浙江医学2025，Vol.47Issue(13)：1370-1377,8.DOI:10.12056/j.issn.1006-2785.2025.47.13.2024-1601
肥胖特征与特定部位恶性肿瘤的因果效应:孟德尔随机化研究
Causal association of obesity characteristics with site-specific malignancies:a Mendelian randomization study
摘要
Abstract
Objective To investigate the causal link between generalized and central obesity and site-specific malignancies through Mendelian randomization(MR)methods.Methods The causal effects of body mass index(BMI)and BMI-adjusted waist-to-hip ratio(WHRadjBMI)on the risk of breast,thyroid,lung,pancreatic,stomach,liver and intrahepatic bile duct,colon,and rectal cancers were assessed using the inverse variance weighting(IVW)method,MR-Egger,and the weighted median method.Results In univariate MR analysis,IVW results showed that BMI was negatively correlated with breast cancer(OR=0.875,95％CI:0.782-0.978,P=0.019),while it was positively correlated with lung cancer(OR=1.753,95％CI:1.391-2.211,P＜0.001),pancreatic cancer(OR=1.442,95％CI:1.005-2.069,P=0.047),and liver and intrahepatic bile duct cancers(OR=1.992,95％CI:1.202-3.301,P=0.008).WHRadjBMI was significantly negatively correlated with breast cancer(OR=0.777,95％CI:0.675-0.894,P＜0.001),and significantly positively correlated with liver and intrahepatic bile duct cancers(OR=2.063,95％CI:1.094-3.890,P=0.025)and colon cancer(OR=1.371,95％CI:1.056-1.780,P=0.018).The results of the MR-Egger and weighted median methods were in agreement with those with the IVW method.After adjusting for potential confounders in multivariate MR analysis,the effect of BMI on the causal effect of breast and lung cancer was not significantly altered,but was attenuated for liver and intrahepatic bile duct cancers and pancreatic cancer;the effect of WHRadjBMI on the causal effect of breast cancer was not significantly altered,but the causal effect of liver and intrahepatic bile duct cancers and colon cancer was attenuated.Conclusion Both generalized and central obesity exerts a protective effect against breast cancer,yet they present an elevated risk for liver and intrahepatic bile duct cancers.Furthermore,general obesity is linked to an increased risk of pancreatic and lung cancers,and central obesity is correlated with an increased risk of colon cancer.关键词
肥胖/体重指数/腰臀比/恶性肿瘤/孟德尔随机化Key words
Obesity/Body mass index/BMI-adjusted waist-to-hip ratio/Malignant tumour/Mendelian randomization引用本文复制引用
田蔚,冯彬彬,王红,韩俊泉..肥胖特征与特定部位恶性肿瘤的因果效应:孟德尔随机化研究[J].浙江医学,2025,47(13):1370-1377,8.基金项目
天津市教委科研计划项目(2021ZD025、2018KJ036) （2021ZD025、2018KJ036）
天津市名医传承工作室建设项目(津卫中[2024]61号) （津卫中[2024]61号）
