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Li M, Cao SM, Dimou N, Wu L, Li JB, Yang J. Association of Metabolic Syndrome With Risk of Lung Cancer: A Population-Based Prospective Cohort Study. Chest 2024; 165:213-223. [PMID: 37572975 PMCID: PMC10790176 DOI: 10.1016/j.chest.2023.08.003] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2023] [Revised: 06/30/2023] [Accepted: 08/02/2023] [Indexed: 08/14/2023] Open
Abstract
BACKGROUND Both the incidence of lung cancer and the prevalence of metabolic syndrome (MetS) have been increasing worldwide. The relationship between MetS and lung cancer remains controversial. RESEARCH QUESTION What is the risk of lung cancer associated with MetS and its components? STUDY DESIGN AND METHODS Multivariable Cox regression models were used to estimate the hazard ratio (HR) of MetS-related variables on lung cancer risk, both overall and by histologic subtype, in the UK Biobank. Stratified analyses were conducted by sex, tobacco use status, and use of medication. HR curves were used to test the nonlinear associations between the metabolic markers and the risk of lung cancer. RESULTS Of the 331,877 participants included in this study, a total of 77,173 participants had a diagnosis of MetS at enrollment. During a median follow-up of 10.9 years, lung cancer as the primary site developed in 2,425 participants. The HRs of MetS were 1.21 (95% CI, 1.09-1.33), 1.28 (95% CI, 1.10-1.50), and 1.16 (95% CI, 0.94-1.44) for the overall risk of lung cancer, adenocarcinoma, and squamous cell carcinoma, respectively. The HRs increased with the number of metabolic abnormalities from 1.11 to approximately 1.4 or 1.5 for those with one to five disorders. Positive association with lung cancer was observed for low high-density lipoprotein cholesterol (HDL-C), elevated waist circumference, and hyperglycemia. The relationship between MetS and lung cancer was modified by sex, with a stronger effect in female patients (P = .031). The risk of lung cancer resulting from MetS was elevated mainly among individuals who used tobacco, although the modification effect of tobacco use was not statistically significant. A nonlinear association was found between lung cancer and HDL-C, waist circumference, and glycated hemoglobin. INTERPRETATION The increased risk of lung cancer associated with MetS suggests the importance of taking metabolic status and markers into consideration for the primary prevention of lung cancer and the selection of high-risk populations for lung cancer screening.
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Affiliation(s)
- Mengmeng Li
- Department of Cancer Prevention, State Key Laboratory of Oncology in South China, Sun Yat-sen University Cancer Center, Guangzhou, China.
| | - Su-Mei Cao
- Department of Cancer Prevention, State Key Laboratory of Oncology in South China, Sun Yat-sen University Cancer Center, Guangzhou, China
| | - Niki Dimou
- Nutrition and Metabolism Branch, International Agency for Research on Cancer, Lyon, France
| | - Lan Wu
- Department of Cancer Prevention, State Key Laboratory of Oncology in South China, Sun Yat-sen University Cancer Center, Guangzhou, China
| | - Ji-Bin Li
- Department of Clinical Research, Sun Yat-sen University Cancer Center, Guangzhou, China
| | - Jun Yang
- School of Public Health, Guangzhou Medical University, Guangzhou, China
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Li X, Lian Y, Ping W, Wang K, Jiang L, Li S. Abdominal obesity and digestive system cancer: a systematic review and meta-analysis of prospective studies. BMC Public Health 2023; 23:2343. [PMID: 38012596 PMCID: PMC10680266 DOI: 10.1186/s12889-023-17275-2] [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: 05/13/2023] [Accepted: 11/20/2023] [Indexed: 11/29/2023] Open
Abstract
BACKGROUND The diagnostic criteria for abdominal obesity are usually waist circumference or waist-to-hip ratio. The magnitude of the risks for cancers of the digestive system and abdominal obesity is unknown. To assess whether abdominal obesity increases the risk of digestive cancer, we conducted a systematic review and meta-analysis of prospective cohort studies in a database. METHODS PubMed, Embase, and Web of Science databases were searched from their inception to December 2022. The 9-star Newcastle Ottawa Scale was used to assess study quality. Pooled relative risks and 95% confidence intervals were calculated using fixed or random effect models respectively. The stability of the results was explored by one-by-one exclusion. Subgroup analysis was conducted to explore sources of heterogeneity. Publication bias was evaluated by Begg's and Egger's tests. RESULTS A total of 43 cohort studies were included. There were 42 and 31 studies in the meta-analysis of waist circumference and waist-to-hip ratio on digestive system cancer, respectively. The results of the meta-analysis revealed that the greater waist circumference and waist-to-hip ratio were correlated with increased incidence of digestive system cancers: waist circumference: RR 1.48, 95% CI 1.38-1.59, p < 0.001; waist-to-hip ratio: RR 1.33, 95% CI 1.28-1.38, p = 0.001. Subgroup analysis by cancer type showed that higher WC and WHR would increase the prevalence of LC, PC, GC, EC, and CRC. The sensitivity analysis was conducted by a one-by-one elimination method, and the results of the meta-analysis remained stable. It is proved that the results were robust by the trim-and-fill method. CONCLUSIONS There was evidence to suggest that abdominal obesity increased the incidence of digestive cancer, it is necessary to take appropriate measures to reduce abdominal obesity. Waist circumference and waist-to-hip ratio may be better predictors of digestive system cancers. However, the association between waist circumference and digestive system cancer was greater, so more attention should be paid to measuring abdominal obesity with waist circumference.
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Affiliation(s)
- Xue Li
- School of Public Health, Shanxi Medical University, Taiyuan, China
| | - Yajun Lian
- Heping Hospital Affiliated to Changzhi Medical College, Changzhi, China
| | - Weiwei Ping
- Department of Public Health and Preventive Medicine, Changzhi Medical College, 161 Jiefang East Street, Changzhi, 046000, Shanxi, China.
| | - Kunbo Wang
- Xiangya School of Public Health, Central South University, Changsha City, China
| | - Lingyan Jiang
- Heping Hospital Affiliated to Changzhi Medical College, Changzhi, China
| | - Shaoxia Li
- Heping Hospital Affiliated to Changzhi Medical College, Changzhi, China
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Li F, Hao S, Gao J, Jiang P. EGCG alleviates obesity-exacerbated lung cancer progression by STAT1/SLC7A11 pathway and gut microbiota. J Nutr Biochem 2023; 120:109416. [PMID: 37451475 DOI: 10.1016/j.jnutbio.2023.109416] [Citation(s) in RCA: 10] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2022] [Revised: 06/24/2023] [Accepted: 07/07/2023] [Indexed: 07/18/2023]
Abstract
Leptin is a nutritional cytokine, and it is closely related to the progression of cancer. However, the detailed effect of leptin in lung cancer remains poorly known. We found leptin-induced A549 cell proliferation, migration, and invasion, which was reversed by epigallocatechin gallate (EGCG) from green tea. Currently, we found that leptin-triggered M2 polarization of tumor-associated macrophages was inhibited by EGCG. Then, to investigate the underlying mechanism effect of leptin on A549 cells was studied. Aberrant activities of STAT1 are implicated in cancer development. Based on the cancer genome atlas data, STAT1 acted as an oncogene in lung cancer and EGCG greatly reduced STAT1 expression in A549 cells. Ferroptosis is an iron-dependent nonapoptotic cell death. STAT1 served as a transcriptional activator for SLC7A11. EGCG restrained lung cancer cell growth induced by leptin via targeting STAT1-SLC7A11 mediated ferroptosis. A high-fat diet (HFD) feeding condition was combined with a multi-dose urethane-induced lung tumorigenesis model using C57BL/6J mice. Obesity was induced with a 60 kcal% HFD feeding. Serum leptin levels increased in urethane-administered and HFD-fed mice. Compared to the control diet-fed mice, the HFD-fed mice exhibited increased lung tumor burden and typical pro-tumorigenic STAT1 activation in lung tissues after urethane administration. In addition, HFD alters the gut microbiome by decreasing the abundance of Clostridia and by increasing the abundance of Deltaproteobacteria and Epsilonproteobacteria while EGCG exhibited a reversed effect. These findings suggested that leptin promoted the development of lung tumorigenesis in vitro and in vivo via mediating activation of the STAT-SLC7A11 pathway and gut microbiota.
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Affiliation(s)
- Fan Li
- Department of Nutrition, Zhongshan Hospital, Fudan University, Shanghai, China
| | - Shengyu Hao
- Department of Critical Care Medicine, Zhongshan Hospital, Fudan University, Shanghai, China
| | - Jian Gao
- Department of Nutrition, Zhongshan Hospital, Fudan University, Shanghai, China.
| | - Pan Jiang
- Department of Nutrition, Zhongshan Hospital, Fudan University, Shanghai, China; Department of Nutrition, QingPu District Central Hospital, Shanghai, China.
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Kim D, Kim JH, Song TJ. Total Cholesterol Variability and the Risk of Osteoporotic Fractures: A Nationwide Population-Based Cohort Study. J Pers Med 2023; 13:jpm13030509. [PMID: 36983690 PMCID: PMC10054569 DOI: 10.3390/jpm13030509] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2023] [Revised: 03/05/2023] [Accepted: 03/10/2023] [Indexed: 03/16/2023] Open
Abstract
Several risk factors for osteoporotic fractures have been identified but reports of the association of lipid parameters with the occurrence of osteoporotic fractures have been limited. We aimed to examine whether serum total cholesterol (TC) variability is associated with osteoporotic fractures. The study included 3,00,326 subjects who had undergone three or more health examinations between 2003 and 2008. The primary endpoint was the incidence of osteoporotic fractures, including vertebral, hip, distal radius, and humerus fractures. TC variability was evaluated based on the following three parameters: coefficient of variation (CV), standard deviation (SD), and variability independent of the mean (VIM). A total of 29,044 osteoporotic fracture events (9.67%) were identified during a median of 11.6 years of follow-up. The risk of osteoporotic fractures in the highest quartile was significantly higher compared with the lowest quartile according to the three indices of TC variability with adjusted hazard ratios (HR) and 95% confidence intervals (CI) as follows: CV (HR 1.11, 95% CI [1.08–1.15]), SD (HR 1.07, 95% CI [1.04–1.11]) and VIM (HR 1.07, 95% CI [1.04–1.11]). The Kaplan–Meier curves showed a significantly positive relationship between the higher quartile of TC variability and overall osteoporotic fractures. The association remained significant in subgroup analyses of vertebral and hip fractures, regardless of the indices of TC variability. Our study showed that visit-to-visit TC variability was found to be associated with osteoporotic fracture risk. Maintaining TC levels stable may help attenuate the osteoporotic fracture risk in the future.
