Department of Pediatric Urology, Ningbo Women & Children's Hospital, Ningbo, Zhejiang, China.
Int J Cancer. 2014 Oct 1;135(7):1673-86. doi: 10.1002/ijc.28813. Epub 2014 Mar 6.
Obesity is accepted as one of the major risk factors for renal cell cancer (RCC). However, conflicting results persist for the pooled risks based on the results from case-control and cohort studies combined, and the exact shape of the dose-response relationship has not been clearly defined yet. To help elucidate the role of obesity, PubMed and Embase databases were searched for published cohort studies on associations between body mass index (BMI) and risk of RCC. Random-effects models and dose-response meta-analyses were used to pool study results. Subgroup analyses were conducted by the available characteristics of studies and participants. Cohort studies (21) with 15,144 cases and 9,080,052 participants were identified. Compared to normal weight, the pooled relative risks and the corresponding 95% confidence intervals of RCC were 1.28(1.24-1.33) for preobesity and 1.77(1.68-1.87) for obesity, respectively. A nonlinear dose-response relationship was also found for RCC risk with BMI (p = 0.000), and the risk increased by 4% for each 1 kg/m(2) increment in BMI. There was no significant between-study heterogeneity among studies (I(2) = 35.6% for preobesity and I(2) = 44.2% for obesity, respectively). Subgroup analysis showed a basically consistent result with the overall analysis. These results suggest that increased BMI are associated with increased risk of RCC both for men and women.
肥胖被认为是肾癌 (RCC) 的主要危险因素之一。然而,基于病例对照和队列研究的综合结果,汇总风险存在矛盾的结果,并且尚未明确界定确切的剂量反应关系。为了帮助阐明肥胖的作用,检索了 PubMed 和 Embase 数据库中关于体重指数 (BMI) 与 RCC 风险之间关联的已发表队列研究。使用随机效应模型和剂量反应荟萃分析来汇总研究结果。通过研究和参与者的可用特征进行了亚组分析。确定了 21 项队列研究(涉及 15144 例病例和 9080052 名参与者)。与正常体重相比,超重和肥胖的 RCC 汇总相对风险和相应的 95%置信区间分别为 1.28(1.24-1.33)和 1.77(1.68-1.87)。还发现 BMI 与 RCC 风险之间存在非线性剂量反应关系(p=0.000),BMI 每增加 1kg/m2,风险增加 4%。各研究之间(超重研究的 I2=35.6%,肥胖研究的 I2=44.2%)没有显著的异质性。亚组分析显示与总体分析基本一致的结果。这些结果表明,BMI 的增加与男性和女性的 RCC 风险增加有关。