts should be augmented accordingly.
Collapse
Affiliation(s)
- Archie Bleyer
- Pediatric & Young Adult Oncology, Oregon Health & Science University, Bend, Oregon, USA
- McGovern Medical School, University of Texas, Houston, Texas, USA
| |
Collapse
|
27
|
Nitecki M, Savitsky B, Akavian I, Yakhin A, Narkiss T, Michael YB, Shapira S, Friedensohn L. B.1.1.7 Variant Outbreak in an Air Force Military Base-Real-World Data. Mil Med 2023; 188:e1293-e1299. [PMID: 34755833 PMCID: PMC8689938 DOI: 10.1093/milmed/usab451] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2021] [Revised: 09/21/2021] [Accepted: 11/04/2021] [Indexed: 01/08/2023] Open
Abstract
OBJECTIVE To assess the clinical features and infectivity of variant B.1.1.7 among healthy young adults in a military setting. MATERIALS AND METHODS Positive cases of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) in a single military base (March 23, 2020 and February 16, 2021) were included. An epidemiological investigation conducted via phone included questions regarding symptoms, exposure history, smoking status, list of contacts, and recently visited places. Symptoms surveyed included fever, cough, shortness of breath, sore throat, loss of smell or taste, gastrointestinal symptoms (GI), headache, chest pain, and constitutional symptoms. Cases were divided before B.1.1.7 first reported case in Israel (December 23, 2020) (period 1) and after its identification (period 2). Symptom distribution and the risk of a contact to be infected were compared between the periods, using a chi-square test, and a negative binominal regression model, respectively. RESULTS Of 293 confirmed cases, 89 were reported in the first period and 204 in the second. 56.0% were men with a median age of 19.5 years (interquartile range 18.6-20.5). GI symptoms, loss of taste or smell, headache, fever, and chills were more prevalent in the first period (P < .001, P = .026, P = .034, P = .001, and P < .001, respectively), while fatigue was more common in the second period (P = .008). The risk of a contact to be infected was three times higher in the second period (relative risk = 3.562 [2.414-5.258]). CONCLUSION An outbreak of SARS-CoV-2 in young healthy adults, during a period with high national-wide B.1.1.7 variant prevalence, is characterized by decreased prevalence of fever, loss of taste or smell and GI symptoms, increased reports of fatigue, and more infected contacts for each index case.
Collapse
Affiliation(s)
- Maya Nitecki
- Israel Defense Forces, Medical Corps, Ramat Gan 02149, Israel
- Department of Military Medicine, Hebrew University, Jerusalem 9112102, Israel
| | - Bella Savitsky
- Department of Nursing, School of Health Science, Ashkelon Academic College, Ashkelon 78211, Israel
| | - Inbal Akavian
- Israel Defense Forces, Medical Corps, Ramat Gan 02149, Israel
| | - Alexey Yakhin
- Israel Defense Forces, Medical Corps, Ramat Gan 02149, Israel
| | - Tamar Narkiss
- Israel Defense Forces, Medical Corps, Ramat Gan 02149, Israel
| | | | - Shachar Shapira
- Israel Defense Forces, Medical Corps, Ramat Gan 02149, Israel
- Department of Military Medicine, Hebrew University, Jerusalem 9112102, Israel
| | - Limor Friedensohn
- Israel Defense Forces, Medical Corps, Ramat Gan 02149, Israel
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv 69978, Israel
| |
Collapse
|
28
|
Playdon MC, Hardikar S, Karra P, Hoobler R, Ibele AR, Cook KL, Kumar A, Ippolito JE, Brown JC. Metabolic and bariatric surgery and obesity pharmacotherapy for cancer prevention: current status and future possibilities. J Natl Cancer Inst Monogr 2023; 2023:68-76. [PMID: 37139980 PMCID: PMC10157771 DOI: 10.1093/jncimonographs/lgad003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2022] [Revised: 12/19/2022] [Accepted: 01/19/2023] [Indexed: 05/05/2023] Open
Abstract
Obesity is a chronic, relapsing, progressive disease of excess adiposity that increases the risk of developing at least 13 types of cancer. This report provides a concise review of the current state of the science regarding metabolic and bariatric surgery and obesity pharmacotherapy related to cancer risk. Meta-analyses of cohort studies report that metabolic and bariatric surgery is independently associated with a lower risk of incident cancer than nonsurgical obesity care. Less is known regarding the cancer-preventive effects of obesity pharmacotherapy. The recent approval and promising pipeline of obesity drugs will provide the opportunity to understand the potential for obesity therapy to emerge as an evidence-based cancer prevention strategy. There are myriad research opportunities to advance our understanding of how metabolic and bariatric surgery and obesity pharmacotherapy may be used for cancer prevention.
Collapse
Affiliation(s)
- Mary C Playdon
- Department of Nutrition and Integrative Physiology, College of Health, University of Utah, Salt Lake City, UT, USA
- Cancer Control and Population Sciences Program, Huntsman Cancer Institute, Salt Lake City, UT, USA
| | - Sheetal Hardikar
- Cancer Control and Population Sciences Program, Huntsman Cancer Institute, Salt Lake City, UT, USA
- Department of Population Health Sciences, School of Medicine, University of Utah, Salt Lake City, UT, USA
| | - Prasoona Karra
- Department of Nutrition and Integrative Physiology, College of Health, University of Utah, Salt Lake City, UT, USA
- Cancer Control and Population Sciences Program, Huntsman Cancer Institute, Salt Lake City, UT, USA
| | - Rachel Hoobler
- Department of Nutrition and Integrative Physiology, College of Health, University of Utah, Salt Lake City, UT, USA
- Cancer Control and Population Sciences Program, Huntsman Cancer Institute, Salt Lake City, UT, USA
| | - Anna R Ibele
- Department of Surgery, School of Medicine, University of Utah, Salt Lake City, UT, USA
| | - Katherine L Cook
- Department of Surgery, Wake Forest School of Medicine, Winston-Salem, NC, USA
- Department of Cancer Biology, Wake Forest School of Medicine, Winston-Salem, NC, USA
- Comprehensive Cancer Center, Wake Forest School of Medicine, Winston-Salem, NC, USA
| | - Amanika Kumar
- Division of Gynecologic Surgery, Mayo Clinic, Rochester, MN, USA
| | - Joseph E Ippolito
- Mallinckrodt Institute of Radiology, Washington University School of Medicine, St. Louis, MO, USA
| | - Justin C Brown
- Pennington Biomedical Research Center, Baton Rouge, LA, USA
- Louisiana State University Health Sciences Center New Orleans School of Medicine, New Orleans, LA, USA
- Stanley S. Scott Cancer Center, Louisiana State University Health Sciences Center, New Orleans, LA, USA
| |
Collapse
|
29
|
Hu X, Xia K, Dai M, Han X, Yuan P, Liu J, Liu S, Jia F, Chen J, Jiang F, Yu J, Yang H, Wang J, Xu X, Jin X, Kristiansen K, Xiao L, Chen W, Han M, Duan S. Intermittent fasting modulates the intestinal microbiota and improves obesity and host energy metabolism. NPJ Biofilms Microbiomes 2023; 9:19. [PMID: 37029135 PMCID: PMC10081985 DOI: 10.1038/s41522-023-00386-4] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2022] [Accepted: 03/23/2023] [Indexed: 04/09/2023] Open
Abstract
Intermittent fasting (IF) is a promising paradigm for weight loss which has been shown to modulate the gut microbiota based on 16S rRNA gene amplicon sequencing. Here, 72 Chinese volunteers with a wide range of body mass index (BMI) participated in a three-week IF program during which an average loss of 3.67 kg body weight accompanied with improved clinical parameters was observed irrespective of initial anthropometric and gut microbiota status. Fecal samples were collected before and after the intervention and subjected to shotgun metagenomic sequencing. De novo assembly yielded 2934 metagenome-assembled genomes (MAGs). Profiling revealed significant enrichment of Parabacteroides distasonis and Bacteroides thetaiotaomicron after the intervention, with inverse correlations between their relative abundances and parameters related to obesity and atherosclerotic cardiovascular diseases (ASCVD). MAGs enriched after the intervention showed high richness and diversity of carbohydrate-active enzymes, with an increased relative abundances of genes related to succinate production and glutamate fermentation.