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Affiliation(s)
- Dongyeop Kim
- Department of Neurology, Seoul Hospital, College of Medicine, Ewha Womans University, Seoul 07804, Republic of Korea
| | - Jee Hyun Kim
- Department of Neurology, Seoul Hospital, College of Medicine, Ewha Womans University, Seoul 07804, Republic of Korea
| | - Tae-Jin Song
- Department of Neurology, Seoul Hospital, College of Medicine, Ewha Womans University, Seoul 07804, Republic of Korea
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Tran TT, Lee J, Gunathilake M, Kim J, Kim SY, Cho H, Kim J. A comparison of machine learning models and Cox proportional hazards models regarding their ability to predict the risk of gastrointestinal cancer based on metabolic syndrome and its components. Front Oncol 2023; 13:1049787. [PMID: 36937438 PMCID: PMC10018751 DOI: 10.3389/fonc.2023.1049787] [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: 10/03/2022] [Accepted: 01/20/2023] [Indexed: 03/06/2023] Open
Abstract
Background Little is known about applying machine learning (ML) techniques to identify the important variables contributing to the occurrence of gastrointestinal (GI) cancer in epidemiological studies. We aimed to compare different ML models to a Cox proportional hazards (CPH) model regarding their ability to predict the risk of GI cancer based on metabolic syndrome (MetS) and its components. Methods A total of 41,837 participants were included in a prospective cohort study. Incident cancer cases were identified by following up with participants until December 2019. We used CPH, random survival forest (RSF), survival trees (ST), gradient boosting (GB), survival support vector machine (SSVM), and extra survival trees (EST) models to explore the impact of MetS on GI cancer prediction. We used the C-index and integrated Brier score (IBS) to compare the models. Results In all, 540 incident GI cancer cases were identified. The GB and SSVM models exhibited comparable performance to the CPH model concerning the C-index (0.725). We also recorded a similar IBS for all models (0.017). Fasting glucose and waist circumference were considered important predictors. Conclusions Our study found comparably good performance concerning the C-index for the ML models and CPH model. This finding suggests that ML models may be considered another method for survival analysis when the CPH model's conditions are not satisfied.
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Affiliation(s)
- Tao Thi Tran
- Department of Cancer Control and Population Health, Graduate School of Cancer Science and Policy, Goyang-si, Gyeonggi-do, Republic of Korea
| | - Jeonghee Lee
- Department of Cancer Biomedical Science, Graduate School of Cancer Science and Policy, Goyang-si, Gyeonggi-do, Republic of Korea
| | - Madhawa Gunathilake
- Department of Cancer Biomedical Science, Graduate School of Cancer Science and Policy, Goyang-si, Gyeonggi-do, Republic of Korea
| | - Junetae Kim
- Department of Cancer Control and Population Health, Graduate School of Cancer Science and Policy, Goyang-si, Gyeonggi-do, Republic of Korea
| | - Sun-Young Kim
- Department of Cancer Control and Population Health, Graduate School of Cancer Science and Policy, Goyang-si, Gyeonggi-do, Republic of Korea
| | - Hyunsoon Cho
- Department of Cancer Control and Population Health, Graduate School of Cancer Science and Policy, Goyang-si, Gyeonggi-do, Republic of Korea
| | - Jeongseon Kim
- Department of Cancer Biomedical Science, Graduate School of Cancer Science and Policy, Goyang-si, Gyeonggi-do, Republic of Korea
- *Correspondence: Jeongseon Kim,
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de Oliveira Andrade F, Verma V, Hilakivi-Clarke L. Maternal obesity and resistance to breast cancer treatments among offspring: Link to gut dysbiosis. Cancer Rep (Hoboken) 2022; 5:e1752. [PMID: 36411524 PMCID: PMC9780430 DOI: 10.1002/cnr2.1752] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2022] [Revised: 08/22/2022] [Accepted: 10/19/2022] [Indexed: 11/23/2022] Open
Abstract
BACKGROUND About 50 000 new cases of cancer in the United States are attributed to obesity. The adverse effects of obesity on breast cancer may be most profound when affecting the early development; that is, in the womb of a pregnant obese mother. Maternal obesity has several long-lasting adverse health effects on the offspring, including increasing offspring's breast cancer risk and mortality. Gut microbiota is a player in obesity as well as may impact breast carcinogenesis. Gut microbiota is established early in life and the microbial composition of an infant's gut becomes permanently dysregulated because of maternal obesity. Metabolites from the microbiota, especially short chain fatty acids (SCFAs), play a critical role in mediating the effect of gut bacteria on multiple biological functions, such as immune system, including tumor immune responses. RECENT FINDINGS Maternal obesity can pre-program daughter's breast cancer to be more aggressive, less responsive to treatments and consequently more likely to cause breast cancer related death. Maternal obesity may also induce poor response to immune checkpoint inhibitor (ICB) therapy through increased abundance of inflammation associated microbiome and decreased abundance of bacteria that are linked to production of SCFAs. Dietary interventions that increase the abundance of bacteria producing SCFAs potentially reverses offspring's resistance to breast cancer therapy. CONCLUSION Since immunotherapies have emerged as highly effective treatments for many cancers, albeit there is an urgent need to enlarge the patient population who will be responsive to these treatments. One of the factors which may cause ICB refractoriness could be maternal obesity, based on its effects on the microbiota markers of ICB therapy response among the offspring. Since about 40% of children are born to obese mothers in the Western societies, it is important to determine if maternal obesity impairs offspring's response to cancer immunotherapies.
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Affiliation(s)
| | - Vivek Verma
- The Hormel Institute, University of Minnesota, Austin, Minnesota, USA
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Joint association of alcohol consumption and adiposity with alcohol- and obesity-related cancer in a population sample of 399,575 UK adults. Br J Nutr 2022:1-10. [PMID: 36268725 DOI: 10.1017/s0007114522003464] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
Obesity and alcohol consumption are both important modifiable risk factors for cancer. We examined the joint association of adiposity and alcohol consumption with alcohol- and obesity-related cancer incidence. This prospective cohort study included cancer-free UK Biobank participants aged 40-69 years. Alcohol consumption was categorised based on current UK guidelines into four groups. We defined three markers of adiposity: body fat percentage (BF %), waist circumference and BMI and categorised each into three groups. We derived a joint alcohol consumption and adiposity marker variable with twelve mutually exclusive categories. Among 399 575 participants, 17 617 developed alcohol-related cancer and 20 214 developed obesity-related cancer over an average follow-up of 11·8 (SD 0·9) years. We found relatively weak evidence of independent associations of alcohol consumption with cancer outcomes. However, the joint association analyses showed that across all adiposity markers, above guideline drinkers who were in the top two adiposity groups had elevated cancer incidence risk (e.g. HR for alcohol-related cancer was 1·53 (95 % CI (1·24, 1·90)) for within guideline drinkers and 1·61 (95 % CI (1·30, 2·00)) for above guideline drinkers among participants who were in the top tertile BF %. Regardless of alcohol consumption status, the risk of obesity-related cancer increased with higher adiposity in a dose-response manner within alcohol consumption categories. Our study provides guidance for public health priorities aimed at lowering population cancer risk via two key modifiable risk factors.
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The Association of Waist Circumference with the Prevalence and Survival of Digestive Tract Cancer in US Adults: A Population Study Based on Machine Learning Methods. COMPUTATIONAL AND MATHEMATICAL METHODS IN MEDICINE 2022; 2022:2492488. [PMID: 36245841 PMCID: PMC9562134 DOI: 10.1155/2022/2492488] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/05/2022] [Accepted: 09/21/2022] [Indexed: 11/29/2022]
Abstract
Aims This paper aims to investigate the relationship of waist circumference (WC) with digestive tract cancer morbidity and mortality. Methods Based on the data from a nationally representative US population survey, we summarized the prevalence of digestive tract cancer and all-cause mortality of cancer patients across WC quartiles. Adjusted logistic regression and restricted spline curve were used to analyze WC and the prevalence of digestive tract cancer. Moreover, Cox regression and the Kaplan-Meier curve were applied to investigate the association of WC with all-cause mortality. We also attempted to make a model to predict cancer happening. Results This paper included a total of 34,041 participants, with digestive tract cancer observed in 265 (0.7%) individuals. WC was positively associated with digestive tract cancer morbidity after full adjustment of covariates (OR: 1.72 and 95% CI: 1.41-2.10). Also, individuals in the highest WC group had a higher risk of digestive tract cancer (Q4, OR: 2.71 and 95% CI: 1.48-5.00). Moreover, no significant association was observed in upper digestive cancer, and WC was associated with a longer survival time once diagnosed (hazard ratio (HR): 0.50 and 95% CI: 0.28-0.92). Finally, the model we made proved to be effective. Conclusion High WC is a risk factor for digestive tract cancer with or without adjusting for body mass index, especially those located in the lower digestive tract. However, once digestive tract cancer has been diagnosed, patients with higher WC showed better survival outcomes. Moreover, machine learning methods can be used to predict digestive tract cancer risk in the future.
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Nguyen TV, Arisawa K, Katsuura-Kamano S, Ishizu M, Nagayoshi M, Okada R, Hishida A, Tamura T, Hara M, Tanaka K, Nishimoto D, Shibuya K, Koyama T, Watanabe I, Suzuki S, Nishiyama T, Kuriki K, Nakamura Y, Saito Y, Ikezaki H, Otonari J, N. Koyanagi Y, Matsuo K, Mikami H, Kusakabe M, Takeuchi K, Wakai K. Associations of metabolic syndrome and metabolically unhealthy obesity with cancer mortality: The Japan Multi-Institutional Collaborative Cohort (J-MICC) study. PLoS One 2022; 17:e0269550. [PMID: 35802721 PMCID: PMC9269937 DOI: 10.1371/journal.pone.0269550] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2021] [Accepted: 05/23/2022] [Indexed: 01/02/2023] Open
Abstract
Purpose The association between metabolic syndrome (MetS) and the risk of death from cancer is still a controversial issue. The purpose of this study was to examine the associations of MetS and metabolically unhealthy obesity (MUHO) with cancer mortality in a Japanese population. Methods We used data from the Japan Multi-Institutional Collaborative Cohort Study. The study population consisted of 28,554 eligible subjects (14,103 men and 14,451 women) aged 35–69 years. MetS was diagnosed based on the criteria of the National Cholesterol Education Program Adult Treatment Panel III (NCEP-ATP III) and the Japan Society for the Study of Obesity (JASSO), using the body mass index instead of waist circumference. The Cox proportional hazards analysis was used to estimate adjusted hazard ratios (HR) and 95% confidence intervals (CI) for total cancer mortality in relation to MetS and its components. Additionally, the associations of obesity and the metabolic health status with cancer mortality were examined. Results During an average 6.9-year follow-up, there were 192 deaths from cancer. The presence of MetS was significantly correlated with increased total cancer mortality when the JASSO criteria were used (HR = 1.51, 95% CI 1.04–2.21), but not when the NCEP-ATP III criteria were used (HR = 1.09, 95% CI 0.78–1.53). Metabolic risk factors, elevated fasting blood glucose, and MUHO were positively associated with cancer mortality (P <0.05). Conclusion MetS diagnosed using the JASSO criteria and MUHO were associated with an increased risk of total cancer mortality in the Japanese population.
