ArticleBMJ open2025
Association of anthropometric indicators with oesophageal squamous carcinoma and precancerous lesions in people aged 40-69 years from high-risk setting in China: a population-based study.
Article in BMJ open, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
objectivesThis study aimed to explore the relationship between multiple anthropometric indicators (AIs), oesophageal squamous cell carcinoma (ESCC) and precancerous lesions.
designCross-sectional study.
participantsA total of 10 115 participants aged 40-69 years, recruited between 2017 and 2022 from Yangzhong City, Jiangsu Province, Southeast China, were included in the analysis.
main outcome measuresThe association of 11 AIs with ESCC and precancerous lesions was analysed using multivariate logistic regression and restricted cubic splines (RCS).
resultsThe prevalence of ESCC and precancerous lesions was 4.52%. Multivariate logistic regression analyses revealed that AIs were not significantly associated with ESCC or precancerous lesions in the total population (all p>0.05). Among men, only the fourth quartile (Q4) level of A Body Shape Index (ABSI) was protective against ESCC and precancerous lesions compared with the first quartile (Q1) (OR = 0.648, 95% CI = 0.440 to 0.955). Among women, the Q4 level of waist circumference (OR=1.612, 95% CI=1.066 to 2.438), third quartile (Q3) level of waist-to-hip ratio (WHR) (OR=1.890, 95% CI=1.252 to 2.854), Q4 level of Conicity Index (CI) (OR=1.869, 95% CI=1.227 to 2.848), and Q3 (OR=1.993, 95% CI=1.266 to 3.136) and Q4 (OR=2.137, 95% CI=1.380 to 3.310) ABSI levels were associated with an increased risk of ESCC and precancerous lesions compared with Q1 (all p<0.05). The risk of ESCC and precancerous lesions increased by 28.5% (OR=1.285, 95% CI=1.117 to 1.480) and 30.6% (OR=1.306, 95% CI=1.139 to 1.496), respectively, for each SD increase in the CI and ABSI among women (all p<0.05). RCS analyses demonstrated a non-linear association between Body Mass Index (BMI) in men and WHR in women with ESCC and precancerous lesions (all p for overall/non-linear <0.05). There was a positive linear association between CI and ABSI for ESCC and precancerous lesions in women (all p for overall <0.05; p for non-linear >0.05).
conclusionsAbdominal obesity and moderately overweight in men appeared to reduce the risk of ESCC and precancerous lesions. However, increasing levels of abdominal obesity in women are associated with a higher risk of ESCC and precancerous lesions. The heterogeneity in the role of adiposity, especially abdominal obesity, on ESCC and precancerous lesions between genders emphasises the importance of maintaining an appropriate body weight.
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