Collapse
Affiliation(s)
- Xiangwei Hu
- BGI-Shenzhen, Shenzhen, 518083, China
- BGI College & Henan Institute of Medical and Pharmaceutical Sciences, Zhengzhou University, Zhengzhou, 450001, China
| | - Kai Xia
- Beijing Key Laboratory of the Innovative Development of Functional Staple and Nutritional Intervention for Chronic Diseases, China National Research Institute of Food and Fermentation Industries Co., Ltd, Beijing, 100015, China
| | - Minhui Dai
- Department of Clinical Nutrition, Xiangya Hospital of Central South University, Changsha, 410008, China
| | - Xiaofeng Han
- Beijing Key Laboratory of the Innovative Development of Functional Staple and Nutritional Intervention for Chronic Diseases, China National Research Institute of Food and Fermentation Industries Co., Ltd, Beijing, 100015, China
| | - Peng Yuan
- Beijing Key Laboratory of the Innovative Development of Functional Staple and Nutritional Intervention for Chronic Diseases, China National Research Institute of Food and Fermentation Industries Co., Ltd, Beijing, 100015, China
| | - Jia Liu
- Beijing Key Laboratory of the Innovative Development of Functional Staple and Nutritional Intervention for Chronic Diseases, China National Research Institute of Food and Fermentation Industries Co., Ltd, Beijing, 100015, China
| | - Shiwei Liu
- Beijing Key Laboratory of the Innovative Development of Functional Staple and Nutritional Intervention for Chronic Diseases, China National Research Institute of Food and Fermentation Industries Co., Ltd, Beijing, 100015, China
| | - Fuhuai Jia
- Ningbo Yufangtang Biological Technology Co., Ltd, Ningbo, 315012, China
| | - Jiayu Chen
- BGI-Shenzhen, Shenzhen, 518083, China
- China National GeneBank, BGI-Shenzhen, Shenzhen, 518120, China
| | - Fangfang Jiang
- BGI-Shenzhen, Shenzhen, 518083, China
- China National GeneBank, BGI-Shenzhen, Shenzhen, 518120, China
| | - Jieyao Yu
- BGI-Shenzhen, Shenzhen, 518083, China
- China National GeneBank, BGI-Shenzhen, Shenzhen, 518120, China
| | - Huanming Yang
- BGI-Shenzhen, Shenzhen, 518083, China
- Institute of Metagenomics, Qingdao-Europe Advance Institute for Life Sciences, BGI-Qingdao, 266555, Qingdao, China
- James D. Watson Institute of Genome Sciences, Hangzhou, 310058, China
| | - Jian Wang
- BGI-Shenzhen, Shenzhen, 518083, China
- James D. Watson Institute of Genome Sciences, Hangzhou, 310058, China
| | - Xun Xu
- BGI-Shenzhen, Shenzhen, 518083, China
- Guangdong Provincial Key Laboratory of Genome Read and Write, BGI-Shenzhen, Shenzhen, 518120, China
| | - Xin Jin
- BGI-Shenzhen, Shenzhen, 518083, China
| | - Karsten Kristiansen
- BGI-Shenzhen, Shenzhen, 518083, China
- Institute of Metagenomics, Qingdao-Europe Advance Institute for Life Sciences, BGI-Qingdao, 266555, Qingdao, China
- Laboratory of Genomics and Molecular Biomedicine, Department of Biology, University of Copenhagen, DK-2100, Copenhagen, Denmark
| | - Liang Xiao
- BGI-Shenzhen, Shenzhen, 518083, China
- Shenzhen Engineering Laboratory of Detection and Intervention of Human Intestinal Microbiome, BGI-Shenzhen, Shenzhen, 518083, China
| | - Wei Chen
- Department of Clinical Nutrition, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, 100730, China.
| | - Mo Han
- BGI-Shenzhen, Shenzhen, 518083, China.
- Laboratory of Genomics and Molecular Biomedicine, Department of Biology, University of Copenhagen, DK-2100, Copenhagen, Denmark.
- Shenzhen Engineering Laboratory of Detection and Intervention of Human Intestinal Microbiome, BGI-Shenzhen, Shenzhen, 518083, China.
| | - Shenglin Duan
- Beijing Key Laboratory of the Innovative Development of Functional Staple and Nutritional Intervention for Chronic Diseases, China National Research Institute of Food and Fermentation Industries Co., Ltd, Beijing, 100015, China.
| |
Collapse
|
30
|
Mohammadian Khonsari N, Shahrestanaki E, Ehsani A, Asadi S, Sokoty L, Mohammadpoor Nami S, Hakak-Zargar B, Qorbani M. Association of childhood and adolescence obesity with incidence and mortality of adulthood cancers. A systematic review and meta-analysis. Front Endocrinol (Lausanne) 2023; 14:1069164. [PMID: 36742402 PMCID: PMC9892178 DOI: 10.3389/fendo.2023.1069164] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/13/2022] [Accepted: 01/02/2023] [Indexed: 01/20/2023] Open
Abstract
BACKGROUND Prevalence and subsequent conditions of childhood and adolescent obesity are increasing. It has been seen that obesity in youth is associated with adulthood cancer. This systematic review and meta-analysis aimed to determine the pooled association of childhood obesity with cancers in adulthood. METHODS In this systematic review, international electronic databases such as Scopus, PubMed, Web of Science, and EMBASE were searched using relevant keywords until February 2022. All Cohort studies assessing the association of childhood and adolescent obesity (under 18 years old) with the incidence and mortality of all types of cancers were included. Two independent reviewers screened and carried out the quality assessment of included studies. Between-studies heterogeneity was assessed using the I squared and Cochran's Q tests. Random/fixed-effect meta-analyses were used to pool the appropriate effect sizes (Hazard ratios (HR)). RESULTS Overall, 46 studies were found to be relevant and were included in this study. Based on the random-effects model meta-analysis, childhood obesity increased the hazard of cancer incidence and mortality in adulthood by 33% (HR: 1.33, 95%CI (1.25, 1.41)) and by 28% (HR: 1.28, 95%CI (1.13, 1.42)), respectively. In the subgroups meta-analysis, the HR of childhood obesity and adulthood cancer incidence mortality in women was higher than in men (HR=1.39, 95%CI (1.25, 1.53) vs HR= 1.20, 95%CI (1.07, 1.32)) and (HR= 1.40, 95%CI (1.10, 1.69) vs HR=1.20, 95%CI (1.04, 1.36)) respectively. CONCLUSION This study found that obesity in childhood and adolescence is associated with a significant increase in the incidence and mortality of cancers in adulthood. Prevention of childhood obesity, in addition to its short-term beneficial effects, can reduce the burden of cancer in adulthood. The data sets of this study are present in the Tables of the current manuscript. Moreover this study was registered online in PROSPERO (registration code: CRD42022331958). SYSTEMIC REVIEW REGISTRATION https://www.crd.york.ac.uk/Prospero/, identifier CRD42022331958.
Collapse
Affiliation(s)
- Nami Mohammadian Khonsari
- Non-Communicable Diseases Research Center, Alborz University of Medical Sciences, Karaj, Iran
- *Correspondence: Mostafa Qorbani, ; Nami Mohammadian Khonsari,
| | - Ehsan Shahrestanaki
- Non-Communicable Diseases Research Center, Alborz University of Medical Sciences, Karaj, Iran
| | - Amir Ehsani
- School of Medicine, Iran University of Medical Sciences, Tehran, Iran
| | - Sara Asadi
- Western Sydney University, Translational Health Research Institute, Sydney, NSW, Australia
| | - Leily Sokoty
- Non-Communicable Diseases Research Center, Alborz University of Medical Sciences, Karaj, Iran
| | - Sahar Mohammadpoor Nami
- Social Determinants of Health Research Center, Alborz University of Medical Sciences, Karaj, Iran
| | | | - Mostafa Qorbani
- Non-Communicable Diseases Research Center, Alborz University of Medical Sciences, Karaj, Iran
- Endocrinology and Metabolism Research Center, Endocrinology and Metabolism Clinical Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
- *Correspondence: Mostafa Qorbani, ; Nami Mohammadian Khonsari,
| |
Collapse
|
31
|
Friedman N, Erez-Granat O, Inbar A, Dubnov-Raz G. Obesity screening in the pediatric emergency department - A missed opportunity? Heliyon 2022; 8:e12473. [PMID: 36590528 PMCID: PMC9801120 DOI: 10.1016/j.heliyon.2022.e12473] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2022] [Revised: 10/25/2022] [Accepted: 12/12/2022] [Indexed: 12/24/2022] Open
Abstract
Objectives There is a low rate of body mass index measurements and obesity screening in primary pediatric care. Pediatric emergency department (PED) visits, with their large volumes and routine weight measurements, provide a unique opportunity to identify and address obesity. The study objectives were to examine the rate of addressing obesity in the PED and to identify its predicting factors. Methods From electronic medical records of PED visits during 2010-2019, we extracted data on age, gender, weight, time, listed diagnoses, and discharge texts. The primary outcome was a listed diagnosis of "obesity" on discharge letters of children with obesity. Secondary outcomes were addressing weight in the discharge letter and written recommendations for obesity-related treatment. Mixed models were used to test for associations between each of the three outcomes and patient/visit characteristics. Results There were 150,250 PED visits by 88,253 different children and adolescents. Obesity was found in 10,691 children (12.1%). Among these, listed "obesity" diagnosis was present in only 240 (1.5%) visits. Text addressing overweight/obesity was recorded in 721 (4.4%) visits, and weight-related recommendations were documented in 716 (4.4%) visits. "Obesity" was documented in females more often than in males, in older children, in children with higher weights, and in visits conducted during the mornings. Conclusions The rate of obesity diagnosis in the PED was extremely low, hence the potential screening ability of the PED in this matter is highly under-utilized. PEDs could increase the recognition of obesity, thus assisting in the global efforts in tackling this disease.
Collapse
Affiliation(s)
- Nir Friedman
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel,Pediatric Emergency Department, Meir Medical Center, Kfar Saba, Israel,Corresponding author.
| | - Ortal Erez-Granat
- The Edmond and Lily Safra Children’s Hospital, Sheba Medical Center, Tel Hashomer, Israel,Pediatric Emergency Department, Meir Medical Center, Kfar Saba, Israel
| | - Alon Inbar
- The Edmond and Lily Safra Children’s Hospital, Sheba Medical Center, Tel Hashomer, Israel
| | - Gal Dubnov-Raz
- The Edmond and Lily Safra Children’s Hospital, Sheba Medical Center, Tel Hashomer, Israel,Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| |
Collapse
|
32
|
Feletto E, Kohar A, Mizrahi D, Grogan P, Steinberg J, Hughes C, Watson WL, Canfell K, Yu XQ. An ecological study of obesity-related cancer incidence trends in Australia from 1983 to 2017. THE LANCET REGIONAL HEALTH. WESTERN PACIFIC 2022; 29:100575. [PMID: 36106135 PMCID: PMC9465341 DOI: 10.1016/j.lanwpc.2022.100575] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/31/2023]
Abstract
BACKGROUND Overweight and obesity is a growing public health issue as it contributes to the future burden of obesity-related diseases, including cancer, especially in high-income countries. In Australia, 4.3% of all cancers diagnosed in 2013 were attributable to overweight and obesity. Our aim was to examine Australian age-specific incidence trends over the last 35 years for obesity-related cancers based on expert review (colorectal, liver, gallbladder, pancreas, breast in postmenopausal women, uterine, ovary, kidney, thyroid, and multiple myeloma) individually and pooled. METHODS Australian incidence data for 10 obesity-related cancers among people aged 25-84 years, diagnosed from 1983 to 2017, were obtained from the Australian Cancer Database. We used age-period-cohort modelling and joinpoint analysis to assess trends, estimating incidence rate ratios (IRR) by birth-cohort for each individual cancer and pooled, and the annual percentage change. The analyses were also conducted for non-obesity-related cancers over the same period. FINDINGS The total number of cancers where some proportion is obesity-related, diagnosed from 1983-2017, was 1,005,933. This grouping was 34.7% of cancers diagnosed. The IRR of obesity-related cancers increased from 0.77 (95% CI 0.73, 0.81) for the 1903 birth-cohort to 2.95 (95% CI 2.58, 3.38) for the recent 1988 cohort relative to the 1943 cohort. The IRRs of non-obesity related cancers were stable with non-significant decreases in younger cohorts. These trends were broadly similar across sex and age groups. INTERPRETATION The incidence of obesity-related cancers in Australia has increased by birth-cohort across all age-groups, which should be monitored. Obesity, a public health epidemic, needs to be addressed through increased awareness, policy support and evidence-based interventions. FUNDING This research received no specific funding.