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Affiliation(s)
- Tien Van Nguyen
- Department of Preventive Medicine, Tokushima University Graduate School of Biomedical Sciences, Tokushima, Japan
| | - Kokichi Arisawa
- Department of Preventive Medicine, Tokushima University Graduate School of Biomedical Sciences, Tokushima, Japan
- * E-mail:
| | - Sakurako Katsuura-Kamano
- Department of Preventive Medicine, Tokushima University Graduate School of Biomedical Sciences, Tokushima, Japan
| | - Masashi Ishizu
- Department of Preventive Medicine, Tokushima University Graduate School of Biomedical Sciences, Tokushima, Japan
| | - Mako Nagayoshi
- Department of Preventive Medicine, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Rieko Okada
- Department of Preventive Medicine, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Asahi Hishida
- Department of Preventive Medicine, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Takashi Tamura
- Department of Preventive Medicine, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Megumi Hara
- Department of Preventive Medicine, Faculty of Medicine, Saga University, Saga, Japan
| | - Keitaro Tanaka
- Department of Preventive Medicine, Faculty of Medicine, Saga University, Saga, Japan
| | - Daisaku Nishimoto
- Department of International Island and Community Medicine, Kagoshima University Graduate School of Medical and Dental Sciences, Kagoshima, Japan
| | - Keiichi Shibuya
- Department of International Island and Community Medicine, Kagoshima University Graduate School of Medical and Dental Sciences, Kagoshima, Japan
| | - Teruhide Koyama
- Department of Epidemiology for Community Health and Medicine, Kyoto Prefectural University of Medicine, Kyoto, Japan
| | - Isao Watanabe
- Department of Epidemiology for Community Health and Medicine, Kyoto Prefectural University of Medicine, Kyoto, Japan
| | - Sadao Suzuki
- Department of Public Health, Nagoya City University Graduate School of Medical Sciences, Nagoya, Japan
| | - Takeshi Nishiyama
- Department of Public Health, Nagoya City University Graduate School of Medical Sciences, Nagoya, Japan
| | - Kiyonori Kuriki
- Division of Nutritional Sciences, Laboratory of Public Health, School of Food and Nutritional Sciences, University of Shizuoka, Shizuoka, Japan
| | - Yasuyuki Nakamura
- Department of Public Health, Shiga University of Medical Science, Otsu, Shiga, Japan
| | - Yoshino Saito
- Department of Nursing, Faculty of Healthcare Science, Aino University, Osaka, Japan
| | - Hiroaki Ikezaki
- Department of Comprehensive General Internal Medicine, Faculty of Medical Sciences, Kyushu University Graduate School of Medicine, Fukuoka, Japan
| | - Jun Otonari
- Department of Psychosomatic Medicine, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Yuriko N. Koyanagi
- Division of Cancer Epidemiology and Prevention, Aichi Cancer Center Research Institute, Nagoya, Japan
| | - Keitaro Matsuo
- Division of Cancer Epidemiology and Prevention, Aichi Cancer Center Research Institute, Nagoya, Japan
| | - Haruo Mikami
- Cancer Prevention Center, Chiba Cancer Center Research Institute, Chiba, Japan
| | - Miho Kusakabe
- Cancer Prevention Center, Chiba Cancer Center Research Institute, Chiba, Japan
| | - Kenji Takeuchi
- Department of Preventive Medicine, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Kenji Wakai
- Department of Preventive Medicine, Nagoya University Graduate School of Medicine, Nagoya, Japan
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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.
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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
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11
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Liu EE, Suthahar N, Paniagua SM, Wang D, Lau ES, Li SX, Jovani M, Takvorian KS, Kreger BE, Benjamin EJ, Meijers WC, Bakker SJ, Kieneker LM, Gruppen EG, van der Vegt B, de Bock GH, Gansevoort RT, Hussain SK, Hoffmann U, Splansky GL, Vasan RS, Larson MG, Levy D, Cheng S, de Boer RA, Ho JE. Association of Cardiometabolic Disease With Cancer in the Community. JACC CardioOncol 2022; 4:69-81. [PMID: 35492825 PMCID: PMC9040108 DOI: 10.1016/j.jaccao.2022.01.095] [Citation(s) in RCA: 13] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2021] [Revised: 01/21/2022] [Accepted: 01/23/2022] [Indexed: 11/03/2022] Open
Abstract
Background Obesity and cardiometabolic dysfunction have been associated with cancer risk and severity. Underlying mechanisms remain unclear. Objectives The aim of this study was to examine associations of obesity and related cardiometabolic traits with incident cancer. Methods FHS (Framingham Heart Study) and PREVEND (Prevention of Renal and Vascular End-Stage Disease) study participants without prevalent cancer were studied, examining associations of obesity, body mass index (BMI), waist circumference, visceral adipose tissue (VAT) and subcutaneous adipose tissue depots, and C-reactive protein (CRP) with future cancer in Cox models. Results Among 20,667 participants (mean age 50 years, 53% women), 2,619 cancer events were observed over a median follow-up duration of 15 years. Obesity was associated with increased risk for future gastrointestinal (HR: 1.30; 95% CI: 1.05-1.60), gynecologic (HR: 1.62; 95% CI: 1.08-2.45), and breast (HR: 1.32; 95% CI: 1.05-1.66) cancer and lower risk for lung cancer (HR: 0.62; 95% CI: 0.44-0.87). Similarly, waist circumference was associated with increased risk for overall, gastrointestinal, and gynecologic but not lung cancer. VAT but not subcutaneous adipose tissue was associated with risk for overall cancer (HR: 1.22; 95% CI: 1.05-1.43), lung cancer (HR: 1.92; 95% CI: 1.01-3.66), and melanoma (HR: 1.56; 95% CI: 1.02-2.38) independent of BMI. Last, higher CRP levels were associated with higher risk for overall, colorectal, and lung cancer (P < 0.05 for all). Conclusions Obesity and abdominal adiposity are associated with future risk for specific cancers (eg, gastrointestinal, gynecologic). Although obesity was associated with lower risk for lung cancer, greater VAT and CRP were associated with higher lung cancer risk after adjusting for BMI.
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Affiliation(s)
- Elizabeth E. Liu
- Cardiovascular Institute and Division of Cardiology, Department of Medicine, Beth Israel Deaconess Medical Center, Boston, Massachusetts, USA
| | - Navin Suthahar
- Department of Cardiology, University Medical Center Groningen, University of Groningen, Groningen, the Netherlands
| | - Samantha M. Paniagua
- Cardiovascular Research Center, Massachusetts General Hospital, Boston, Massachusetts, USA
| | - Dongyu Wang
- Cardiovascular Institute and Division of Cardiology, Department of Medicine, Beth Israel Deaconess Medical Center, Boston, Massachusetts, USA
| | - Emily S. Lau
- Corrigan Minehan Heart Center, Massachusetts General Hospital, Boston, Massachusetts, USA
- Cardiology Division, Massachusetts General Hospital, Boston, Massachusetts, USA
- Department of Medicine, Massachusetts General Hospital, Boston, Massachusetts, USA
| | - Shawn X. Li
- Department of Medicine, Massachusetts General Hospital, Boston, Massachusetts, USA
| | - Manol Jovani
- Division of Gastroenterology, Massachusetts General Hospital, Boston, Massachusetts, USA
- Clinical and Translational Epidemiology Unit, Massachusetts General Hospital, Boston, Massachusetts, USA
- Division of Gastroenterology, University of Kentucky Albert B. Chandler Hospital, Lexington, Kentucky, USA
| | | | - Bernard E. Kreger
- Department of Medicine, Boston University School of Medicine, Boston, Massachusetts, USA
- The Framingham Heart Study, Framingham, Massachusetts, USA
| | - Emelia J. Benjamin
- The Framingham Heart Study, Framingham, Massachusetts, USA
- Cardiology and Preventative Medicine Sections, Boston University School of Medicine, Boston, Massachusetts, USA
- Department of Epidemiology, Boston University School of Public Health, Boston, Massachusetts, USA
| | - Wouter C. Meijers
- Department of Cardiology, University Medical Center Groningen, University of Groningen, Groningen, the Netherlands
| | - Stephan J.L. Bakker
- Department of Nephrology, University Medical Center Groningen, University of Groningen, Groningen, the Netherlands
| | - Lyanne M. Kieneker
- Department of Nephrology, University Medical Center Groningen, University of Groningen, Groningen, the Netherlands
| | - Eke G. Gruppen
- Department of Nephrology, University Medical Center Groningen, University of Groningen, Groningen, the Netherlands
| | - Bert van der Vegt
- Department of Pathology, University Medical Center Groningen, University of Groningen, Groningen, the Netherlands
| | - Geertruida H. de Bock
- Department of Epidemiology, University Medical Center Groningen, University of Groningen, Groningen, the Netherlands
| | - Ron T. Gansevoort
- Department of Nephrology, University Medical Center Groningen, University of Groningen, Groningen, the Netherlands
| | - Shehnaz K. Hussain
- Department of Public Health Sciences, School of Medicine, University of California, Davis, Davis, California, USA
| | - Udo Hoffmann
- Cardiovascular Imaging Research Center, Massachusetts General Hospital, Boston, Massachusetts, USA
- Harvard Medical School, Boston, Massachusetts, USA
| | | | - Ramachandran S. Vasan
- Department of Medicine, Boston University School of Medicine, Boston, Massachusetts, USA
- The Framingham Heart Study, Framingham, Massachusetts, USA
- Cardiology and Preventative Medicine Sections, Boston University School of Medicine, Boston, Massachusetts, USA
- Department of Epidemiology, Boston University School of Public Health, Boston, Massachusetts, USA
| | - Martin G. Larson
- The Framingham Heart Study, Framingham, Massachusetts, USA
- Department of Biostatistics, Boston University School of Public Health, Boston, Massachusetts, USA
| | - Daniel Levy
- The Framingham Heart Study, Framingham, Massachusetts, USA
- Population Sciences Branch, Division of Intramural Research, National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, Maryland
| | - Susan Cheng
- Department of Cardiology, Smidt Heart Institute, Cedars-Sinai Medical Center, Los Angeles, California, USA
| | - Rudolf A. de Boer
- Department of Cardiology, University Medical Center Groningen, University of Groningen, Groningen, the Netherlands
| | - Jennifer E. Ho
- Cardiovascular Institute and Division of Cardiology, Department of Medicine, Beth Israel Deaconess Medical Center, Boston, Massachusetts, USA
- Harvard Medical School, Boston, Massachusetts, USA
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12
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Sattayapiwat O, Wan P, Hernandez BY, Le Marchand L, Wilkens L, Haiman CA. Association of Anthropometric Measures With the Risk of Prostate Cancer in the Multiethnic Cohort. Am J Epidemiol 2021; 190:1770-1783. [PMID: 33751036 PMCID: PMC8675395 DOI: 10.1093/aje/kwab054] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2020] [Revised: 02/23/2021] [Accepted: 02/26/2021] [Indexed: 11/13/2022] Open
Abstract
In studies of anthropometric measures and prostate cancer risk, conducted primarily in White men, positive associations with advanced disease have been reported. We assessed body size in relation to incident prostate cancer risk in 79,950 men from the Multiethnic Cohort, with 8,819 cases identified over 22 years (1993-2015). Height was associated with increased risk of advanced prostate cancer (≥68 inches (≥ 173 cm) vs. < 66 inches (168 cm); hazard ratio (HR) = 1.24, 95% confidence interval (CI): 1.04, 1.48) and high-grade disease (HR = 1.15, 95% CI: 1.02, 1.31). Compared with men of normal weight, men overweight at baseline were at higher risk of high-grade cancer (HR = 1.15, 95% CI: 1.04, 1.26). Greater weight was positively associated with localized and low-grade disease in Blacks and Native Hawaiians (by race, P for heterogeneity = 0.0002 and 0.008, respectively). Weight change since age 21 years was positively associated with high-grade disease (for ≥ 40 pounds (18 kg) vs. 10 pounds (4.5 kg), HR = 1.20, 95% CI: 1.05, 1.37; P for trend = 0.005). Comparing highest versus lowest quartile, waist-to-hip ratio was associated with a 1.78-fold increase (95% CI: 1.28, 2.46) in the risk of advanced prostate cancer. Positive associations with the majority of anthropometric measures were observed in all 5 racial/ethnic groups, suggesting a general impact of anthropometric measures on risk across populations.
