Metabolically (un)healthy obesity and risk of obesity-related cancers : a pooled study
(2023) In Journal of the National Cancer Institute 115(4). p.456-467- Abstract
BACKGROUND: Studies of obesity with or without metabolic aberrations, commonly termed metabolically unhealthy or healthy obesity, in relation to cancer risk are scarce.
METHODS: We investigated body mass index (BMI, normal weight/overweight/obesity) jointly and in interaction with metabolic health status in relation to obesity-related cancer risk (n = 23,630) among 797,193 European individuals. A metabolic score comprising mid-blood pressure, plasma glucose and triglycerides was used to define metabolically healthy and unhealthy status. Hazard ratios (HRs) and multiplicative interactions were assessed using Cox regression, and additive interactions were assessed using the relative excess risk for interaction. All statistical tests... (More)
BACKGROUND: Studies of obesity with or without metabolic aberrations, commonly termed metabolically unhealthy or healthy obesity, in relation to cancer risk are scarce.
METHODS: We investigated body mass index (BMI, normal weight/overweight/obesity) jointly and in interaction with metabolic health status in relation to obesity-related cancer risk (n = 23,630) among 797,193 European individuals. A metabolic score comprising mid-blood pressure, plasma glucose and triglycerides was used to define metabolically healthy and unhealthy status. Hazard ratios (HRs) and multiplicative interactions were assessed using Cox regression, and additive interactions were assessed using the relative excess risk for interaction. All statistical tests were two-sided.
RESULTS: Metabolically unhealthy obesity, with a baseline prevalence of 7%, was, compared to metabolically healthy normal weight, associated with an increased relative risk of any obesity-related cancer and of colon, rectal, pancreas, endometrial, liver, gallbladder, and renal cell cancer (p < 0.05), with the highest risk estimates for endometrial, liver, and renal cell cancer (HRs, 2.55 to 3.00). Metabolically healthy obesity showed a higher relative risk for any obesity-related cancer and colon (in men), endometrial, renal cell, liver, and gallbladder cancer, though the risk relationships were weaker. There were no multiplicative interactions, but there were additive, positive interactions between BMI and metabolic health status on obesity-related and rectal cancer among men, and on endometrial cancer (p < 0.05).
CONCLUSIONS: This study highlights that the type of metabolic obesity phenotype is important when assessing obesity-related cancer risk. In general, metabolic aberrations further increased the obesity-induced cancer risk, suggesting that both obesity and metabolic aberrations are useful targets for prevention.
(Less)
- author
- organization
- publishing date
- 2023-01-17
- type
- Contribution to journal
- publication status
- published
- subject
- in
- Journal of the National Cancer Institute
- volume
- 115
- issue
- 4
- pages
- 456 - 467
- publisher
- Oxford University Press
- external identifiers
-
- scopus:85150040100
- pmid:36647199
- ISSN
- 1460-2105
- DOI
- 10.1093/jnci/djad008
- language
- English
- LU publication?
- yes
- additional info
- © The Author(s) 2023. Published by Oxford University Press.
- id
- edabd08b-9ba3-4c76-8143-8ed4723a363c
- date added to LUP
- 2023-01-25 15:00:10
- date last changed
- 2025-01-26 00:24:37
@article{edabd08b-9ba3-4c76-8143-8ed4723a363c,
abstract = {{<p>BACKGROUND: Studies of obesity with or without metabolic aberrations, commonly termed metabolically unhealthy or healthy obesity, in relation to cancer risk are scarce.</p><p>METHODS: We investigated body mass index (BMI, normal weight/overweight/obesity) jointly and in interaction with metabolic health status in relation to obesity-related cancer risk (n = 23,630) among 797,193 European individuals. A metabolic score comprising mid-blood pressure, plasma glucose and triglycerides was used to define metabolically healthy and unhealthy status. Hazard ratios (HRs) and multiplicative interactions were assessed using Cox regression, and additive interactions were assessed using the relative excess risk for interaction. All statistical tests were two-sided.</p><p>RESULTS: Metabolically unhealthy obesity, with a baseline prevalence of 7%, was, compared to metabolically healthy normal weight, associated with an increased relative risk of any obesity-related cancer and of colon, rectal, pancreas, endometrial, liver, gallbladder, and renal cell cancer (p < 0.05), with the highest risk estimates for endometrial, liver, and renal cell cancer (HRs, 2.55 to 3.00). Metabolically healthy obesity showed a higher relative risk for any obesity-related cancer and colon (in men), endometrial, renal cell, liver, and gallbladder cancer, though the risk relationships were weaker. There were no multiplicative interactions, but there were additive, positive interactions between BMI and metabolic health status on obesity-related and rectal cancer among men, and on endometrial cancer (p < 0.05).</p><p>CONCLUSIONS: This study highlights that the type of metabolic obesity phenotype is important when assessing obesity-related cancer risk. In general, metabolic aberrations further increased the obesity-induced cancer risk, suggesting that both obesity and metabolic aberrations are useful targets for prevention.</p>}},
author = {{Sun, Ming and Fritz, Josef and Häggström, Christel and Bjørge, Tone and Nagel, Gabriele and Manjer, Jonas and Engeland, Anders and Zitt, Emanuel and van Guelpen, Bethany and Stattin, Pär and Ulmer, Hanno and Stocks, Tanja}},
issn = {{1460-2105}},
language = {{eng}},
month = {{01}},
number = {{4}},
pages = {{456--467}},
publisher = {{Oxford University Press}},
series = {{Journal of the National Cancer Institute}},
title = {{Metabolically (un)healthy obesity and risk of obesity-related cancers : a pooled study}},
url = {{http://dx.doi.org/10.1093/jnci/djad008}},
doi = {{10.1093/jnci/djad008}},
volume = {{115}},
year = {{2023}},
}