Collapse
Affiliation(s)
- Eleonora Feletto
- The Daffodil Centre, The University of Sydney, a joint venture with Cancer Council NSW, Australia
| | - Ankur Kohar
- The Daffodil Centre, The University of Sydney, a joint venture with Cancer Council NSW, Australia
| | - David Mizrahi
- The Daffodil Centre, The University of Sydney, a joint venture with Cancer Council NSW, Australia
| | - Paul Grogan
- The Daffodil Centre, The University of Sydney, a joint venture with Cancer Council NSW, Australia
| | - Julia Steinberg
- The Daffodil Centre, The University of Sydney, a joint venture with Cancer Council NSW, Australia
| | - Clare Hughes
- Cancer Prevention and Advocacy Division, Cancer Council NSW, Australia
| | - Wendy L. Watson
- Cancer Prevention and Advocacy Division, Cancer Council NSW, Australia
| | - Karen Canfell
- The Daffodil Centre, The University of Sydney, a joint venture with Cancer Council NSW, Australia
| | - Xue Qin Yu
- The Daffodil Centre, The University of Sydney, a joint venture with Cancer Council NSW, Australia
| |
Collapse
|
33
|
Xu H, Wu L, Lu H, Sun Y, Wu D, He Y, Yu L, Peng H, Li H. Relationship between Gestational Weight Gain Rate Trajectory and Overweight in Offspring at Three Years of Age. Child Obes 2022; 18:540-547. [PMID: 35352949 DOI: 10.1089/chi.2021.0288] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/25/2023]
Abstract
Background: The incidence of childhood obesity has increased rapidly, and its relationship with adult diseases is constantly being revealed. Maternal factors have been shown to play an important role in the growth and development of newborns. In this article, we explored the relationship between the gestational weight gain (GWG) rate and overweight/obesity in offspring at 3 years of age. Methods: A total of 5146 pregnant women and their children registered between January 2010 and December 2018 were studied by a retrospective cohort study. The Group-based Trajectory Model was used to distinguish the GWG rate patterns. Overweight/obesity was diagnosed by the weight-for-height Z-score at 3 years of age. Logistic regression was used to analyze the association between GWG rate patterns and outcomes. Odds ratio (OR) and 95% confidence interval (95% CI) were calculated to analyze the association between GWG rate patterns and overweight/obesity in offspring at 3 years of age. Results: Three GWG rate growth patterns were identified in this study. The incidence of offspring overweight/obesity in the low-stable, high-stable, and low-sharp patterns was 8.33%, 3.68%, and 6.03% respectively. After adjusting covariates, compared with the low-stable pattern, the high-stable pattern increased the risk for offspring to be overweight/obesity at 3 years of age, with OR of 2.26 (95% CI, 1.31-3.90). However, the low-sharp pattern was not associated with overweight/obesity in offspring at 3 years of age. Conclusions: The high-stable increasing pattern of the GWG rate is a risk factor for overweight/obesity in offspring at 3 years of age.
Collapse
Affiliation(s)
- He Xu
- Department of Epidemiology, School of Public Health, Medical College of Soochow University, Suzhou, Jiangsu, China
| | - Lei Wu
- Department of Maternal and Child Health, Suzhou Industrial Park Center for Disease Control and Prevention, Suzhou, Jiangsu, China
| | - Heng Lu
- Department of Epidemiology, School of Public Health, Medical College of Soochow University, Suzhou, Jiangsu, China
| | - Yexiu Sun
- Department of Epidemiology, School of Public Health, Medical College of Soochow University, Suzhou, Jiangsu, China
| | - Di Wu
- Department of Epidemiology, School of Public Health, Medical College of Soochow University, Suzhou, Jiangsu, China
| | - Yan He
- Department of Epidemiology, School of Public Health, Medical College of Soochow University, Suzhou, Jiangsu, China
| | - Lugang Yu
- Department of Maternal and Child Health, Suzhou Industrial Park Center for Disease Control and Prevention, Suzhou, Jiangsu, China
| | - Hao Peng
- Department of Epidemiology, School of Public Health, Medical College of Soochow University, Suzhou, Jiangsu, China.,Jiangsu Key Laboratory of Preventive and Translational Medicine for Geriatric Diseases, Suzhou, Jiangsu, China
| | - Hongmei Li
- Department of Epidemiology, School of Public Health, Medical College of Soochow University, Suzhou, Jiangsu, China.,Jiangsu Key Laboratory of Preventive and Translational Medicine for Geriatric Diseases, Suzhou, Jiangsu, China
| |
Collapse
|
34
|
Abstract
Childhood obesity is, according to the WHO, one of the most serious challenges of the 21st century. More than 100 million children have obesity today. Already during childhood, almost all organs are at risk of being affected by obesity. In this review, we present the current knowledge about diseases associated with childhood obesity and how they are affected by weight loss. One major causative factor is obesity-induced low-grade chronic inflammation, which can be observed already in preschool children. This inflammation-together with endocrine, paracrine, and metabolic effects of obesity-increases the long-term risk for several severe diseases. Type 2 diabetes is increasingly prevalent in adolescents and young adults who have had obesity during childhood. When it is diagnosed in young individuals, the morbidity and mortality rate is higher than when it occurs later in life, and more dangerous than type 1 diabetes. Childhood obesity also increases the risk for several autoimmune diseases such as multiple sclerosis, Crohn's disease, arthritis, and type 1 diabetes and it is well established that childhood obesity also increases the risk for cardiovascular disease. Consequently, childhood obesity increases the risk for premature mortality, and the mortality rate is three times higher already before 30 years of age compared with the normal population. The risks associated with childhood obesity are modified by weight loss. However, the risk reduction is affected by the age at which weight loss occurs. In general, early weight loss-that is, before puberty-is more beneficial, but there are marked disease-specific differences.
Collapse
Affiliation(s)
- Claude Marcus
- Division of Pediatrics, Department of Clinical Science, Intervention and Technology, Karolinska Institutet, Stockholm, Sweden
| | - Pernilla Danielsson
- Division of Pediatrics, Department of Clinical Science, Intervention and Technology, Karolinska Institutet, Stockholm, Sweden
| | - Emilia Hagman
- Division of Pediatrics, Department of Clinical Science, Intervention and Technology, Karolinska Institutet, Stockholm, Sweden
| |
Collapse
|
35
|
Hoyt M, Song Y, Gao S, O'Palka J, Zhang J. Prediagnostic BMI trajectories in relation to pancreatic cancer risk in the Prostate, Lung, Colorectal, and Ovarian Cancer Screening Trial. Obesity (Silver Spring) 2022; 30:2275-2285. [PMID: 36156459 PMCID: PMC9826088 DOI: 10.1002/oby.23550] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/13/2022] [Revised: 06/26/2022] [Accepted: 06/28/2022] [Indexed: 01/11/2023]
Abstract
OBJECTIVE It remains elusive whether prediagnostic BMI trajectory is associated with pancreatic cancer. METHODS This study investigated this question among 145,489 participants who gave rise to 696 incident cases of pancreatic cancer over a median follow-up of 12 years in the Prostate, Lung, Colorectal, and Ovarian (PLCO) Cancer Screening Trial. At baseline, participants were asked to recall their weight at ages 20, 50, and 55 to 74 years (at enrollment), as well as their height. RESULTS At age 50 years, people with obesity had a significantly increased risk of pancreatic cancer compared with those with a normal weight after adjustment for confounders (hazard ratio [95% CI]: 1.27 [1.01-1.60]). Individuals who had overweight at age 20 years experienced a marginally significant elevated risk of pancreatic cancer (hazard ratio [95% CI]: 1.22 [0.99-1.50]). Compared with individuals who maintained a steady normal weight during follow-up, no significantly altered risk of pancreatic cancer was observed for those whose weight status changed from normal weight to overweight, from normal weight to obesity, and from overweight to obesity. CONCLUSIONS The present study revealed that prediagnostic adulthood BMI trajectory was not associated with pancreatic cancer risk, but overweight at young adulthood and obesity at middle adulthood may confer an elevated risk of this malignancy.