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Affiliation(s)
| | | | | | | | | | - Christopher A Haiman
- Correspondence to Dr. Christopher A. Haiman, Department of Preventive Medicine, Keck School of Medicine, University of Southern California/Norris Comprehensive Cancer Center, Harlyne Norris Research Tower, 1450 Biggy Street, Room 1504A, Mail Code LG591 MC9601, Los Angeles, CA 90033 (e-mail: )
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13
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Christakoudi S, Tsilidis KK, Evangelou E, Riboli E. A Body Shape Index (ABSI), hip index, and risk of cancer in the UK Biobank cohort. Cancer Med 2021; 10:5614-5628. [PMID: 34196490 PMCID: PMC8366087 DOI: 10.1002/cam4.4097] [Citation(s) in RCA: 29] [Impact Index Per Article: 9.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2021] [Revised: 05/21/2021] [Accepted: 06/07/2021] [Indexed: 12/16/2022] Open
Abstract
Abdominal size is associated positively with the risk of some cancers but the influence of body mass index (BMI) and gluteofemoral size is unclear because waist and hip circumference are strongly correlated with BMI. We examined associations of 33 cancers with A Body Shape Index (ABSI) and hip index (HI), which are independent of BMI by design, and compared these with waist and hip circumference, using multivariable Cox proportional hazards models in UK Biobank. During a mean follow-up of 7 years, 14,682 incident cancers were ascertained in 200,289 men and 12,965 cancers in 230,326 women. In men, ABSI was associated positively with cancers of the head and neck (hazard ratio HR = 1.14; 95% confidence interval 1.03-1.26 per one standard deviation increment), esophagus (adenocarcinoma, HR = 1.27; 1.12-1.44), gastric cardia (HR = 1.31; 1.07-1.61), colon (HR = 1.18; 1.10-1.26), rectum (HR = 1.13; 1.04-1.22), lung (adenocarcinoma, HR = 1.16; 1.03-1.30; squamous cell carcinoma [SCC], HR = 1.33; 1.17-1.52), and bladder (HR = 1.15; 1.04-1.27), while HI was associated inversely with cancers of the esophagus (adenocarcinoma, HR = 0.89; 0.79-1.00), gastric cardia (HR = 0.79; 0.65-0.96), colon (HR = 0.92; 0.86-0.98), liver (HR = 0.86; 0.75-0.98), and multiple myeloma (HR = 0.86; 0.75-1.00). In women, ABSI was associated positively with cancers of the head and neck (HR = 1.27; 1.10-1.48), esophagus (SCC, HR = 1.37; 1.07-1.76), colon (HR = 1.08; 1.01-1.16), lung (adenocarcinoma, HR = 1.17; 1.06-1.29; SCC, HR = 1.40; 1.20-1.63; small cell, HR = 1.39; 1.14-1.69), kidney (clear-cell, HR = 1.25; 1.03-1.50), and post-menopausal endometrium (HR = 1.11; 1.02-1.20), while HI was associated inversely with skin SCC (HR = 0.91; 0.83-0.99), post-menopausal kidney cancer (HR = 0.77; 0.67-0.88), and post-menopausal melanoma (HR = 0.90; 0.83-0.98). Unusually, ABSI was associated inversely with melanoma in men (HR = 0.89; 0.82-0.96) and pre-menopausal women (HR = 0.77; 0.65-0.91). Waist and hip circumference reflected associations with BMI, when examined individually, and provided biased risk estimates, when combined with BMI. In conclusion, preferential positive associations of ABSI or inverse of HI with several major cancers indicate an important role of factors determining body shape in cancer development.
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Affiliation(s)
- Sofia Christakoudi
- Department of Epidemiology and BiostatisticsSchool of Public HealthImperial College LondonNorfolk Place, LondonUK
- MRC Centre for TransplantationKing’s College LondonLondonUK
| | - Konstantinos K. Tsilidis
- Department of Epidemiology and BiostatisticsSchool of Public HealthImperial College LondonNorfolk Place, LondonUK
- Department of Hygiene and EpidemiologyUniversity of Ioannina School of MedicineIoanninaGreece
| | - Evangelos Evangelou
- Department of Epidemiology and BiostatisticsSchool of Public HealthImperial College LondonNorfolk Place, LondonUK
- Department of Hygiene and EpidemiologyUniversity of Ioannina School of MedicineIoanninaGreece
| | - Elio Riboli
- Department of Epidemiology and BiostatisticsSchool of Public HealthImperial College LondonNorfolk Place, LondonUK
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14
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Yun P, Xia B, Tian XH, Gong T, Liu AR, Yuan JQ, Li FP. Body composition and risk of major gynecologic malignancies: Results from the UK Biobank prospective cohort. Cancer Med 2021; 10:4522-4531. [PMID: 34114748 PMCID: PMC8267135 DOI: 10.1002/cam4.3925] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2020] [Revised: 02/15/2021] [Accepted: 04/14/2021] [Indexed: 12/12/2022] Open
Abstract
OBJECTIVE To evaluate the association between body composition and subsequent risk of the major gynecologic malignancies. METHODS This is a prospective analysis of participants from the UK Biobank. We measured baseline body composition and confirmed cancer diagnosis through linkage to cancer and death registries. We evaluated hazard ratios (HRs) and confidence interval (CIs) with COX models adjusting for potential confounders. RESULTS We document 1430 cases of the top three gynecologic malignancies (uterine corpus cancer 847 cases, ovarian cancer 514 cases, and cervical cancer 69 cases) from 245,084 female participants (75,307 were premenopausal and 169,777 were postmenopausal). For premenopausal women, whole body fat-free mass (WBFFM) was associated with an increased risk of uterine corpus cancer (Adjusted HR per unit increase 1.04, 95% CI 1.02-1.06). For postmenopausal women, compared with the first quartile, the fourth quartile of WBFFM and whole body fat mass(WBFM) was associated with 2.16 (95% CI 1.49-3.13) times and 1.89 (95% CI 1.31-2.72) times of increased uterine corpus cancer risk, respectively. Regarding the distribution of body fat mass (FM)/fat-free mass (FFM), FFM distributed in the trunk was associate with increased uterine corpus cancer risk in premenopausal (HR 1.18,95% CI 1.07-1.31) and postmenopausal women (HR 1.13,95% CI 1.09-1.18). Meanwhile, FM/FFM distributed in the limbs present an U-shaped associations with uterine corpus cancer risk. We did not observe any association between aforementioned body composition indices with ovarian or cervical cancer. CONCLUSION FM is associated with an increased risk of uterine corpus cancer in postmenopausal women. Meanwhile, FFM is found to be a risk factor for uterine corpus cancer in both premenopausal and postmenopausal women. No association of body composition with ovarian or cervical cancer was observed.
