PubMed, Embase, and Web of Science databases were searched from their inception to December 2022. The 9-star Newcastle Ottawa Scale was used to assess study quality. Pooled relative risks and 95% confidence intervals were calculated using fixed or random effect models respectively. The stability of the results was explored by one-by-one exclusion. Subgroup analysis was conducted to explore sources of heterogeneity. Publication bias was evaluated by Begg\'s and Egger\'s tests.
A total of 43 cohort studies were included. There were 42 and 31 studies in the meta-analysis of waist circumference and waist-to-hip ratio on digestive system cancer, respectively. The results of the meta-analysis revealed that the greater waist circumference and waist-to-hip ratio were correlated with increased incidence of digestive system cancers: waist circumference: RR 1.48, 95% CI 1.38-1.59, p < 0.001; waist-to-hip ratio: RR 1.33, 95% CI 1.28-1.38, p = 0.001. Subgroup analysis by cancer type showed that higher WC and WHR would increase the prevalence of LC, PC, GC, EC, and CRC. The sensitivity analysis was conducted by a one-by-one elimination method, and the results of the meta-analysis remained stable. It is proved that the results were robust by the trim-and-fill method.
There was evidence to suggest that abdominal obesity increased the incidence of digestive cancer, it is necessary to take appropriate measures to reduce abdominal obesity. Waist circumference and waist-to-hip ratio may be better predictors of digestive system cancers. However, the association between waist circumference and digestive system cancer was greater, so more attention should be paid to measuring abdominal obesity with waist circumference.
方法:PubMed,Embase,从成立到2022年12月,搜索了WebofScience数据库。9星纽卡斯尔渥太华量表用于评估研究质量。分别使用固定或随机效应模型计算集合相对风险和95%置信区间。通过逐一排除来探索结果的稳定性。进行亚组分析以探索异质性的来源。通过Begg和Egger的测试评估了出版偏差。
结果:共纳入43项队列研究。有42和31个研究的荟萃分析的腰围和腰臀比对消化系统癌症,分别。荟萃分析结果显示,腰围和腰臀比增大与消化系统癌症发病率增加相关:腰围:RR1.48,95%CI1.38-1.59,p<0.001;腰臀比:RR1.33,95%CI1.28-1.38,p=0.001。根据癌症类型进行的亚组分析显示,较高的WC和WHR会增加LC的患病率,PC,GC,EC,和CRC。敏感性分析采用逐一消除法,meta分析的结果保持稳定.通过修剪填充方法证明了结果的鲁棒性。
结论:有证据表明腹型肥胖会增加消化道肿瘤的发病率,有必要采取适当措施减少腹型肥胖。腰围和腰臀比可能是消化系统癌症的更好预测因素。然而,腰围和消化系统癌症之间的关联更大,因此,更应该注意用腰围测量腹部肥胖。