Collapse
Affiliation(s)
- Margaret Hoyt
- Department of EpidemiologyRichard M. Fairbanks School of Public Health, Indiana University–Purdue UniversityIndianapolisIndianaUSA
| | - Yiqing Song
- Department of EpidemiologyRichard M. Fairbanks School of Public Health, Indiana University–Purdue UniversityIndianapolisIndianaUSA
| | - Sujuan Gao
- Department of Biostatistics and Health Data ScienceRichard M. Fairbanks School of Public Health and School of Medicine, Indiana University–Purdue UniversityIndianapolisIndianaUSA
| | - Jacquelynn O'Palka
- Department of Nutrition and DieteticsSchool of Health and Human Sciences, Indiana University–Purdue UniversityIndianapolisIndianaUSA
| | - Jianjun Zhang
- Department of EpidemiologyRichard M. Fairbanks School of Public Health, Indiana University–Purdue UniversityIndianapolisIndianaUSA
- Melvin and Bren Simon Comprehensive Cancer CenterIndiana University–Purdue UniversityIndianapolisIndianaUSA
| |
Collapse
|
36
|
Tsur AM, David P, Watad A, Nissan D, Cohen AD, Amital H. Ankylosing Spondylitis and the Risk of Hip Fractures: a Matched Cohort Study. J Gen Intern Med 2022; 37:3283-3288. [PMID: 35411534 PMCID: PMC9550950 DOI: 10.1007/s11606-021-07241-2] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/19/2021] [Accepted: 10/20/2021] [Indexed: 10/18/2022]
Abstract
BACKGROUNDS It has been hypothesized that ankylosing spondylitis is associated with an increased risk of incident hip fractures due to osteoporosis and risk of falls but the supporting evidence is limited and mixed. OBJECTIVES To assess the risk of hip fractures in a large cohort of patients with ankylosing spondylitis compared to a matched cohort. DESIGN A retrospective cohort study. SUBJECTS Men and women diagnosed with ankylosing spondylitis from 1 January 2002 to 31 December 2018. Matching in a 5:1 ratio was based on age and sex. Follow-up ended on 23 June 2019. MAIN MEASURES Cox regression models adjusting for confounders defined in a causal inference framework were used to determine the hazard ratio for hip fractures. KEY RESULT The final cohorts included 5,909 ankylosing spondylitis patients and 28,671 matched patients. The ankylosing spondylitis cohort had a mean age of 49 (17) years and was composed of 3,762 (64%) men, 3,638 (62%) patients born in Israel, and 1,532 (26%) patients of low residential socioeconomic status. During 45,388 and 224,192 cumulative person-years of follow-up, the ankylosing spondylitis and matched cohorts had 2.47 and 1.63 cases of hip fractures per 1,000 person-years, respectively. Ankylosing spondylitis patients also developed hip fractures earlier (74 [13] vs. 79 [10] years, p = 0.002). Ankylosing spondylitis was associated with hip fractures in the unadjusted (HR = 1.52, 95% CI [1.23-1.88]) and adjusted (HR = 1.56, 95% CI [1.27-1.93]) models. The association was evident in men (HR = 1.65, 95% CI [1.25-2.18]) and women (HR = 1.48, 95% CI [1.07-2.05]). CONCLUSION This study found that ankylosing spondylitis patients developed hip fractures earlier and more often compared to a matched cohort. This study suggests that ankylosing spondylitis patients might benefit from more proactive screening, mitigation, and prevention of risk factors for hip fractures.
Collapse
Affiliation(s)
- Avishai M Tsur
- Department of Medicine B, Zabludowicz Center for Autoimmune Diseases, Sheba Medical Center, 5262100, Tel-Hashomer, Israel
- Sackler Faculty of Medicine, Tel-Aviv University, Tel-Aviv, Israel
- Israel Defense Forces, Medical Corps, Tel Hashomer, Ramat Gan, Israel
- Department of Military Medicine, Hebrew University of Jerusalem Faculty of Medicine, Jerusalem, Israel
| | - Paula David
- Department of Medicine B, Zabludowicz Center for Autoimmune Diseases, Sheba Medical Center, 5262100, Tel-Hashomer, Israel
- Sackler Faculty of Medicine, Tel-Aviv University, Tel-Aviv, Israel
| | - Abdulla Watad
- Department of Medicine B, Zabludowicz Center for Autoimmune Diseases, Sheba Medical Center, 5262100, Tel-Hashomer, Israel
- Sackler Faculty of Medicine, Tel-Aviv University, Tel-Aviv, Israel
| | - Daniel Nissan
- School of Public Health, Sackler Faculty of Medicine, Tel Aviv University, Tel-Aviv, Israel
| | - Arnon D Cohen
- Chief Physicians Office, Clalit Health Services, Tel Aviv, Israel
- Siaal Research Center for Family Medicine and Primary Care, Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer Sheva, Israel
| | - Howard Amital
- Department of Medicine B, Zabludowicz Center for Autoimmune Diseases, Sheba Medical Center, 5262100, Tel-Hashomer, Israel.
- Sackler Faculty of Medicine, Tel-Aviv University, Tel-Aviv, Israel.
| |
Collapse
|
37
|
Persistent asymptomatic isolated microscopic hematuria in adolescents is not associated with an increased risk for early onset urinary tract cancer. Urology 2022; 169:29-34. [PMID: 35985524 DOI: 10.1016/j.urology.2022.06.048] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2022] [Revised: 06/22/2022] [Accepted: 06/26/2022] [Indexed: 10/15/2022]
Abstract
OBJECTIVE To elucidate the association between adolescent microscopic hematuria and early onset urothelial carcinoma and renal cell carcinoma. METHODS Nationwide, population-based, retrospective cohort study using medical data of 970,366 adolescents aged 16 through 19 years (58.6% male) examined for fitness for military service between 1980 and 1997. Diagnoses of persistent isolated microscopic hematuria were given after thorough work up process excluding any other renal abnormalities. Incident cases of urothelial carcinoma and renal cell carcinoma diagnosed during the years of 1982 to 2012 were retrieved from the Israeli National Cancer Registry. Cox proportional hazards models were used to estimate the hazard ratio (HR) separately for urothelial carcinoma and renal cell carcinoma. RESULTS During a cumulative follow-up of 22,115,629 person-years (median follow-up, 22.8), persistent isolated microscopic hematuria was diagnosed among 5509 (0.6%) adolescents. Urothelial carcinoma and renal cell carcinoma developed in 332 (3 among those with persistent isolated microscopic hematuria) and 292 (2) individuals, respectively. The adjusted HR for incident urothelial carcinoma among adolescents with isolated microscopic hematuria was 1.17 (95% CI, 0.38-3.66) and the adjusted HR for renal cell carcinoma was 1.02 (95% CI, 0.25-4.12). CONCLUSIONS Persistent asymptomatic isolated microscopic hematuria at adolescence was not associated with increased risk for urothelial carcinoma nor renal cell carcinoma.
Collapse
|
38
|
Bhardwaj NJ, Chae K, Sheng JY, Yeh HC. Clinical interventions to break the obesity and cancer link: a narrative review. Cancer Metastasis Rev 2022; 41:719-735. [PMID: 35933566 DOI: 10.1007/s10555-022-10055-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/04/2022] [Accepted: 07/25/2022] [Indexed: 11/26/2022]
Abstract
Excess body weight is a significant risk factor for the development and recurrence of many types of cancer. Patients with a history or current diagnosis of cancer who are overweight or have obesity have an increased risk of cancer treatment-related morbidity, recurrence, and decreased quality of life. Weight loss and maintenance of a healthy body weight may reduce cancer morbidity and recurrence in cancer survivors. While guidelines for cancer survivorship elaborate sufficiently on lifestyle interventions, little guidance is provided when considering additional therapies like anti-obesity pharmacotherapy or bariatric surgery for weight loss. This review will highlight and address current recommendations and feasible interventions that clinicians may consider to further reduce the incidence and recurrence of cancer in patients with obesity.
Collapse
Affiliation(s)
- Nakul J Bhardwaj
- Department of Medicine, Johns Hopkins School of Medicine, Baltimore, MD, USA
| | - Kacey Chae
- Department of Medicine, Johns Hopkins School of Medicine, Baltimore, MD, USA
| | - Jennifer Y Sheng
- Department of Oncology, Johns Hopkins School of Medicine, Baltimore, MD, USA
| | - Hsin-Chieh Yeh
- Department of Medicine, Johns Hopkins School of Medicine, Baltimore, MD, USA.
| |
Collapse
|
39
|
Moore EM, Blacklock H, Wellard C, Spearing R, Merriman L, Poplar S, George A, Baker B, Chan H, McQuilten ZK, Wood EM, Spencer A. Māori and Pacific Peoples With Multiple Myeloma in New Zealand are Younger and Have Inferior Survival Compared to Other Ethnicities: A Study From the Australian and New Zealand Myeloma and Related Diseases Registry (MRDR). CLINICAL LYMPHOMA, MYELOMA & LEUKEMIA 2022; 22:e762-e769. [PMID: 35501256 DOI: 10.1016/j.clml.2022.04.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/20/2021] [Accepted: 04/04/2022] [Indexed: 06/14/2023]
Abstract
BACKGROUND Māori and Pacific peoples (MPP) in New Zealand (NZ) have poorer health outcomes than other ethnicities. However, this has not been clinically investigated in multiple myeloma (MM). Using data from the Australian and NZ Myeloma and Related Diseases Registry for all participating centers in NZ, we compared MPP demographics, clinical characteristics, diagnostics, treatment, and outcomes to non-MPP. PATIENTS AND METHODS MPP were defined as having ≥1 grandparent of this heritage. We tested ethnicity as a predictor of overall survival (OS) with multivariable Cox regression. RESULTS Of 568 NZ patients with MM (September 2012 to April 2021) and ethnicity data, 138 were MPP. They were diagnosed younger than non-MPP (median age 63 [IQR: 57-72] vs. 70y [62-77], P < .001). Obesity (53 vs. 27%, P < .001), diabetes (24 vs. 8%, P < .001), renal insufficiency (28 vs. 17%, P = .005), pulmonary disease (10 vs. 5%, P = .02) and FISH abnormalities (54 vs. 42%, P = .04) were more common in MPP, and a lower proportion received first-line drug therapy (88 vs. 94%, P = .03) and autologous stem cell transplant (ASCT) (age <70y: 56 vs. 70%, P = .03). OS for MPP was shorter than non-MPP even after adjusting for age, comorbidities, disease stage, performance status, FISH abnormalities and treatment (HR 1.58 [1.04-2.39], P = .03). CONCLUSION MPP with MM in NZ were younger, a greater proportion had comorbidities and FISH abnormalities at diagnosis, fewer received first-line treatment and/or ASCT, and they had poorer OS than non-MPP. Investigation of modifiable factors to improve outcomes and discern why MM occurs at a younger age in MPP is needed.