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Affiliation(s)
- Peng Yun
- Department of Endocrinology, The Seventh Affiliated Hospital of Sun Yat-sen University, Shenzhen, China
| | - Bin Xia
- Clinical medicine research center, The Seventh Affiliated Hospital of Sun Yat-sen University, Shenzhen, China
| | - Xiao-Hui Tian
- Department of Obstetrics and Gynecology, The Seventh Affiliated Hospital of Sun Yat-sen University, Shenzhen, China
| | - Ting Gong
- Department of Radiology, The Seventh Affiliated Hospital of Sun Yat-sen University, Shenzhen, China
| | - An-Ran Liu
- Department of Nutriology, The Seventh Affiliated Hospital of Sun Yat-sen University, Shenzhen, China
| | - Jin-Qiu Yuan
- Clinical medicine research center, The Seventh Affiliated Hospital of Sun Yat-sen University, Shenzhen, China
| | - Fang-Ping Li
- Department of Endocrinology, The Seventh Affiliated Hospital of Sun Yat-sen University, Shenzhen, China
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15
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Unintentional Weight Loss as a Marker of Malignancy Across Body Weight Categories. CURRENT CARDIOVASCULAR RISK REPORTS 2021. [DOI: 10.1007/s12170-021-00674-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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16
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Madani NH, Etemadi A, Nalini M, Poustchi H, Khajavi A, Mirzazade E, Mirfakhraei H, Pourshams A, Khoshnia M, Gharavi A, Merat S, Khamseh ME, Malekzadeh R. Obesity and incident gastrointestinal cancers: overall body size or central obesity measures, which factor matters? Eur J Cancer Prev 2021; 30:267-274. [PMID: 33783379 PMCID: PMC8015184 DOI: 10.1097/cej.0000000000000657] [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] [Indexed: 11/25/2022]
Abstract
BMI does not reflect the location or amount of body fat. We aimed to investigate the role of general and central obesity measures in the prediction of incident gastrointestinal cancers. In this analysis of the Golestan Cohort Study, we included 47 586 cancer-free individuals followed for 12.3 years (IQR: 10.5-13.2). We investigated the association of obesity measures including BMI, waist circumference and waist-to-hip ratio (WHR) at enrollment and the incidence of esophageal, gastric, colorectal and pancreatic cancers. Cox proportional hazard models were used to estimate the association between covariates and gastrointestinal cancer risk. We observed no significant associations between obesity measures and incidence of the above-mentioned gastrointestinal cancers in men. In women, BMI, waist circumference and WHR were associated with significant reductions in the risk of esophageal squamous cell carcinoma (ESCC): hazard ratio (HR): 0.67 [95% confidence interval (CI): 0.56-0.81], HR: 0.71 (95% CI: 0.60-0.84) and HR: 0.80 (95% CI: 0.68- 0.94), respectively. In addition, WHR was associated with significantly increased risks for colorectal cancer (HR: 1.39, 95% CI: 1.08-1.78) and gastric cancer (HR: 1.24, 95% CI: 1.01-1.51) in women. In this study, statistically significant associations between obesity measures and incident esophageal, gastric and colorectal cancers were seen in women.
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Affiliation(s)
- Nahid Hashemi Madani
- Endocrine Research Center, Institute of Endocrinology and Metabolism, Iran University of Medical Science, Tehran, Iran
| | - Arash Etemadi
- Digestive Oncology Research Center, Digestive Diseases Research Institute, Tehran University of Medical Sciences, Tehran, Iran
- Metabolic Epidemiology Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, NIH, Bethesda, Maryland, USA
| | - Mahdi Nalini
- Cardiovascular Research Center, Health Institute, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Hossein Poustchi
- Digestive Disease Research Center, Digestive Disease Research Institute, Tehran University of Medical Sciences, Tehran, Iran
- Liver and Pancreatobiliary Diseases Research Center, Digestive Diseases Research Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Alireza Khajavi
- Student Research Committee, School of Allied Medical Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Elahe Mirzazade
- Firoozabadi Clinical Research Development Unit, Iran University of Medical Science, Tehran, Iran
| | - Hosna Mirfakhraei
- Firoozabadi Clinical Research Development Unit, Iran University of Medical Science, Tehran, Iran
| | - Akram Pourshams
- Digestive Oncology Research Center, Digestive Diseases Research Institute, Tehran University of Medical Sciences, Tehran, Iran
- Digestive Disease Research Center, Digestive Disease Research Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Masoud Khoshnia
- Digestive Oncology Research Center, Digestive Diseases Research Institute, Tehran University of Medical Sciences, Tehran, Iran
- Golestan Research Center of Gastroenterology and Hepatology, Golestan University of Medical Sciences, Gorgan, Iran
| | - Abdolsamad Gharavi
- Digestive Oncology Research Center, Digestive Diseases Research Institute, Tehran University of Medical Sciences, Tehran, Iran
- Golestan Research Center of Gastroenterology and Hepatology, Golestan University of Medical Sciences, Gorgan, Iran
| | - Shahin Merat
- Digestive Disease Research Center, Digestive Disease Research Institute, Tehran University of Medical Sciences, Tehran, Iran
- Liver and Pancreatobiliary Diseases Research Center, Digestive Diseases Research Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Moahammad E. Khamseh
- Endocrine Research Center, Institute of Endocrinology and Metabolism, Iran University of Medical Science, Tehran, Iran
| | - Reza Malekzadeh
- Digestive Oncology Research Center, Digestive Diseases Research Institute, Tehran University of Medical Sciences, Tehran, Iran
- Digestive Disease Research Center, Digestive Disease Research Institute, Tehran University of Medical Sciences, Tehran, Iran
- Liver and Pancreatobiliary Diseases Research Center, Digestive Diseases Research Institute, Tehran University of Medical Sciences, Tehran, Iran
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17
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Shi D, Wu J, Wu Y, Lin X, Xu C, Lian X. High-Fat Diet-Related Obesity Promotes Urethane-Induced Lung Tumorigenesis in C57BL/6J Mice. Front Oncol 2021; 11:620993. [PMID: 33708630 PMCID: PMC7942226 DOI: 10.3389/fonc.2021.620993] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2020] [Accepted: 01/08/2021] [Indexed: 12/24/2022] Open
Abstract
Epidemiological studies have recently shown that obesity increases lung cancer risk, but the underlying biological connection is unclear. To determine whether high-fat diet (HFD)-induced obesity influences the susceptibility to chemical-induced lung tumorigenesis, a HFD feeding condition was combined with a multi-dose urethane-induced lung tumorigenesis model using C57BL/6J mice. In cell culture models, lung cancer cell lines A549 and H460 were used to investigate the effect of leptin on cell viability and its underlying mechanism of action. The results showed that obesity was induced with a 60 kcal% HFD feeding. Serum leptin levels increased with HFD feeding and further increased in urethane-administered and HFD-fed mice. Compared to the control diet-fed mice, the HFD-fed mice exhibited increased lung tumor burden and typical pro-tumorigenic STAT3 pathway activation in lung tissues after urethane administration. In vitro, leptin significantly increased the viability of lung cancer cell lines A549 and H460 in a dose-dependent manner by activation of STAT3, Bcl-2, and cyclin D1. These effects were significantly attenuated when PI3K or mTOR were inhibited by LY294002 or rapamycin, respectively. These results suggested that HFD-induced obesity could promote the development of lung tumorigenesis in C57BL/6J mice, and leptin-mediated activation of the PI3K/Akt/mTOR/STAT3 pathway was likely involved in this mechanism.
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Affiliation(s)
- Dan Shi
- Center for Lipid Research, Key Laboratory of Molecular Biology for Infectious Diseases, Ministry of Education, Chongqing Medical University, Chongqing, China.,Department of Nutrition and Food Hygiene, School of Public Health and Management, Chongqing Medical University, Chongqing, China
| | - Jingjing Wu
- Center for Lipid Research, Key Laboratory of Molecular Biology for Infectious Diseases, Ministry of Education, Chongqing Medical University, Chongqing, China.,Department of Nutrition and Food Hygiene, School of Public Health and Management, Chongqing Medical University, Chongqing, China
| | - Youqile Wu
- Center for Lipid Research, Key Laboratory of Molecular Biology for Infectious Diseases, Ministry of Education, Chongqing Medical University, Chongqing, China.,Department of Child Health Care, Mianyang Maternity and Child Healthcare Hospital, Mianyang, China
| | - Xiaojing Lin
- Department of Nutrition and Food Hygiene, School of Public Health and Management, Chongqing Medical University, Chongqing, China
| | - Cai Xu
- Department of Nutrition and Food Hygiene, School of Public Health and Management, Chongqing Medical University, Chongqing, China
| | - Xuemei Lian
- Center for Lipid Research, Key Laboratory of Molecular Biology for Infectious Diseases, Ministry of Education, Chongqing Medical University, Chongqing, China.,Department of Nutrition and Food Hygiene, School of Public Health and Management, Chongqing Medical University, Chongqing, China
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18
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Parra-Soto S, Petermann-Rocha F, Boonpor J, Gray SR, Pell JP, Celis-Morales C, Ho FK. Combined association of general and central obesity with incidence and mortality of cancers in 22 sites. Am J Clin Nutr 2021; 113:401-409. [PMID: 33381801 DOI: 10.1093/ajcn/nqaa335] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2020] [Accepted: 10/22/2020] [Indexed: 12/17/2022] Open
Abstract
BACKGROUND Body mass index (BMI) and waist circumference (WC) are measures of general and central obesity, respectively, and both have been shown to be associated with cancer. However, there is insufficient evidence of their combined association with the risk of cancer. OBJECTIVES This study aimed to investigate the associations of combinations of BMI and WC with cancer at 22 sites. METHODS A total of 386,101 (54.5% women) UK Biobank participants aged from 37 to 73 y were included. The outcomes were incidence of and mortality from cancer at 22 sites. Participants were categorized as normal weight (BMI 18.5-24.9) or overweight (including obese, BMI ≥ 25) and as normal WC or centrally obese (WC ≥ 94 cm for men and ≥80 cm for women). Four mutually exclusive groups were derived: 1) normal weight without central obesity, 2) normal weight with central obesity, 3) overweight without central obesity, and 4) overweight with central obesity. We used Cox proportional hazards models to estimate HRs and 95% CIs. RESULTS The mean follow-up period was 8.8 y. Compared with participants with normal weight and WC, men who were overweight and centrally obese had higher cancer incidence risk at 3 sites [stomach (HR: 1.75; 95% CI: 1.33, 2.32; Padj = 0.002), kidney (HR: 1.45; 95% CI: 1.17, 1.81; Padj = 0.016), and colorectal (HR: 1.31; 95% CI: 1.17, 1.47; Padj < 0.001) cancer]. Similar associations were found at 4 sites in women [endometrial (HR: 2.48; 95% CI: 2.06, 2.98; Padj < 0.001), uterine (HR: 2.23; 95% CI: 1.89, 2.64; Padj < 0.001), kidney (HR: 1.84; 95% CI: 1.37, 2.46; Padj = 0.001), and breast (HR: 1.24; 95% CI: 1.16, 1.32; Padj < 0.001) cancer] and for all-cause cancer (HR: 1.07; 95% CI: 1.03, 1.10; Padj = 0.003). Only endometrial cancer mortality (HR: 3.28; 95% CI: 1.77, 6.07; Padj = 0.004) was significantly associated with being overweight and centrally obese. CONCLUSIONS The combination of general and central obesity was associated with a higher risk at several cancer sites and some associations were sex-specific.
