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American Journal of Epidemiology Advance Access originally published online on April 24, 2009
American Journal of Epidemiology 2009 169(12):1492-1499; doi:10.1093/aje/kwp074
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American Journal of Epidemiology © The Author 2009. Published by the Johns Hopkins Bloomberg School of Public Health. All rights reserved. For permissions, please e-mail: journals.permissions@oxfordjournals.org.

ORIGINAL CONTRIBUTIONS

Obesity, Lifestyle Factors, and Risk of Myelodysplastic Syndromes in a Large US Cohort

Xiaomei Ma, Unhee Lim, Yikyung Park, Susan T. Mayne, Rong Wang, Patricia Hartge, Albert R. Hollenbeck and Arthur Schatzkin

Correspondence to Dr. Xiaomei Ma, Division of Chronic Disease Epidemiology, Yale School of Public Health, 60 College Street, Box 208034, New Haven, CT 06520-8034 (e-mail: xiaomei.ma{at}yale.edu).

Received for publication December 8, 2008. Accepted for publication March 10, 2009.

The etiology of myelodysplastic syndromes (MDS) is not well understood. The authors examined the relations of obesity and lifestyle factors to MDS in a cohort of 471,799 persons aged 50–71 years who were recruited into the National Institutes of Health-AARP Diet and Health Study, a large US prospective study, in 1995–1996. Incident MDS was diagnosed in 193 persons during 2001–2003. A significant positive association was observed between body mass index (BMI; weight (kg)/height (m)2) at baseline and MDS. Compared with persons with a BMI less than 25.0, the hazard ratios for persons with BMIs of 25.0–<30.0 and ≥30.0 were 1.15 (95% confidence interval (CI): 0.81, 1.64) and 2.18 (95% CI: 1.51, 3.17; P for trend < 0.001), respectively. The association was not affected by physical activity, cigarette smoking, or alcohol intake. As reported in previous studies, the risk of MDS was elevated among former smokers (hazard ratio = 1.68, 95% CI: 1.17, 2.41) and current smokers (hazard ratio = 3.17, 95% CI: 2.02, 4.98) as compared with never smokers. Physical activity, alcohol consumption, meat intake, and fruit and vegetable intake did not appear to significantly influence the risk of MDS in this analysis. This prospective investigation of MDS implicates both obesity and smoking as modifiable risk factors.

life style; myelodysplastic syndromes; obesity; smoking

Abbreviations: BMI, body mass index; CI, confidence interval; HR, hazard ratio; MDS, myelodysplastic syndromes; NIH, National Institutes of Health; RAEB, refractory anemia with excess blasts; SEER, Surveillance, Epidemiology, and End Results


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