ORIGINAL CONTRIBUTIONS |
Effect of Adiposity and Fat Distribution on Endometrial Cancer Risk in Shanghai Women
1 Department of Epidemiology, Shanghai Cancer Institute, Shanghai, China
2 Department of Medicine, Division of Internal Medicine, Vanderbilt University School of Medicine, Nashville, TN
3 Center for Health Services Research, Vanderbilt-Ingram Cancer Center, Vanderbilt University School of Medicine, Nashville, TN
4 Geriatric Research, Education, and Clinical Center, Veterans Affairs Tennessee Valley Healthcare System, Nashville, TN
Correspondence to Dr. Xiao Ou Shu, Center for Health Services Research, 6009 Medical Center East, Vanderbilt University, 1215 21st Avenue South, Nashville, TN 37232-8300 (e-mail: Xiao-Ou.Shu{at}vanderbilt.edu).
The authors conducted a population-based case-control study of 832 endometrial cancer cases and 846 frequency-matched controls in Shanghai, China (1997–2001), to examine the association of overall adiposity and body fat distribution with disease risk. Overall adiposity was estimated using weight and body mass index (BMI); upper body fat distribution was evaluated using waist circumference and waist:hip ratio. Overall and upper-body obesity were both associated with an elevated risk of endometrial cancer. Adjusted odds ratios and 95% confidence intervals for highest-versus-lowest quartile comparisons were 2.6 (95% confidence interval (CI): 2.0, 3.5) for weight, 2.9 (95% CI: 2.2, 3.9) for BMI, 4.7 (95% CI: 3.4, 6.4) for waist circumference, and 3.5 (95% CI: 2.6, 4.8) for waist:hip ratio. The positive associations with weight and BMI vanished after results were controlled for waist circumference, while associations with waist circumference and waist:hip ratio persisted after adjustment for BMI. The positive association with upper-body obesity was more pronounced among younger women, women who had never used oral contraceptives, and women with a history of diabetes mellitus (p for multiplicative interaction < 0.05). Upper-body obesity was related to increased risk among women with low BMI. These results suggest that obesity, particularly upper-body fat deposition, is associated with an increased risk of endometrial cancer.
body composition; body mass index; case-control studies; endometrial neoplasms; obesity
Abbreviations: BMI, body mass index; CI, confidence interval; IGF-1, insulin-like growth factor 1
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