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Affiliation(s)
- Solange Parra-Soto
- Institute of Health and Wellbeing, University of Glasgow, Glasgow, United Kingdom.,Institute of Cardiovascular and Medical Sciences, University of Glasgow, Glasgow, United Kingdom
| | - Fanny Petermann-Rocha
- Institute of Health and Wellbeing, University of Glasgow, Glasgow, United Kingdom.,Institute of Cardiovascular and Medical Sciences, University of Glasgow, Glasgow, United Kingdom
| | - Jirapitcha Boonpor
- Institute of Cardiovascular and Medical Sciences, University of Glasgow, Glasgow, United Kingdom
| | - Stuart R Gray
- Institute of Cardiovascular and Medical Sciences, University of Glasgow, Glasgow, United Kingdom
| | - Jill P Pell
- Institute of Health and Wellbeing, University of Glasgow, Glasgow, United Kingdom
| | - Carlos Celis-Morales
- Institute of Health and Wellbeing, University of Glasgow, Glasgow, United Kingdom.,Institute of Cardiovascular and Medical Sciences, University of Glasgow, Glasgow, United Kingdom.,Centre for Exercise Physiology Research (CIFE), University Mayor, Santiago, Chile.,Research Group in Education, Physical Activity and Health (GEEAFyS), University Católica del Maule, Talca, Chile
| | - Frederick K Ho
- Institute of Health and Wellbeing, University of Glasgow, Glasgow, United Kingdom
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19
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Parra-Soto S, Cowley ES, Rezende LFM, Ferreccio C, Mathers JC, Pell JP, Ho FK, Celis-Morales C. Associations of six adiposity-related markers with incidence and mortality from 24 cancers-findings from the UK Biobank prospective cohort study. BMC Med 2021; 19:7. [PMID: 33423670 PMCID: PMC7798245 DOI: 10.1186/s12916-020-01848-8] [Citation(s) in RCA: 22] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/29/2020] [Accepted: 11/09/2020] [Indexed: 12/21/2022] Open
Abstract
BACKGROUND Adiposity is a strong risk factor for cancer incidence and mortality. However, most of the evidence available has focused on body mass index (BMI) as a marker of adiposity. There is limited evidence on relationships of cancer with other adiposity markers, and if these associations are linear or not. The aim of this study was to investigate the associations of six adiposity markers with incidence and mortality from 24 cancers by accounting for potential non-linear associations. METHODS A total of 437,393 participants (53.8% women; mean age 56.3 years) from the UK Biobank prospective cohort study were included in this study. The median follow-up was 8.8 years (interquartile range 7.9 to 9.6) for mortality and 9.3 years (IQR 8.6 to 9.9) for cancer incidence. Adiposity-related exposures were BMI, body fat percentage, waist-hip ratio, waist-height ratio, and waist and hip circumference. Incidence and mortality of 24 cancers sites were the outcomes. Cox proportional hazard models were used with each of the exposure variables fitted separately on penalised cubic splines. RESULTS During follow-up, 47,882 individuals developed cancer and 11,265 died due to cancer during the follow-up period. All adiposity markers had similar associations with overall cancer incidence. BMI was associated with a higher incidence of 10 cancers (stomach cardia (hazard ratio per 1 SD increment 1.35, (95% CI 1.23; 1.47)), gallbladder (1.33 (1.12; 1.58)), liver (1.27 (1.19; 1.36)), kidney (1.26 (1.20; 1.33)), pancreas (1.12 (1.06; 1.19)), bladder (1.09 (1.04; 1.14)), colorectal (1.10 (1.06; 1.13)), endometrial (1.73 (1.65; 1.82)), uterine (1.68 (1.60; 1.75)), and breast cancer (1.08 (1.05; 1.11))) and overall cancer (1.03 (1.02; 1.04)). All these associations were linear except for breast cancer in postmenopausal women. Similar results were observed when other markers of central and overall adiposity were used. For mortality, nine cancer sites were linearly associated with BMI and eight with waist circumference and body fat percentage. CONCLUSION Adiposity, regardless of the marker used, was associated with an increased risk in 10 cancer sites.
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Affiliation(s)
- Solange Parra-Soto
- Institute of Health and Wellbeing, University of Glasgow, Glasgow, G12 8RZ, UK.,Institute of Cardiovascular and Medical Sciences, University of Glasgow, Glasgow, G12 8TA, UK
| | - Emma S Cowley
- Institute of Cardiovascular and Medical Sciences, University of Glasgow, Glasgow, G12 8TA, UK
| | - Leandro F M Rezende
- Departamento de Medicina Preventiva, Universidade Federal de São Paulo, Escola Paulista de Medicina, Sao Paulo, Brazil
| | - Catterina Ferreccio
- Advanced Center for Chronic Diseases, Universidad de Chile and Pontificia Universidad Católica de Chile, Santiago, Chile.,Facultad de Medicina, Pontificia Universidad Católica de Chile, Santiago, Chile
| | - John C Mathers
- Human Nutrition Research Centre, Population Health Sciences Institute, Newcastle University, Newcastle upon Tyne, NE2 4HH, UK
| | - Jill P Pell
- Institute of Health and Wellbeing, University of Glasgow, Glasgow, G12 8RZ, UK
| | - Frederick K Ho
- Institute of Health and Wellbeing, University of Glasgow, Glasgow, G12 8RZ, UK
| | - Carlos Celis-Morales
- Institute of Health and Wellbeing, University of Glasgow, Glasgow, G12 8RZ, UK. .,Institute of Cardiovascular and Medical Sciences, University of Glasgow, Glasgow, G12 8TA, UK. .,Centro de Investigación en Fisiología del Ejercicio (CIFE), Universidad Mayor, 7510041, Santiago, Chile. .,Laboratorio de Rendimiento Humano, Grupo de Estudio en Educación, Actividad Física y Salud (GEEAFyS), Universidad Católica del Maule, 3480112, Talca, Chile.
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20
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Silveira EA, Kliemann N, Noll M, Sarrafzadegan N, de Oliveira C. Visceral obesity and incident cancer and cardiovascular disease: An integrative review of the epidemiological evidence. Obes Rev 2021; 22:e13088. [PMID: 32692447 PMCID: PMC7757158 DOI: 10.1111/obr.13088] [Citation(s) in RCA: 76] [Impact Index Per Article: 25.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/23/2020] [Revised: 06/08/2020] [Accepted: 06/08/2020] [Indexed: 02/07/2023]
Abstract
Evidence shows a strong relationship between obesity, cancer and cardiovascular disease (CVD) risk. However, there is not enough evidence of the role of visceral obesity on both CVD and cancer. Visceral obesity may be more pro-oncogenic than total body fat. Therefore, it is important to know whether abdominal obesity can lead to both CVD and cancer. The present integrative review aimed at evaluating epidemiological evidence on the potential connection of visceral obesity in the occurrence of cancer and CVD. The following databases were searched: SCOPUS, PubMed, Science Direct, Lilacs, SciELO, Google Scholar, Web of Science, Scopus and ProQuest. The presence of visceral obesity can increase the risk of some specific cancer types, but there is controversial evidence about CVD risk based on sex-specific and ageing analyses. There is enough evidence that visceral obesity increases the risk of colorectal, pancreatic and gastro-oesophageal cancer. However, for some types of cancer such as breast, endometrial and renal, visceral obesity is a risk only in post-menopausal women. Regarding prostate cancer, the evidence is controversial. Despite the risk of visceral obesity being consistently associated with CVD in adults, this association disappears in sex-specific and older adults analyses. Moreover, in older adults, the results are controversial due to the use of different measures such as waist circumference and visceral adipose tissue. However, the evidence showing visceral obesity as a risk factor to CVD remains controversial. Sex differences, ageing and body mass index (BMI) category can potentially modify this association. Therefore, further epidemiological studies with analyses stratified by sex and samples including older adults aged 65 and older are needed.
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Affiliation(s)
- Erika Aparecida Silveira
- Affiliate Academic at the Department of Epidemiology & Public Health, Institute of Epidemiology & Health CareUniversity College LondonLondonUK
- Postgraduate Program in Health Sciences, Faculty of MedicineFederal University of GoiásGoiâniaBrazil
| | - Nathalie Kliemann
- Nutritional Epidemiology Group, Nutrition and Metabolism Section, International Agency for Research on CancerWorld Health OrganizationLyonFrance
| | - Matias Noll
- Instituto Federal GoianoPublic Health DeptCeresBrasil
| | - Nizal Sarrafzadegan
- Isfahan Cardiovascular Research Center, Cardiovascular Research InstituteIsfahan University of Medical SciencesIsfahanIran
- School of Population and Public Health, Faculty of MedicineUniversity of British ColumbiaVancouverBritish ColumbiaCanada
| | - Cesar de Oliveira
- Department of Epidemiology & Public Health, Institute of Epidemiology & Health CareUniversity College LondonLondonUK
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21
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Wen J, Liu Q, Liu M, Wang B, Li M, Wang M, Shi X, Liu H, Wu J. Increasing Imbalance of Treg/Th17 Indicates More Severe Glucose Metabolism Dysfunction in Overweight/obese Patients. Arch Med Res 2020; 52:339-347. [PMID: 33317842 DOI: 10.1016/j.arcmed.2020.11.012] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2019] [Revised: 11/15/2020] [Accepted: 11/27/2020] [Indexed: 12/15/2022]
Abstract
BACKGROUND Chronic low-grade inflammation and dysfunction of metabolism has been reported to be involved in obesity. Regulatory T cell (Treg) and helper T cell 17 (Th17) are involved in chronic inflammatory diseases. Impaired balance of Treg/Th17 is one of the major factors contributing to inflammatory status in obesity. METHODS Overweight/obese patients (n = 80) were recruited and classified into three subgroups: normal glucose tolerance group (NGT, n = 32), impaired glucose regulation group (IGR, n = 19) and type two diabetes mellitus group (T2DM, n = 29). Healthy individuals were paired as normal control group (NC, n = 37). We used flow cytometry to test the frequencies of circulating Treg and Th17 cells of all subjects. Serum IL-6, IL-10, TNF-α, IL-17A levels were detected by cytometric bead array and clinical information was extracted from medical records. RESULTS In group IGR and T2DM, we revealed a severe decrease in peripheral ratio of Treg/Th17 compared with NC, but no significant difference was seen in group NGT. The serum level of IL-6 in group NGT and T2DM was higher than healthy subjects. The FPG and HbA1c levels were negatively correlated with the ratio of Treg/Th17 in overweight/obese patients. ROC curve analysis revealed that peripheral Treg/Th17 ratio <1.255 was a risk factor for prediabetes and diabetes in overweight/obese patients. CONCLUSION Peripheral Treg/Th17 imbalance exists in overweight/obese patients with IGR or T2DM and peripheral Treg/Th17 imbalance might be a risk factor for prediabetes and diabetes in overweight/obese patients.