Collapse
Affiliation(s)
- Elizabeth M Moore
- School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia.
| | | | - Cameron Wellard
- School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia
| | | | | | | | - Anup George
- Wellington Hospital, Wellington, New Zealand
| | - Bart Baker
- Palmerston North Hospital, Palmerston North, New Zealand
| | - Henry Chan
- North Shore Hospital, Auckland, New Zealand; University of Auckland, Auckland, New Zealand
| | - Zoe K McQuilten
- School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia
| | - Erica M Wood
- School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia
| | - Andrew Spencer
- Alfred Hospital, Monash University, Melbourne, Australia
| |
Collapse
|
40
|
Cavalheiro EKFF, da Silva LE, Oliveira MP, Silva MG, Damiani AP, Ribeiro CB, Magenis ML, Cucker L, Michels M, Joaquim L, Machado RS, Vilela TC, Bitencourt RM, Andrade VM, Dal-Pizzol F, Petronilho F, Tuon T, Rezin GT. Effects of obesity on neuroinflammatory and neurochemical parameters in an animal model of reserpine-induced Parkinson's disease. Behav Brain Res 2022; 434:114019. [PMID: 35872330 DOI: 10.1016/j.bbr.2022.114019] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2022] [Revised: 06/30/2022] [Accepted: 07/19/2022] [Indexed: 12/06/2022]
Abstract
Obesity is associated with low-grade chronic inflammation and oxidative stress, affecting the brain's reward system by decreasing dopaminergic neurotransmission. It is known that dopaminergic neurotransmission is also reduced in Parkinson's disease (PD), and high adiposity is considered a risk factor for the development of several neurodegenerative diseases, including PD. This study aimed to assess the effects of obesity on neuroinflammatory and neurochemical parameters in an animal model of reserpine-induced PD. The obese group showed increased inflammation and oxidative damage as well as inhibition of mitochondrial respiratory chain complexes I and II and DNA damage in the evaluated structures. The PD group did not show inflammation or mitochondrial dysfunction but exhibited oxidative damage in the hippocampus. The combination group (obesity + PD) showed reduced inflammation and oxidative stress and increased activity of complexes I and II of the mitochondrial respiratory chain in most of the analyzed structures. On the other hand, obesity + PD caused oxidative damage to proteins in the liver, prefrontal cortex, striatum, and cerebral cortex and oxidative stress in the hypothalamus, resulting in reduced catalase activity. Furthermore, the combination group showed DNA damage in blood, liver, and cerebral cortex. In conclusion, it was observed that the association of obesity and PD did not increase inflammation, oxidative stress, or mitochondrial dysfunction in most of the evaluated structures but increased oxidative damage and induced mechanisms that led to DNA damage in peripheral tissues and brain structures.
Collapse
Affiliation(s)
- Eulla Keimili Fernandes Ferreira Cavalheiro
- Laboratory of Neurobiology of Inflammatory and Metabolic Processes, Postgraduate Program in Health Sciences, University of Southern Santa Catarina, Tubarão, Santa Catarina, Brazil
| | - Larissa Espindola da Silva
- Laboratory of Neurobiology of Inflammatory and Metabolic Processes, Postgraduate Program in Health Sciences, University of Southern Santa Catarina, Tubarão, Santa Catarina, Brazil
| | - Mariana P Oliveira
- Laboratory of Neurobiology of Inflammatory and Metabolic Processes, Postgraduate Program in Health Sciences, University of Southern Santa Catarina, Tubarão, Santa Catarina, Brazil
| | - Marina G Silva
- Laboratory of Behavioral Neuroscience, Postgraduate Program in Health Sciences, University of Southern Santa Catarina, Tubarão, Santa Catarina, Brazil
| | - Adriani P Damiani
- Laboratório de Biologia Celular e Molecular, Universidade do Extremo Sul Catarinense, UNESC, Avenida Universitária, 1105, Criciúma, SC, Brazil
| | - Catharina B Ribeiro
- Laboratório de Biologia Celular e Molecular, Universidade do Extremo Sul Catarinense, UNESC, Avenida Universitária, 1105, Criciúma, SC, Brazil
| | - Marina L Magenis
- Laboratório de Biologia Celular e Molecular, Universidade do Extremo Sul Catarinense, UNESC, Avenida Universitária, 1105, Criciúma, SC, Brazil
| | - Luana Cucker
- Laboratory of Experimental Pathophysiology, Graduate Program in Health Sciences, University of Southern Santa Catarina, Criciúma, SC, Brazil
| | - Monique Michels
- Laboratory of Experimental Pathophysiology, Graduate Program in Health Sciences, University of Southern Santa Catarina, Criciúma, SC, Brazil
| | - Larissa Joaquim
- Laboratory of Neurobiology of Inflammatory and Metabolic Processes, Postgraduate Program in Health Sciences, University of Southern Santa Catarina, Tubarão, Santa Catarina, Brazil
| | - Richard Simon Machado
- Laboratory of Neurobiology of Inflammatory and Metabolic Processes, Postgraduate Program in Health Sciences, University of Southern Santa Catarina, Tubarão, Santa Catarina, Brazil
| | - Thais C Vilela
- Laboratory of Neurobiology of Inflammatory and Metabolic Processes, Postgraduate Program in Health Sciences, University of Southern Santa Catarina, Tubarão, Santa Catarina, Brazil
| | - Rafael M Bitencourt
- Laboratory of Behavioral Neuroscience, Postgraduate Program in Health Sciences, University of Southern Santa Catarina, Tubarão, Santa Catarina, Brazil
| | - Vanessa M Andrade
- Laboratório de Biologia Celular e Molecular, Universidade do Extremo Sul Catarinense, UNESC, Avenida Universitária, 1105, Criciúma, SC, Brazil
| | - Felipe Dal-Pizzol
- Laboratory of Experimental Pathophysiology, Graduate Program in Health Sciences, University of Southern Santa Catarina, Criciúma, SC, Brazil
| | - Fabrícia Petronilho
- Laboratory of Neurobiology of Inflammatory and Metabolic Processes, Postgraduate Program in Health Sciences, University of Southern Santa Catarina, Tubarão, Santa Catarina, Brazil
| | - Talita Tuon
- Laboratory of Neurobiology of Inflammatory and Metabolic Processes, Postgraduate Program in Health Sciences, University of Southern Santa Catarina, Tubarão, Santa Catarina, Brazil
| | - Gislaine Tezza Rezin
- Laboratory of Neurobiology of Inflammatory and Metabolic Processes, Postgraduate Program in Health Sciences, University of Southern Santa Catarina, Tubarão, Santa Catarina, Brazil.
| |
Collapse
|
41
|
Karra P, Winn M, Pauleck S, Bulsiewicz-Jacobsen A, Peterson L, Coletta A, Doherty J, Ulrich CM, Summers SA, Gunter M, Hardikar S, Playdon MC. Metabolic dysfunction and obesity-related cancer: Beyond obesity and metabolic syndrome. Obesity (Silver Spring) 2022; 30:1323-1334. [PMID: 35785479 PMCID: PMC9302704 DOI: 10.1002/oby.23444] [Citation(s) in RCA: 45] [Impact Index Per Article: 22.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/17/2021] [Revised: 02/24/2022] [Accepted: 03/09/2022] [Indexed: 01/26/2023]
Abstract
OBJECTIVES The metabolic dysfunction driven by obesity, including hyperglycemia and dyslipidemia, increases risk for developing at least 13 cancer types. The concept of "metabolic dysfunction" is often defined by meeting various combinations of criteria for metabolic syndrome. However, the lack of a unified definition of metabolic dysfunction makes it difficult to compare findings across studies. This review summarizes 129 studies that evaluated variable definitions of metabolic dysfunction in relation to obesity-related cancer risk and mortality after a cancer diagnosis. Strategies for metabolic dysfunction management are also discussed. METHODS A comprehensive search of relevant publications in MEDLINE (PubMed) and Google Scholar with review of references was conducted. RESULTS Metabolic dysfunction, defined as metabolic syndrome diagnosis or any number of metabolic syndrome criteria out of clinical range, inflammatory biomarkers, or markers of metabolic organ function, has been associated with risk for, and mortality from, colorectal, pancreatic, postmenopausal breast, and bladder cancers. Metabolic dysfunction associations with breast and colorectal cancer risk have been observed independently of BMI, with increased risk in individuals with metabolically unhealthy normal weight or overweight/obesity compared with metabolically healthy normal weight. CONCLUSION Metabolic dysfunction is a key risk factor for obesity-related cancer, regardless of obesity status. Nonetheless, a harmonized definition of metabolic dysfunction will further clarify the magnitude of the relationship across cancer types, enable better comparisons across studies, and further guide criteria for obesity-related cancer risk stratification.
