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Abstract：
Weight cycling, defined as intentional weight loss followed by unintentional weight regain, may attenuate the benefit of intentional weight loss on endometrial cancer risk. We summarized the literature on intentional weight loss, weight cycling after intentional weight loss, bariatric surgery, and endometrial cancer risk.
A systematic search was conducted using MEDLINE, Embase, and Cochrane Central Register of Controlled Trials databases published between January 2000 and November 2018. We followed Preferred Reporting Items of Systematic Reviews and Meta-analysis (PRISMA) guidelines. We qualitatively summarized studies related to intentional weight loss and weight cycling due to the inconsistent definition, and quantitatively summarized studies when bariatric surgery was the mechanism of intentional weight loss.
A total of 127 full-text articles were reviewed, and 13 were included (bariatric surgery n=7, self-reported intentional weight loss n=2, self-reported weight cycling n=4). Qualitative synthesis suggested that, compared with stable weight, self-reported intentional weight loss was associated with lower endometrial cancer risk (RR range 0.61-0.96), whereas self-reported weight cycling was associated with higher endometrial cancer risk (OR range 1.07-2.33). The meta-analysis yielded a 59% lower risk of endometrial cancer following bariatric surgery (OR 0.41, 95% CI 0.22 to 0.74).
Our findings support the notion that intentional weight loss and maintenance of a stable, healthy weight can lower endometrial cancer risk. Strategies to improve awareness and maintenance of weight loss among women with obesity are needed to reduce endometrial cancer risk.
A systematic search was conducted using MEDLINE, Embase, and Cochrane Central Register of Controlled Trials databases published between January 2000 and November 2018. We followed Preferred Reporting Items of Systematic Reviews and Meta-analysis (PRISMA) guidelines. We qualitatively summarized studies related to intentional weight loss and weight cycling due to the inconsistent definition, and quantitatively summarized studies when bariatric surgery was the mechanism of intentional weight loss.
A total of 127 full-text articles were reviewed, and 13 were included (bariatric surgery n=7, self-reported intentional weight loss n=2, self-reported weight cycling n=4). Qualitative synthesis suggested that, compared with stable weight, self-reported intentional weight loss was associated with lower endometrial cancer risk (RR range 0.61-0.96), whereas self-reported weight cycling was associated with higher endometrial cancer risk (OR range 1.07-2.33). The meta-analysis yielded a 59% lower risk of endometrial cancer following bariatric surgery (OR 0.41, 95% CI 0.22 to 0.74).
Our findings support the notion that intentional weight loss and maintenance of a stable, healthy weight can lower endometrial cancer risk. Strategies to improve awareness and maintenance of weight loss among women with obesity are needed to reduce endometrial cancer risk.
摘要：
体重骑自行车,定义为有意的体重减轻，然后是无意的体重恢复，可能会削弱有意减肥对子宫内膜癌风险的益处。我们总结了有关有意减肥的文献，有意减肥后的体重循环，减肥手术,和子宫内膜癌的风险。
使用MEDLINE进行了系统搜索，Embase,和Cochrane中央对照试验注册数据库在2000年1月至2018年11月之间发布。我们遵循系统评价和荟萃分析（PRISMA）指南的首选报告项目。由于定义不一致，我们定性地总结了与有意减肥和体重循环相关的研究，并定量总结了减肥手术是有意减肥机制的研究。
共回顾了127篇全文，纳入13例(减重手术n=7,自我报告有意减重n=2,自我报告体重循环n=4).定性综合表明，与稳定的体重相比，自我报告的有意体重减轻与子宫内膜癌风险降低相关(RR范围0.61-0.96),而自我报告的体重循环与较高的子宫内膜癌风险相关(OR范围为1.07-2.33).荟萃分析得出减重手术后子宫内膜癌的风险降低了59％（OR0.41，95％CI0.22至0.74）。
我们的研究结果支持这样的观点，即有意减肥和维持稳定，健康的体重可以降低子宫内膜癌的风险。需要提高肥胖女性对减肥的认识和维持策略，以降低子宫内膜癌的风险。
使用MEDLINE进行了系统搜索，Embase,和Cochrane中央对照试验注册数据库在2000年1月至2018年11月之间发布。我们遵循系统评价和荟萃分析（PRISMA）指南的首选报告项目。由于定义不一致，我们定性地总结了与有意减肥和体重循环相关的研究，并定量总结了减肥手术是有意减肥机制的研究。
共回顾了127篇全文，纳入13例(减重手术n=7,自我报告有意减重n=2,自我报告体重循环n=4).定性综合表明，与稳定的体重相比，自我报告的有意体重减轻与子宫内膜癌风险降低相关(RR范围0.61-0.96),而自我报告的体重循环与较高的子宫内膜癌风险相关(OR范围为1.07-2.33).荟萃分析得出减重手术后子宫内膜癌的风险降低了59％（OR0.41，95％CI0.22至0.74）。
我们的研究结果支持这样的观点，即有意减肥和维持稳定，健康的体重可以降低子宫内膜癌的风险。需要提高肥胖女性对减肥的认识和维持策略，以降低子宫内膜癌的风险。