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Affiliation(s)
- Jie Wen
- Department of Endocrinology, Xiangya Hospital, Central South University, Changsha, Hunan, China; Department of Endocrinology, The Second Xiangya Hospital, Central South University, Changsha, Hunan, China
| | - Qingjing Liu
- Department of Endocrinology, Xiangya Hospital, Central South University, Changsha, Hunan, China
| | - Mengmeng Liu
- Department of Endocrinology, Xiangya Hospital, Central South University, Changsha, Hunan, China
| | - Bian Wang
- Department of Endocrinology, Xiangya Hospital, Central South University, Changsha, Hunan, China
| | - Mei Li
- Department of Endocrinology, Xiangya Hospital, Central South University, Changsha, Hunan, China
| | - Min Wang
- Department of Endocrinology, Xiangya Hospital, Central South University, Changsha, Hunan, China
| | - Xiajie Shi
- Department of Endocrinology, The Second Xiangya Hospital, Central South University, Changsha, Hunan, China
| | - Hong Liu
- Department of Dermatology, Xiangya Hospital, Central South University, Changsha, Hunan, China
| | - Jing Wu
- Department of Endocrinology, Xiangya Hospital, Central South University, Changsha, Hunan, China.
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22
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Diagnostic accuracy of administrative database for bile duct cancer by ICD-10 code in a tertiary institute in Korea. Hepatobiliary Pancreat Dis Int 2020; 19:575-580. [PMID: 32249128 DOI: 10.1016/j.hbpd.2020.03.002] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/27/2019] [Accepted: 03/12/2020] [Indexed: 02/06/2023]
Abstract
BACKGROUND Administrative database provides valuable information for large cohort studies, especially when tissue diagnosis is rather difficult such as the diagnosis for bile duct cancer (BDC). The aim of this study was to evaluate the diagnostic accuracy of administrative database for BDC by International Classification of Diseases (ICD)-10 codes in a tertiary institute. METHODS BDC and control groups were collected from 2003 to 2016 at Seoul National University Bundang Hospital. Cases of BDC were identified in the National Health Insurance Service (NHIS) database by ICD 10-code supported by V code. The control group was selected from cases without ICD-10 codes for BDC. A definite or possible diagnosis was defined according to pathologic reports. Medical records, images, and pathology reports were analyzed to evaluate ICD-10 codes for BDC. Sensitivity, specificity, positive predictive value, and negative predictive value for BDC were analyzed according to diagnostic criteria and cancer locations. RESULTS A total of 1707 patients with BDC and 1707 controls were collected. Among those with BDC, 1320 (77.3%) were diagnosed by definite criteria. Most (99.4%) of them had adenocarcinoma. Rate of definite diagnosis was the highest for ampulla of Vater (88.9%), followed by that for extrahepatic (84.9%) and intrahepatic (68.3%) BDCs. False positive cases commonly had hepatocellular carcinomas. For overall diagnosis of BDC, sensitivity, specificity, positive predictive value, and negative predictive value were 99.94%, 98.33%, 98.30%, and 99.94%, respectively. Diagnostic accuracies were similar regardless of diagnostic criteria or tumor locations. CONCLUSIONS Administrative database for BDC collected according to ICD-10 code with V code shows good accuracy.
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23
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Omiyale W, Allen NE, Sweetland S. Body size, body composition and endometrial cancer risk among postmenopausal women in UK Biobank. Int J Cancer 2020; 147:2405-2415. [PMID: 32338769 DOI: 10.1002/ijc.33023] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2020] [Revised: 04/07/2020] [Accepted: 04/17/2020] [Indexed: 12/22/2022]
Abstract
Previous studies on the association of adiposity with endometrial cancer risk have mostly used body mass index (BMI) as the main exposure of interest. Whether more precise measures of body fat, such as body fat percentage and fat mass estimated by bioimpedance analyses, are better indicators of risk than BMI is unknown. The role of central adiposity and fat-free mass in endometrial cancer development remains unclear. We used Cox regression models to estimate hazard ratios (HR) and corresponding 95% confidence intervals (CI) for the associations of various measures of body size/composition with the risk of endometrial cancer among 135 110 postmenopausal women enrolled in UK Biobank. During a mean follow up of 6.8 years, 706 endometrial cancers were diagnosed, with a mean age at diagnosis of 65.5 years. The HRs (95% CIs) for endometrial cancer per 1 SD increase in BMI, body fat percentage and fat mass were broadly comparable, being 1.71 (1.61-1.82), 1.92 (1.75-2.11) and 1.73 (1.63-1.85), respectively. There was an indication of positive association between central adiposity, as reflected by waist circumference (HRper 1-SD increase = 1.08, 95% CI: 1.00-1.17) and waist to hip ratio (HRper 1-SD increase = 1.13, 95% CI: 1.01-1.26), and endometrial cancer risk after accounting for BMI. Fat-free mass was not an independent predictor of risk in this cohort. These findings suggest that body fat percentage and fat mass are not better indicators of endometrial cancer risk than BMI. Further studies are needed to establish whether central adiposity contributes to risk beyond overall adiposity.
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Affiliation(s)
- Wemimo Omiyale
- Clinical Trial Service and Epidemiological Studies Unit, Nuffield Department of Population Health, University of Oxford, Oxford, UK
| | - Naomi E Allen
- Clinical Trial Service and Epidemiological Studies Unit, Nuffield Department of Population Health, University of Oxford, Oxford, UK
- UK Biobank Ltd, Stockport, UK
| | - Siân Sweetland
- Cancer Epidemiology Unit, Nuffield Department of Population Health, University of Oxford, Oxford, UK
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24
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Cao Z, Zheng X, Yang H, Li S, Xu F, Yang X, Wang Y. Association of obesity status and metabolic syndrome with site-specific cancers: a population-based cohort study. Br J Cancer 2020; 123:1336-1344. [PMID: 32728095 PMCID: PMC7555864 DOI: 10.1038/s41416-020-1012-6] [Citation(s) in RCA: 37] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2020] [Revised: 07/03/2020] [Accepted: 07/16/2020] [Indexed: 12/24/2022] Open
Abstract
Background Obesity and metabolic syndrome (MetS) appear in clusters and are both associated with an increased risk of cancer. However, it remains unknown whether obesity status with or without MetS increases the risk of site-specific cancers. Methods We used data derived from 390,575 individuals (37–73 years old) from the UK Biobank who were enrolled from 2006–2016 with a median of 7.8 years of follow-up. Obesity was defined by BMI ≥ 30 kg/m2 and MetS was defined by the criteria of the Adult Treatment Panel-III (ATP-III). Cox proportional hazards models were used to investigate the associations of BMI and MetS with 22 cancers. Results Metabolically healthy obesity (MHO) and metabolically unhealthy obesity (MUO) phenotypes represented 6.7% and 17.9% of the total analytic samples and 27.1% and 72.9% of the included subpopulation with obesity, respectively. Obesity was independently associated with higher risks of 10 of 22 cancers. Stratified by metabolic status, the MUO phenotype was consistently associated with 10 obesity-related cancers. In contrast, the MHO phenotype was only associated with increased risks of five cancers: endometrium, oesophagus, kidney, pancreas and postmenopausal breast cancers. Conclusion Even in metabolically healthy individuals, obesity was associated with increased risks of five cancers, whereas we did not find that these individuals were associated with increased risks of several other obesity-related cancers.
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Affiliation(s)
- Zhi Cao
- School of Public Health, Tianjin Medical University, Tianjin, China
| | - Xiaomin Zheng
- Department of Radiation Oncology, Anhui Provincial Hospital of Anhui Medical University, Hefei, China
| | - Hongxi Yang
- School of Public Health, Tianjin Medical University, Tianjin, China.,Department of Biostatistics, School of Public Health, Yale University, New Haven, USA
| | - Shu Li
- School of Public Health, Tianjin Medical University, Tianjin, China
| | - Fusheng Xu
- School of Public Health, Tianjin Medical University, Tianjin, China
| | - Xilin Yang
- School of Public Health, Tianjin Medical University, Tianjin, China
| | - Yaogang Wang
- School of Public Health, Tianjin Medical University, Tianjin, China.