Collapse
Affiliation(s)
- Prasoona Karra
- Department of Nutrition and Integrative Physiology, College of Health, University of Utah, Salt Lake City, Utah, USA
- Cancer Control and Population Sciences Program, Huntsman Cancer Institute, Salt Lake City, Utah, USA
| | - Maci Winn
- Cancer Control and Population Sciences Program, Huntsman Cancer Institute, Salt Lake City, Utah, USA
- Department of Population Health Sciences, School of Medicine, University of Utah, Salt Lake City, Utah, USA
| | - Svenja Pauleck
- Cancer Control and Population Sciences Program, Huntsman Cancer Institute, Salt Lake City, Utah, USA
| | | | - Lacie Peterson
- Department of Nutrition and Integrative Physiology, College of Health, University of Utah, Salt Lake City, Utah, USA
- Cancer Control and Population Sciences Program, Huntsman Cancer Institute, Salt Lake City, Utah, USA
| | - Adriana Coletta
- Cancer Control and Population Sciences Program, Huntsman Cancer Institute, Salt Lake City, Utah, USA
- Department of Health and Kinesiology, University of Utah, Salt Lake City, Utah, USA
| | - Jennifer Doherty
- Cancer Control and Population Sciences Program, Huntsman Cancer Institute, Salt Lake City, Utah, USA
- Department of Population Health Sciences, School of Medicine, University of Utah, Salt Lake City, Utah, USA
| | - Cornelia M. Ulrich
- Cancer Control and Population Sciences Program, Huntsman Cancer Institute, Salt Lake City, Utah, USA
- Department of Population Health Sciences, School of Medicine, University of Utah, Salt Lake City, Utah, USA
| | - Scott A. Summers
- Department of Nutrition and Integrative Physiology, College of Health, University of Utah, Salt Lake City, Utah, USA
| | - Marc Gunter
- Nutrition and Metabolism Section, International Agency for Research on Cancer, World Health Organization, Lyon, France
- Department of Epidemiology and Biostatistics, School of Public Health, Imperial College, London, United Kingdom
| | - Sheetal Hardikar
- Cancer Control and Population Sciences Program, Huntsman Cancer Institute, Salt Lake City, Utah, USA
- Department of Population Health Sciences, School of Medicine, University of Utah, Salt Lake City, Utah, USA
| | - Mary C. Playdon
- Department of Nutrition and Integrative Physiology, College of Health, University of Utah, Salt Lake City, Utah, USA
- Cancer Control and Population Sciences Program, Huntsman Cancer Institute, Salt Lake City, Utah, USA
| |
Collapse
|
42
|
Célind J, Bygdell M, Martikainen J, Ohlsson C, Kindblom JM. Childhood overweight and risk of obesity-related adult cancer in men. Cancer Commun (Lond) 2022; 42:576-579. [PMID: 35394703 PMCID: PMC9198342 DOI: 10.1002/cac2.12286] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2021] [Revised: 03/03/2022] [Accepted: 03/28/2022] [Indexed: 12/11/2022] Open
Affiliation(s)
- Jimmy Célind
- Sahlgrenska Osteoporosis Centre, Centre for Bone and Arthritis Research, Institute of Medicine, Sahlgrenska Academy at University of Gothenburg, Gothenburg, Västra Götaland, 413 45, Sweden.,Department of Pediatrics, Institute of Clinical Sciences, The Sahlgrenska Academy at University of Gothenburg, Gothenburg, Västra Götaland, 411 24, Sweden
| | - Maria Bygdell
- Sahlgrenska Osteoporosis Centre, Centre for Bone and Arthritis Research, Institute of Medicine, Sahlgrenska Academy at University of Gothenburg, Gothenburg, Västra Götaland, 413 45, Sweden
| | - Jari Martikainen
- Bioinformatics Core Facility, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Västra Götaland, 411 24, Sweden
| | - Claes Ohlsson
- Sahlgrenska Osteoporosis Centre, Centre for Bone and Arthritis Research, Institute of Medicine, Sahlgrenska Academy at University of Gothenburg, Gothenburg, Västra Götaland, 413 45, Sweden.,Department of Drug Treatment, Sahlgrenska University Hospital, Region Västra Götaland, Gothenburg, 413 45, Sweden
| | - Jenny M Kindblom
- Sahlgrenska Osteoporosis Centre, Centre for Bone and Arthritis Research, Institute of Medicine, Sahlgrenska Academy at University of Gothenburg, Gothenburg, Västra Götaland, 413 45, Sweden.,Pediatric Clinical Research Center, Sahlgrenska University Hospital, Region Västra Götaland, Gothenburg, 413 45, Sweden
| |
Collapse
|
43
|
Vabistsevits M, Davey Smith G, Sanderson E, Richardson TG, Lloyd-Lewis B, Richmond RC. Deciphering how early life adiposity influences breast cancer risk using Mendelian randomization. Commun Biol 2022; 5:337. [PMID: 35396499 PMCID: PMC8993830 DOI: 10.1038/s42003-022-03272-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2021] [Accepted: 03/14/2022] [Indexed: 12/17/2022] Open
Abstract
Studies suggest that adiposity in childhood may reduce the risk of breast cancer in later life. The biological mechanism underlying this effect is unclear but is likely to be independent of body size in adulthood. Using a Mendelian randomization framework, we investigate 18 hypothesised mediators of the protective effect of childhood adiposity on later-life breast cancer, including hormonal, reproductive, physical, and glycaemic traits. Our results indicate that, while most of the hypothesised mediators are affected by childhood adiposity, only IGF-1 (OR: 1.08 [1.03: 1.15]), testosterone (total/free/bioavailable ~ OR: 1.12 [1.05: 1.20]), age at menopause (OR: 1.05 [1.03: 1.07]), and age at menarche (OR: 0.92 [0.86: 0.99], direct effect) influence breast cancer risk. However, multivariable Mendelian randomization analysis shows that the protective effect of childhood body size remains unaffected when accounting for these traits (ORs: 0.59-0.67). This suggests that none of the investigated potential mediators strongly contribute to the protective effect of childhood adiposity on breast cancer risk individually. It is plausible, however, that several related traits could collectively mediate the effect when analysed together, and this work provides a compelling foundation for investigating other mediating pathways in future studies.
Collapse
Affiliation(s)
- Marina Vabistsevits
- Medical Research Council Integrative Epidemiology Unit at the University of Bristol, University of Bristol, Oakfield House, Oakfield Grove, Bristol, BS8 2BN, UK.
- Population Health Sciences, Bristol Medical School, University of Bristol, Oakfield House, Oakfield Grove, Bristol, BS8 2BN, UK.
| | - George Davey Smith
- Medical Research Council Integrative Epidemiology Unit at the University of Bristol, University of Bristol, Oakfield House, Oakfield Grove, Bristol, BS8 2BN, UK
- Population Health Sciences, Bristol Medical School, University of Bristol, Oakfield House, Oakfield Grove, Bristol, BS8 2BN, UK
| | - Eleanor Sanderson
- Medical Research Council Integrative Epidemiology Unit at the University of Bristol, University of Bristol, Oakfield House, Oakfield Grove, Bristol, BS8 2BN, UK
- Population Health Sciences, Bristol Medical School, University of Bristol, Oakfield House, Oakfield Grove, Bristol, BS8 2BN, UK
| | - Tom G Richardson
- Medical Research Council Integrative Epidemiology Unit at the University of Bristol, University of Bristol, Oakfield House, Oakfield Grove, Bristol, BS8 2BN, UK
- Population Health Sciences, Bristol Medical School, University of Bristol, Oakfield House, Oakfield Grove, Bristol, BS8 2BN, UK
- Novo Nordisk Research Centre, Headington, Oxford, OX3 7FZ, UK
| | - Bethan Lloyd-Lewis
- School of Cellular and Molecular Medicine, University of Bristol, Biomedical Sciences Building, Bristol, BS8 1TD, UK
| | - Rebecca C Richmond
- Medical Research Council Integrative Epidemiology Unit at the University of Bristol, University of Bristol, Oakfield House, Oakfield Grove, Bristol, BS8 2BN, UK
- Population Health Sciences, Bristol Medical School, University of Bristol, Oakfield House, Oakfield Grove, Bristol, BS8 2BN, UK
| |
Collapse
|
44
|
Tsur AM, Twig G. The actual burden of obesity-accounting for multimorbidity. Lancet Diabetes Endocrinol 2022; 10:233-234. [PMID: 35248170 DOI: 10.1016/s2213-8587(22)00073-0] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/16/2022] [Accepted: 02/16/2022] [Indexed: 12/22/2022]
Affiliation(s)
- Avishai M Tsur
- Department of Medicine, Sheba Medical Center, Ramat Gan, Israel; Israel Defense Forces Medical Corps and School of Public Health, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Gilad Twig
- Institute of Endocrinology, Sheba Medical Center, Ramat Gan, Israel; Israel Defense Forces Medical Corps and School of Public Health, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.
| |
Collapse
|
45
|
Role of Obesity, Physical Exercise, Adipose Tissue-Skeletal Muscle Crosstalk and Molecular Advances in Barrett's Esophagus and Esophageal Adenocarcinoma. Int J Mol Sci 2022; 23:ijms23073942. [PMID: 35409299 PMCID: PMC8999972 DOI: 10.3390/ijms23073942] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2022] [Revised: 03/28/2022] [Accepted: 03/30/2022] [Indexed: 02/07/2023] Open
Abstract
Both obesity and esophageal adenocarcinoma (EAC) rates have increased sharply in the United States and Western Europe in recent years. EAC is a classic example of obesity-related cancer where the risk of EAC increases with increasing body mass index. Pathologically altered visceral fat in obesity appears to play a key role in this process. Visceral obesity may promote EAC by directly affecting gastroesophageal reflux disease and Barrett’s esophagus (BE), as well as a less reflux-dependent effect, including the release of pro-inflammatory adipokines and insulin resistance. Deregulation of adipokine production, such as the shift to an increased amount of leptin relative to “protective” adiponectin, has been implicated in the pathogenesis of BE and EAC. This review discusses not only the epidemiology and pathophysiology of obesity in BE and EAC, but also molecular alterations at the level of mRNA and proteins associated with these esophageal pathologies and the potential role of adipokines and myokines in these disorders. Particular attention is given to discussing the possible crosstalk of adipokines and myokines during exercise. It is concluded that lifestyle interventions to increase regular physical activity could be helpful as a promising strategy for preventing the development of BE and EAC.
