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Metabolically (un)healthy obesity and risk of obesity-related cancers: a pooled study
Department of Translational Medicine, Lund University, Wallenberg Laboratory Floor 5, Clinical Research Centre, Malmö, Sweden.
Department of Translational Medicine, Lund University, Wallenberg Laboratory Floor 5, Clinical Research Centre, Box 50332, Malmö, Sweden; Institute of Medical Statistics and Informatics, Medical University of Innsbruck, Innsbruck, Austria.
Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine. Department of Surgical Sciences, Uppsala University, Uppsala, Sweden.ORCID iD: 0000-0001-6808-4405
Department of Global Public Health and Primary Care, University of Bergen, Bergen, Norway; Section for Cervical Cancer Screening, Cancer Registry of Norway, Oslo, Norway.
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2023 (English)In: Journal of the National Cancer Institute, ISSN 0027-8874, E-ISSN 1460-2105, Vol. 115, no 4, p. 456-467Article in journal (Refereed) Published
Abstract [en]

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 (normal weight, overweight, obesity) jointly and in interaction with metabolic health status in relation to obesity-related cancer risk (n = 23630) among 797193 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 2-sided.

Results: Metabolically unhealthy obesity, with a baseline prevalence of 7%, was, compared with 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 <. 05), with the highest risk estimates for endometrial, liver, and renal cell cancer (HR = 2.55-3.00). 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 body mass index and metabolic health status on obesity-related and rectal cancer among men and on endometrial cancer (P <. 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 obesity and metabolic aberrations are useful targets for prevention.

Place, publisher, year, edition, pages
Oxford University Press, 2023. Vol. 115, no 4, p. 456-467
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Cancer and Oncology
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URN: urn:nbn:se:umu:diva-211797DOI: 10.1093/jnci/djad008ISI: 000941199500001PubMedID: 36647199Scopus ID: 2-s2.0-85150040100OAI: oai:DiVA.org:umu-211797DiVA, id: diva2:1782017
Funder
Swedish Cancer Society, CAN 2017/1019Available from: 2023-07-12 Created: 2023-07-12 Last updated: 2023-07-12Bibliographically approved

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Häggström, Christelvan Guelpen, Bethany

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