ECO2013：过去60年的数据显示儿时的肥胖和身高指数与成人子宫内膜癌相关

发布在5月12日开始的利维浦欧洲肥胖会议（ECO）上的一项新的研究显示儿童期的肥胖和身高指数可能与成人期子宫内膜癌相关。这项研究由哥本哈根大学附属医院预防医学研究院的Julie Aarestrup，Copenhagen, Denmark及其同事完成。
欧洲每年新发子宫内膜癌超过90,000例，在女性肿瘤中排名第四。对于成年女性，子宫内膜癌的风险增加与高体质指数（BMI）密切相关，而与身高无明显相关。然而，这些风险是否起源于儿童期尚不清楚。在这项最新研究中，研究者研究了7-13岁儿童各年龄的体质指数（BMI）和身高是否与成人期子宫内膜癌风险存在关联。
这项队列研究的158,459名妇女出生于1930年至1989年，并且哥本哈根学院健康记录档案完整记录了其7-13岁的身高和体重。体质指数和身高转换为年龄别z评分，年龄别z评分是一种比较研究对象与参照人群体重和身高差异的方法。随访通过丹麦癌症登记处个人识别码，医院出院记录（子宫切除信息）以及人口统计记录进行。所有研究对象随访至出现以下任何一种情况时停止随访：诊断子宫内膜癌、子宫切除、死亡、移民、失访或者已随访至2010年12月31日。
研究者发现随访期间共诊断子宫内膜癌940例。7岁时体质指数z评分及身高z评分每增加1分，成人期子宫内膜癌风险分别增加18%和12%。也就是说，与出生于20世纪50年代末期女童的平均身高和体重(122.4 cm, 22.9kg)相比，身高相同但是体重大于平均体重3.3kg的女童，其成人期子宫内膜癌风险增加18%。而且儿童期身高也能增加成人期子宫内膜癌的风险。与女童身高和体重平均值相比，同年龄但是身高大于平均身高5.2cm的女童，其成人期子宫内膜癌风险增加12%。当观察出生于20世纪50年代末期的13岁女童时，与女童平均身高和体重(156.7cm, 44.6 kg)相比，身高相同但是体重大于平均值6.8kg的女童，其成人期子宫内膜癌风险增加24%；同年龄但是身高大于平均值6.9cm的女童，其成人期子宫内膜癌风险增加15%。
子宫内膜癌发生的高峰年龄大约为65岁。因此，出生于20世纪50年代的女童其子宫内膜癌发生风险接近峰值。由于该队列研究对象的年龄略小于子宫内膜癌发生的高峰年龄，为了评价子宫内膜癌的发生风险，研究者将对研究对象继续进行随访。
Aarestrup总结说：“儿童期较高的体质指数和身高与成人期增加的子宫内膜癌风险相关。这些结果说明成年女性的子宫内膜癌风险起源于儿童期。”
研究这正在分析不同子宫内膜异位症亚型与儿童体质量和身高的关系。这项计划是Dr. Jennifer L主持的系列研究的一部分。预防医学研究院的Baker正在探索儿童体型大小与晚期患癌（包括肝癌、前列腺癌、甲状腺癌）风险的关系。这项研究是欧洲科学研究委员会（ERC）计划“儿童生长与癌症：儿童期体型大小，生长以及青春期时间表与成人期患癌风险”的一部分，ERC计划由JenniferL. Baker副教授主持。

原文阅读：Research shows possible link between obesity and height in childhood and endometrial cancer in adulthood
New research presented at the European Congress in Liverpool (ECO) shows a possible link between obesity and height in childhood and endometrial cancer in adulthood. The research is conducted by Julie Aarestrup, Institute of Preventive Medicine, Copenhagen University Hospital, Copenhagen, Denmark, and colleagues.
Endometrial cancer in Europe is the fourth most common cancer in women with more than 90,000 new cases diagnosed each year. In adult women, a high body mass index (BMI) is associated with an increased risk of endometrial cancer, whereas associations with height are limited. It is largely unknown, however, whether any of the risk originates in childhood. In this new study, the researchers investigated if childhood BMI and height at each age from 7-13 years were associated with risk of endometrial cancer in adulthood.
The total cohort consisted of 158,459 women from the Copenhagen School Health Records Register with data on measured heights and weights at 7 to 13 years who were born between 1930 and 1989. BMI and height were transformed into age-specific z-scores, a method for comparing how large or tall a child is compared to a reference population. Follow-up occurred by linkage via a personal identification number to the Danish Cancer Registry, the Hospital Discharge Register (hysterectomy information), and the vital statistics register. Subjects were followed until a diagnosis of endometrial cancer, hysterectomy, death, emigration, loss-to-follow-up, or December 31, 2010; whichever came first.
The researchers found 940 diagnoses of endometrial cancer occurred during follow-up. At age 7, the risk of endometrial cancer in adulthood increased by 18 per cent per increase in BMI z-score and by 12 per cent per increase in height z-score. To put this in perspective, compared to an average height and weight girl born in the late 1950s (122.4 cm, 22.9kg), another girl of the same height but who weighed 3.3 kg more would have an 18 per cent higher risk of endometrial cancer.
Further, height also increased the risk; compared to the same average girl, another girl of the same age but who was 5.2cm taller had a 12 per cent increased risk of endometrial cancer. When looking at a girl aged 13 years born in the late 1950s compared to an average height and weight girl (156.7cm, 44.6 kg), another girl of the same height but who weighed 6.8kg more had a 24 per cent increased risk of endometrial cancer; and another girl of the same age but who was 6.9cm taller had a 15 per cent increased risk of endometrial cancer.
The peak age of endometrial cancer diagnosis is approximately 65 years. Therefore girls born in the 1950s are approaching their highest risk years. As the cohort members from later birth years continue to age, the study will continue to follow them in order to assess their risk of endometrial cancer.
Aarestrup concludes, “Higher BMI and height during childhood are associated with an increased risk of endometrial cancer in adulthood. These results suggest that some risk of endometrial cancer observed in adult women has its origins in childhood.”
Research is ongoing to refine these results by subtypes of endometrial cancer. This project forms part of a series of studies led by Dr Jennifer L Baker, also of the Institute of Preventive Medicine, that are exploring associations between childhood body size and the later risk of cancers including those of the liver, prostate and thyroid.