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25
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Xia B, He Q, Pan Y, Gao F, Liu A, Tang Y, Chong C, Teoh AYB, Li F, He Y, Zhang C, Yuan J. Metabolic syndrome and risk of pancreatic cancer: A population‐based prospective cohort study. Int J Cancer 2020; 147:3384-3393. [PMID: 32580250 DOI: 10.1002/ijc.33172] [Citation(s) in RCA: 31] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2020] [Revised: 06/05/2020] [Accepted: 06/08/2020] [Indexed: 12/12/2022]
Affiliation(s)
- Bin Xia
- Clinical Research Center, The Seventh Affiliated Hospital, Sun Yat-sen University, Shenzhen, Guangdong, China
- Scientific Research Center, The Seventh Affiliated Hospital, Sun Yat-sen University, Shenzhen, Guangdong, China
- Center for Digestive Disease, The Seventh Affiliated Hospital, Sun Yat-sen University, Shenzhen, Guangdong, China
| | - Qiangsheng He
- Clinical Research Center, The Seventh Affiliated Hospital, Sun Yat-sen University, Shenzhen, Guangdong, China
- Scientific Research Center, The Seventh Affiliated Hospital, Sun Yat-sen University, Shenzhen, Guangdong, China
- Center for Digestive Disease, The Seventh Affiliated Hospital, Sun Yat-sen University, Shenzhen, Guangdong, China
| | - Yihang Pan
- Precision Medicine Center. Scientific Research Center, The Seventh Affiliated Hospital, Sun Yat-sen University, Shenzhen, Guangdong, China
| | - Fang Gao
- Perioperative, Critical Care and Trauma Trials Group, Institute of Inflammation and Ageing, University of Birmingham, Birmingham, UK
| | - Anran Liu
- Center for Digestive Disease, The Seventh Affiliated Hospital, Sun Yat-sen University, Shenzhen, Guangdong, China
- Department of Nutriology, The Seventh Affiliated Hospital, Sun Yat-sen University, Shenzhen, Guangdong, China
| | - Yan Tang
- Clinical Research Center, The Seventh Affiliated Hospital, Sun Yat-sen University, Shenzhen, Guangdong, China
- Scientific Research Center, The Seventh Affiliated Hospital, Sun Yat-sen University, Shenzhen, Guangdong, China
| | - Charing Chong
- Department of Surgery, The Chinese University of Hong Kong, Prince of Wales Hospital, Shatin, New Territories, Hong Kong SAR, China
| | - Anthony Y B Teoh
- Department of Surgery, The Chinese University of Hong Kong, Prince of Wales Hospital, Shatin, New Territories, Hong Kong SAR, China
| | - Fangping Li
- Department of Endocrinology, The Seventh Affiliated Hospital, Sun Yat-sen University, Shenzhen, Guangdong, China
| | - Yulong He
- Center for Digestive Disease, The Seventh Affiliated Hospital, Sun Yat-sen University, Shenzhen, Guangdong, China
| | - Changhua Zhang
- Center for Digestive Disease, The Seventh Affiliated Hospital, Sun Yat-sen University, Shenzhen, Guangdong, China
| | - Jinqiu Yuan
- Clinical Research Center, The Seventh Affiliated Hospital, Sun Yat-sen University, Shenzhen, Guangdong, China
- Scientific Research Center, The Seventh Affiliated Hospital, Sun Yat-sen University, Shenzhen, Guangdong, China
- Center for Digestive Disease, The Seventh Affiliated Hospital, Sun Yat-sen University, Shenzhen, Guangdong, China
- Precision Medicine Center. Scientific Research Center, The Seventh Affiliated Hospital, Sun Yat-sen University, Shenzhen, Guangdong, China
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26
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Liu L, Jin R, Hao J, Zeng J, Yin D, Yi Y, Zhu M, Mandal A, Hua Y, Ng CK, Egilmez NK, Sauter ER, Li B. Consumption of the Fish Oil High-Fat Diet Uncouples Obesity and Mammary Tumor Growth through Induction of Reactive Oxygen Species in Protumor Macrophages. Cancer Res 2020; 80:2564-2574. [PMID: 32213543 DOI: 10.1158/0008-5472.can-19-3184] [Citation(s) in RCA: 44] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2019] [Revised: 01/22/2020] [Accepted: 03/19/2020] [Indexed: 01/22/2023]
Abstract
Obesity is associated with increased risk of many types of cancer and can be induced by various high-fat diets (HFD) from different fat sources. It remains unknown whether fatty acid composition in different HFD influences obesity-associated tumor development. Here we report that consumption of either a cocoa butter or fish oil HFD induced similar obesity in mouse models. While obesity induced by the cocoa butter HFD was associated with accelerated mammary tumor growth, consumption of the fish oil HFD uncoupled obesity from increased mammary tumor growth and exhibited a decrease in protumor macrophages. Compared with fatty acid (FA) components in both HFDs, n-3 FA rich in the fish oil HFD induced significant production of reactive oxygen species (ROS) and macrophage death. Moreover, A-FABP expression in the protumor macrophages facilitated intracellular transportation of n-3 FA and oxidation of mitochondrial FA. A-FABP deficiency diminished n-3 FA-mediated ROS production and macrophage death in vitro and in vivo. Together, our results demonstrate a novel mechanism by which n-3 FA induce ROS-mediated protumor macrophage death in an A-FABP-dependent manner. SIGNIFICANCE: This study provides mechanistic insight into dietary supplementation with fish oil for breast cancer prevention and advances a new concept that not all HFDs leading to obesity are tumorigenic. GRAPHICAL ABSTRACT: http://cancerres.aacrjournals.org/content/canres/80/12/2564/F1.large.jpg.
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MESH Headings
- Animals
- Carcinogenesis/immunology
- Carcinogenesis/metabolism
- Cell Line, Tumor/transplantation
- Diet, High-Fat/adverse effects
- Diet, High-Fat/methods
- Dietary Fats/adverse effects
- Fatty Acid-Binding Proteins/genetics
- Fatty Acid-Binding Proteins/metabolism
- Female
- Fish Oils/administration & dosage
- Humans
- Macrophages/cytology
- Macrophages/immunology
- Macrophages/metabolism
- Mammary Glands, Animal/cytology
- Mammary Glands, Animal/immunology
- Mammary Glands, Animal/pathology
- Mammary Neoplasms, Experimental/genetics
- Mammary Neoplasms, Experimental/immunology
- Mammary Neoplasms, Experimental/metabolism
- Mammary Neoplasms, Experimental/prevention & control
- Mice
- Mice, Knockout
- Mitochondria/metabolism
- Obesity/complications
- Obesity/immunology
- Obesity/metabolism
- Primary Cell Culture
- Reactive Oxygen Species/metabolism
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Affiliation(s)
- Lianliang Liu
- College of Food and Pharmaceutical Sciences, Ningbo University, Ningbo, China
- Department of Microbiology and Immunology, University of Louisville, Louisville, Kentucky
| | - Rong Jin
- Department of Microbiology and Immunology, University of Louisville, Louisville, Kentucky
- Department of Immunology, School of Basic Medical Sciences, Peking University, Beijing, China
| | - Jiaqing Hao
- Department of Microbiology and Immunology, University of Louisville, Louisville, Kentucky
| | - Jun Zeng
- Department of Microbiology and Immunology, University of Louisville, Louisville, Kentucky
- School of Basic Medical Sciences, Guangzhou Medical University, Guangzhou, China
| | - Di Yin
- Department of Microbiology and Immunology, University of Louisville, Louisville, Kentucky
- School of Basic Medical Sciences, Guangzhou Medical University, Guangzhou, China
| | - Yanmei Yi
- Department of Microbiology and Immunology, University of Louisville, Louisville, Kentucky
- Department of Histology and Embryology, Guangdong Medical University, Guangdong, China
| | - Mingming Zhu
- Department of Radiology, University of Louisville, Louisville, Kentucky
| | - Anita Mandal
- Department of Microbiology and Immunology, University of Louisville, Louisville, Kentucky
| | - Yuan Hua
- Department of Microbiology and Immunology, University of Louisville, Louisville, Kentucky
| | - Chin K Ng
- Department of Radiology, University of Louisville, Louisville, Kentucky
| | - Nejat K Egilmez
- Department of Microbiology and Immunology, University of Louisville, Louisville, Kentucky
| | - Edward R Sauter
- Division of Cancer Prevention, NCI, NIH, Rockville, Maryland
| | - Bing Li
- Department of Microbiology and Immunology, University of Louisville, Louisville, Kentucky.
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27
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Fielding R. Developing a preventive psycho-oncology for a global context. The International Psycho-Oncology Society 2018 Sutherland Award Lecture. Psychooncology 2019; 28:1595-1600. [PMID: 31222864 DOI: 10.1002/pon.5139] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2019] [Revised: 05/22/2019] [Accepted: 05/22/2019] [Indexed: 12/23/2022]
Abstract
OBJECTIVE Growing rates of cancer and survivorship, in situations of severe resource constraints, force a rethink about managing cancer-related psychosocial distress (CRPD). Here, a prevention-oriented natural history of distress is proposed, derived from developments in our understanding of the evolution and decay of CRPD. METHODS The literature indicates that at least four classes or natural histories of CRPD are identifiable. These are described in the context of prevention-oriented activities in psycho-oncology: (1) CRPD in persons with good coping resources, resulting from reaction to the diagnosis and treatment lifestyle disruption, which is largely self-limiting and preferably self-managed; (2) CRPD arising from residual, or late effects of disease or treatment, potentially persistent and debilitating; (3) CRPD in persons with preexisting coping difficulties; and (4) CRPD arising from existential issues such as mortality and fear of recurrence. RESULTS It is hypothesized that different natural histories of CRPD display different evolution, indicating potential causal processes, treatment priorities, and preventive strategies. In particular, the effective management of residual symptoms is crucial to prevent CRPD chronicity. Optimal patient involvement in treatment decision-making is also required. CONCLUSIONS There is a need to develop methods to differentiate if, early in the illness trajectory, the distressed patient is not able to self-manage the stress of cancer diagnosis and treatment. Not all distressed patients want or need help, and addressing just the CRPD may be inadequate where unresolved residual symptoms prevent renormalization after treatment. Improved doctor-patient communication around treatment decisions is warranted.
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Affiliation(s)
- Richard Fielding
- Centre for Psycho-Oncology Research & Training and Hong Kong Jockey Club Integrated Cancer Centre, The University of Hong Kong, Pokfulam, Hong Kong
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28
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Gao J, Lin X, He Y, Fu Y, Wu Y, Liao J, Wu Y, Lian X. The Comparison of Different Obesity Indexes and the Risk of Lung Cancer: A Meta-Analysis of Prospective Cohort Studies. Nutr Cancer 2019; 71:908-921. [DOI: 10.1080/01635581.2019.1595037] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Affiliation(s)
- Jing Gao
- School of Public Health and Management, Research Center for Medicine and Social Development Innovation Center for Social Risk Governance in Health Chongqing Medical University, Chongqing, P.R. China
- Key Laboratory of Molecular Biology for Infectious Diseases (Ministry of Education), Center for Lipid Research, Chongqing, China
| | - Xiaojing Lin
- School of Public Health and Management, Research Center for Medicine and Social Development Innovation Center for Social Risk Governance in Health Chongqing Medical University, Chongqing, P.R. China
- Key Laboratory of Molecular Biology for Infectious Diseases (Ministry of Education), Center for Lipid Research, Chongqing, China
| | - Yunyun He
- School of Public Health and Management, Research Center for Medicine and Social Development Innovation Center for Social Risk Governance in Health Chongqing Medical University, Chongqing, P.R. China
- Key Laboratory of Molecular Biology for Infectious Diseases (Ministry of Education), Center for Lipid Research, Chongqing, China
| | - Youyun Fu
- School of Public Health and Management, Research Center for Medicine and Social Development Innovation Center for Social Risk Governance in Health Chongqing Medical University, Chongqing, P.R. China
- Key Laboratory of Molecular Biology for Infectious Diseases (Ministry of Education), Center for Lipid Research, Chongqing, China
| | - Youqile Wu
- School of Public Health and Management, Research Center for Medicine and Social Development Innovation Center for Social Risk Governance in Health Chongqing Medical University, Chongqing, P.R. China
- Key Laboratory of Molecular Biology for Infectious Diseases (Ministry of Education), Center for Lipid Research, Chongqing, China
| | - Jie Liao
- School of Public Health and Management, Research Center for Medicine and Social Development Innovation Center for Social Risk Governance in Health Chongqing Medical University, Chongqing, P.R. China
- Key Laboratory of Molecular Biology for Infectious Diseases (Ministry of Education), Center for Lipid Research, Chongqing, China
| | - Yang Wu
- Chongqing key Laboratory of Oral Diseases and Biomedical Sciences College of Stomatology, Chongqing Medical University, Chongqing, P.R. China
| | - Xuemei Lian
- School of Public Health and Management, Research Center for Medicine and Social Development Innovation Center for Social Risk Governance in Health Chongqing Medical University, Chongqing, P.R. China
- Key Laboratory of Molecular Biology for Infectious Diseases (Ministry of Education), Center for Lipid Research, Chongqing, China
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