Collapse
|
46
|
Reinehr T. 13/m mit deutlicher Gewichtszunahme. Monatsschr Kinderheilkd 2022. [DOI: 10.1007/s00112-022-01437-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
|
47
|
Tsur AM, Akavian I, Derazne E, Tzur D, Vivante A, Grossman E, Rotem RS, Fishman B, Afek A, Coresh J, Chodick G, Twig G. Adolescent Blood Pressure and the Risk for Early Kidney Damage in Young Adulthood. Hypertension 2022; 79:974-983. [PMID: 35253445 DOI: 10.1161/hypertensionaha.121.18748] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
BACKGROUND Recent guidelines classified blood pressure above 130/80 mm Hg as hypertension. However, outcome data were lacking. OBJECTIVE To determine the association between blood pressure in adolescence and the risk for early kidney damage in young adulthood. METHODS In this nationwide cohort study, we included 629 168 adolescents aged 16 to 20 who underwent medical examinations before mandatory military service in Israel. We excluded 30 466 adolescents with kidney pathology, hypertension, or missing blood pressure or anthropometric data at study entry. Blood pressure measurements at study entry were categorized according to the Clinical Practice Guideline for Screening and Management of High Blood Pressure in Children and Adolescents: group A (<120/<80 mm Hg; Reference group), group B (120/<80-129/<80 mm Hg), group C (130/80-139/89 mm Hg), and group D (≥140/90 mm Hg). Early kidney damage in young adulthood was defined as albuminuria of ≥30 mg/g with an estimated glomerular filtration rate of 60 mL/(min·1.73 m2) or over. RESULTS Of 598 702 adolescents (54% men), 2004 (0.3%) developed early kidney damage during a mean follow-up of 15.1 (7.2) years. The adjusted hazard ratios for early kidney damage in blood pressure group C were 1.17 (1.03-1.32) and 1.51 (1.22-1.86) among adolescents with lean (body mass index <85th percentile) and high body mass index (body mass index ≥85th percentile), respectively. Corresponding hazard ratios for kidney disease in group D were 1.49 (1.15-1.93) and 1.79 (1.35-2.38) among adolescents with lean and high body mass index, respectively. CONCLUSIONS Blood pressure of ≥130/80 mm Hg was associated with early kidney damage in young adulthood, especially in adolescents with overweight and obesity.
Collapse
Affiliation(s)
- Avishai M Tsur
- Israel Defense Forces, Medical Corps, Tel Hashomer, Ramat Gan, Israel (A.M.T., I.A., E.D., D.T., G.T.).,Department of Military Medicine, Hebrew University of Jerusalem Faculty of Medicine, Jerusalem, Israel (A.M.T., I.A., G.T.).,Department of Medicine, Sheba Medical Center, Tel-Hashomer, Israel. (A.M.T., E.G., B.F.).,Sackler Faculty of Medicine, Tel Aviv University, Israel (A.M.T., A.V., E.G., B.F., G.C., G.T.)
| | - Inbal Akavian
- Israel Defense Forces, Medical Corps, Tel Hashomer, Ramat Gan, Israel (A.M.T., I.A., E.D., D.T., G.T.).,Department of Military Medicine, Hebrew University of Jerusalem Faculty of Medicine, Jerusalem, Israel (A.M.T., I.A., G.T.)
| | - Estela Derazne
- Israel Defense Forces, Medical Corps, Tel Hashomer, Ramat Gan, Israel (A.M.T., I.A., E.D., D.T., G.T.)
| | - Dorit Tzur
- Israel Defense Forces, Medical Corps, Tel Hashomer, Ramat Gan, Israel (A.M.T., I.A., E.D., D.T., G.T.)
| | - Asaf Vivante
- Department of Pediatrics B and Pediatric Nephrology Unit, Edmond and Lily Safra Children's Hospital, Sheba Medical Center, Tel-Hashomer, Israel. (A.V.).,Sackler Faculty of Medicine, Tel Aviv University, Israel (A.M.T., A.V., E.G., B.F., G.C., G.T.)
| | - Ehud Grossman
- Department of Medicine, Sheba Medical Center, Tel-Hashomer, Israel. (A.M.T., E.G., B.F.).,Sackler Faculty of Medicine, Tel Aviv University, Israel (A.M.T., A.V., E.G., B.F., G.C., G.T.)
| | - Ran S Rotem
- Maccabitech Institute for Research and Innovation, Maccabi Healthcare Services, Tel Aviv, Israel (R.S.R., G.C.).,Department of Environmental Health, Harvard T. H. Chan School of Public Health, Boston, MA (R.S.R.)
| | - Boris Fishman
- Department of Medicine, Sheba Medical Center, Tel-Hashomer, Israel. (A.M.T., E.G., B.F.).,Sackler Faculty of Medicine, Tel Aviv University, Israel (A.M.T., A.V., E.G., B.F., G.C., G.T.)
| | - Arnon Afek
- Central Management, Sheba Medical Center, Tel-Hashomer, Israel. (A.A.)
| | - Josef Coresh
- Johns Hopkins Bloomberg School of Public Health, Baltimore, MD (J.C.)
| | - Gabriel Chodick
- Sackler Faculty of Medicine, Tel Aviv University, Israel (A.M.T., A.V., E.G., B.F., G.C., G.T.).,Maccabitech Institute for Research and Innovation, Maccabi Healthcare Services, Tel Aviv, Israel (R.S.R., G.C.)
| | - Gilad Twig
- Israel Defense Forces, Medical Corps, Tel Hashomer, Ramat Gan, Israel (A.M.T., I.A., E.D., D.T., G.T.).,Department of Military Medicine, Hebrew University of Jerusalem Faculty of Medicine, Jerusalem, Israel (A.M.T., I.A., G.T.).,Division of Endocrinology, Diabetes and Metabolism, Sheba Medical Center, Tel-Hashomer, Israel. (G.T.).,Sackler Faculty of Medicine, Tel Aviv University, Israel (A.M.T., A.V., E.G., B.F., G.C., G.T.)
| |
Collapse
|
48
|
Nuotio J, Laitinen TT, Sinaiko AR, Woo JG, Urbina EM, Jacobs DR, Steinberger J, Prineas RJ, Sabin MA, Burgner DP, Minn H, Burns TL, Bazzano LA, Venn AJ, Viikari JSA, Hutri-Kähönen N, Daniels SR, Raitakari OT, Magnussen CG, Juonala M, Dwyer T. Obesity during childhood is associated with higher cancer mortality rate during adulthood: the i3C Consortium. Int J Obes (Lond) 2022; 46:393-399. [PMID: 34728776 PMCID: PMC8794778 DOI: 10.1038/s41366-021-01000-3] [Citation(s) in RCA: 15] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/08/2021] [Revised: 10/04/2021] [Accepted: 10/13/2021] [Indexed: 11/09/2022]
Abstract
BACKGROUND In high-income countries, cancer is the leading cause of death among middle-aged adults. Prospective data on the effects of childhood risk exposures on subsequent cancer mortality are scarce. METHODS We examined whether childhood body mass index (BMI), blood pressure, glucose and lipid levels were associated with adult cancer mortality, using data from 21,012 children enrolled aged 3-19 years in seven prospective cohort studies from the U.S., Australia, and Finland that have followed participants from childhood into adulthood. Cancer mortality (cancer as a primary or secondary cause of death) was captured using registries. RESULTS 354 cancer deaths occurred over the follow-up. In age-, sex, and cohort-adjusted analyses, childhood BMI (Hazard ratio [HR], 1.13; 95% confidence interval [CI] 1.03-1.24 per 1-SD increase) and childhood glucose (HR 1.22; 95%CI 1.01-1.47 per 1-SD increase), were associated with subsequent cancer mortality. In a multivariable analysis adjusted for age, sex, cohort, and childhood measures of fasting glucose, total cholesterol, triglycerides, and systolic blood pressure, childhood BMI remained as an independent predictor of subsequent cancer mortality (HR, 1.24; 95%CI, 1.03-1.49). The association of childhood BMI and subsequent cancer mortality persisted after adjustment for adulthood BMI (HR for childhood BMI, 1.35; 95%CI 1.12-1.63). CONCLUSIONS Higher childhood BMI was independently associated with increased overall cancer mortality.
Collapse
Affiliation(s)
- Joel Nuotio
- Research Centre of Applied and Preventive Cardiovascular Medicine, University of Turku, Turku, Finland.
- Heart Center, Turku University Hospital and University of Turku, Turku, Finland.
- Murdoch Children's Research Institute, Melbourne, VIC, Australia.
- Centre for Population Health Research, University of Turku and Turku University Hospital, Turku, Finland.
| | - Tomi T Laitinen
- Research Centre of Applied and Preventive Cardiovascular Medicine, University of Turku, Turku, Finland
- Murdoch Children's Research Institute, Melbourne, VIC, Australia
- Centre for Population Health Research, University of Turku and Turku University Hospital, Turku, Finland
- Paavo Nurmi Centre, Sports and Exercise Medicine Unit, Department of Physical Activity and Health, University of Turku, Turku, Finland
| | - Alan R Sinaiko
- Department of Pediatrics, University of Minnesota School of Medicine, Minneapolis, MN, USA
| | - Jessica G Woo
- Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, OH, USA
- Division of Biostatistics and Epidemiology, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA
| | - Elaine M Urbina
- Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, OH, USA
- The Heart Institute, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA
| | - David R Jacobs
- Division of Epidemiology and Community Health, School of Public Health, University of Minnesota, Minneapolis, MN, USA
| | - Julia Steinberger
- Department of Pediatrics, University of Minnesota School of Medicine, Minneapolis, MN, USA
| | - Ronald J Prineas
- Division of Public Health Science, Wake Forest University, Winston-Salem, NC, USA
| | - Matthew A Sabin
- Murdoch Children's Research Institute, Melbourne, VIC, Australia
- Department of Paediatrics, The University of Melbourne, Parkville, VIC, Australia
- Department of Endocrinology and Diabetes, The Royal Children's Hospital, Parkville, VIC, Australia
| | - David P Burgner
- Murdoch Children's Research Institute, Melbourne, VIC, Australia
- Department of Paediatrics, The University of Melbourne, Parkville, VIC, Australia
| | - Heikki Minn
- Department of Oncology, Turku University Hospital, Turku, Finland
| | - Trudy L Burns
- Department of Epidemiology, College of Public Health, University of Iowa, Iowa City, IA, USA
| | - Lydia A Bazzano
- Department of Epidemiology, Tulane University School of Public Health and Tropical Medicine, New Orleans, LA, USA
| | - Alison J Venn
- Menzies Institute for Medical Research, University of Tasmania, Hobart, TAS, Australia
| | - Jorma S A Viikari
- Department of Internal Medicine, University of Turku, Turku, Finland
- Division of Medicine, Turku University Hospital, Turku, Finland
| | - Nina Hutri-Kähönen
- Department of Pediatrics, Tampere University Hospital, and Faculty of Medicine and Health Technology, Tampere University, Tampere, Finland
| | - Stephen R Daniels
- Department of Epidemiology, College of Public Health, University of Iowa, Iowa City, IA, USA
| | - Olli T Raitakari
- Research Centre of Applied and Preventive Cardiovascular Medicine, University of Turku, Turku, Finland
- Centre for Population Health Research, University of Turku and Turku University Hospital, Turku, Finland
- Department of Clinical Physiology and Nuclear Medicine, Turku University Hospital, Turku, Finland
| | - Costan G Magnussen
- Research Centre of Applied and Preventive Cardiovascular Medicine, University of Turku, Turku, Finland
- Centre for Population Health Research, University of Turku and Turku University Hospital, Turku, Finland
- Menzies Institute for Medical Research, University of Tasmania, Hobart, TAS, Australia
| | - Markus Juonala
- Murdoch Children's Research Institute, Melbourne, VIC, Australia
- Department of Internal Medicine, University of Turku, Turku, Finland
- Division of Medicine, Turku University Hospital, Turku, Finland
| | | |
Collapse
|
49
|
Decreased Iron Ion Concentrations in the Peripheral Blood Correlate with Coronary Atherosclerosis. Nutrients 2022; 14:nu14020319. [PMID: 35057500 PMCID: PMC8781549 DOI: 10.3390/nu14020319] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2021] [Revised: 12/29/2021] [Accepted: 01/08/2022] [Indexed: 12/16/2022] Open
Abstract
(1) Background: Obesity and diabetes continue to reach epidemic levels in the population with major health impacts that include a significantly increased risk of coronary atherosclerosis. The imbalance of trace elements in the body caused by nutritional factors can lead to the progression of coronary atherosclerosis. (2) Methods: We measured the concentrations of sodium (Na), potassium (K), magnesium (Mg), calcium (Ca), Zinc (Zn), and iron (Fe) in peripheral blood samples from 4243 patients and performed baseline analysis and propensity matching of the patient datasets. The patients were grouped into acute myocardial infarction (AMI, 702 patients) and stable coronary heart disease (SCAD1, 253 patients) groups. Both of these groups were included in the AS that had a total of 1955 patients. The control group consisted of 2288 patients. The plasma concentrations of calcium, magnesium, and iron were measured using a colorimetric method. For comparison, 15 external quality assessment (EQA) samples were selected from the Clinical Laboratory Center of the Ministry of Health of China. SPSS software was used for statistical analysis. The average values and deviations of all of the indicators in each group were calculated, and a p-value threshold of <0.05 was used to indicate statistical significance. (3) Results: The iron ion concentrations of the acute myocardial infarction (AMI) group were significantly lower than the control group (p < 0.05, AUC = 0.724, AUC = 0.702), irrespective of tendency matching. Compared to the data from the stable coronary artery disease (SCAD) group, the concentration of iron ions in the acute myocardial infarction group was significantly lower (p < 0.05, AUC = 0.710, AUC = 0.682). Furthermore, the iron ion concentrations in the (AMI + SCAD) group were significantly lower (p < 0.05) than in the control group. (4) Conclusions: The data presented in this study strongly indicate that the concentration of iron ions in the peripheral blood is related to coronary atherosclerosis. Decreases in the levels of iron ions in the peripheral blood can be used as a predictive biomarker of coronary atherosclerosis.
Collapse
|
50
|
Chodick G, Omer-Gilon M, Derazne E, Puris G, Rotem R, Tzur D, Pinhas-Hamiel O, Cukierman-Yaffe T, Shina A, Zucker I, Tirosh A, Afek A, Shalev V, Twig G. Adolescent body mass index and changes in pre-pregnancy body mass index in relation to risk of gestational diabetes. EClinicalMedicine 2021; 42:101211. [PMID: 34849479 PMCID: PMC8609013 DOI: 10.1016/j.eclinm.2021.101211] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/12/2021] [Revised: 10/29/2021] [Accepted: 11/04/2021] [Indexed: 02/05/2023] Open
Abstract
BACKGROUND Pregestational excessive body mass index (BMI) is linked to an increased risk for gestational diabetes mellitus (GDM), but less is known on the effect of adolescent BMI on GDM occurrence. The study aimed to investigate possible associations of adolescent BMI and changes in BMI experienced before first pregnancy, with gestational diabetes risk. METHODS This retrospective study was based on linkage of a military screening database of adolescent health status (Israel Defence Forces) including measured height and weight, with medical records (Maccabi Healthcare Services, MHS) of a state-mandated health provider. The latter covers about 25% of the Israeli population; about 90% of pregnant women undergo screening by the two-step Carpenter-Coustan method. Adolescent BMI was categorized according to Center of Disease Control and Prevention percentiles. Only first documented pregnanies were analyzed and GDM was the outcome. FINDINGS Of 190,905 nulliparous women, 10,265 (5.4%) developed GDM. Incidence proportions of GDM were 5.1%, 6.1%, 7.3%, and 8.9% among women with adolescent normal BMI, underweight, overweight, and obesity (p<0.001), respectively. In models that accounted for age at pregnancy, birth year, and sociodemographic variables, the adjusted odd ratios (aORs) for developing GDM were: 1.2 (95%CI, 1.1-1.3), 1.5 (1.4-1.6), and 1.9 (1.7-2.1) for adolescent underweight, overweight, and obesity (reference group, normal BMI). Adolescent BMI tracked with BMI notes in the pre-pregnancy period (r=63%). Resuming normal pre-pregnancy BMI from overweight or obesity in adolescence diminished GDM risk, but this diminished risk was not observed among those who returned to a normal per-pre-pregnancy BMI from being underweight in adolescence. Sustained overweight or obesity conferred an aOR for developing GDM of 2.5 (2.2-2.7); weight gain from adolescent underweight and normal BMI to pre-pregnancy excessive BMI conferred aORs of 3.1 (1.6-6.2) and 2.6 (2.2-2.7), respectively. INTERPRETATION Change in BMI status from adolescence to pre-pregnancy may contribute to GDM risk. Identifying at-risk populations is important for early preventive interventions. FUNDING None.
Collapse
Affiliation(s)
- Gabriel Chodick
- Maccabitech Research Institute, Maccabi Healthcare Services, Tel Aviv, Israel
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
- Corresponding Authors: Gabriel Chodick, PhD, Maccabitech Research Institute, Maccabi Healthcare Services, Tel Aviv, Israel
| | - Maayan Omer-Gilon
- Department of Military Medicine, Hebrew University, Jerusalem and the Israel Defense Forces Medical Corps, Ramat Gan, Israel
| | - Estela Derazne
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Gal Puris
- Department of Military Medicine, Hebrew University, Jerusalem and the Israel Defense Forces Medical Corps, Ramat Gan, Israel
| | - Ran Rotem
- Maccabitech Research Institute, Maccabi Healthcare Services, Tel Aviv, Israel
- Department of Environmental Health, Harvard T H Chan School of Public Health, Boston, MA
| | - Dorit Tzur
- Department of Military Medicine, Hebrew University, Jerusalem and the Israel Defense Forces Medical Corps, Ramat Gan, Israel
| | - Orit Pinhas-Hamiel
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
- Pediatric Endocrine and Diabetes Unit, Edmond and Lily Safra Children's Hospital, Institute of Endocrinology, Sheba Medical Center, Tel Hashomer, Ramat Gan, Israel
| | - Tali Cukierman-Yaffe
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
- Chaim Sheba Medical Center at Tel Hashomer, Ramat Gan, Israel
| | - Avi Shina
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
- Department of Military Medicine, Hebrew University, Jerusalem and the Israel Defense Forces Medical Corps, Ramat Gan, Israel
| | - Inbar Zucker
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
- Israeli Ministry of Health, Jerusalem, Israel
| | - Amir Tirosh
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
- Chaim Sheba Medical Center at Tel Hashomer, Ramat Gan, Israel
| | - Arnon Afek
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
- Central Management, Sheba Medical Center, Tel Hashomer, Ramat Gan, Israel
| | - Varda Shalev
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Gilad Twig
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
- Department of Military Medicine, Hebrew University, Jerusalem and the Israel Defense Forces Medical Corps, Ramat Gan, Israel
- Chaim Sheba Medical Center at Tel Hashomer, Ramat Gan, Israel
- Co-Corresponding Authors: Gilad Twig, M.D., MPH, Ph.D., Academy and Research Division, Surgeon General Headquarters, Israel Defense Forces, Ramat-Gan, Israel
| |
Collapse
|