METHODS: We systematically searched the PubMed, Web of Science, EconLit, Embase, Food Sciences and Technology Abstracts, PsycINFO, and Cochrane databases for literature published up to July 2023. Inclusion criteria were cohort studies with BMI or weight change as an exposure factor, cancer as a diagnostic outcome, and data type as an unadjusted hazard ratio (HR) or headcount ratio. Random- or fixed-effects models were used to calculate the pooled HR along with the 95% confidence interval (CI).
RESULTS: Seventy-three cohort studies were included in the meta-analysis. Compared with normal weight, overweight or obesity was a risk factor for overall survival (OS) in patients with breast cancer (HR 1.37, 95% CI 1.22-1.53; P < 0.0001), while obesity was a protective factor for OS in patients with gastrointestinal tumors (HR 0.67, 95% CI 0.56-0.80; P < 0.0001) and lung cancer (HR 0.67, 95% CI 0.48-0.92; P = 0.01) compared with patients without obesity. Compared with normal weight, underweight was a risk factor for OS in patients with breast cancer (HR 1.15, 95% CI 0.98-1.35; P = 0.08), gastrointestinal tumors (HR 1.54, 95% CI 1.32-1.80; P < 0.0001), and lung cancer (HR 1.28, 95% CI 1.22-1.35; P < 0.0001). Compared with nonweight change, weight loss was a risk factor for OS in patients with gastrointestinal cancer.
CONCLUSIONS: Based on the results of the meta-analysis, we concluded that BMI, weight change, and tumor prognosis were significantly correlated. These findings may provide a more reliable argument for the development of more effective oncology treatment protocols.
方法:我们系统地搜索了PubMed,WebofScience,EconLit,Embase,食品科学与技术文摘,PsycINFO,和截至2023年7月出版的Cochrane文献数据库。纳入标准是以BMI或体重变化为暴露因素的队列研究,癌症作为诊断结果,和数据类型为未调整的危险比(HR)或人数比。使用随机或固定效应模型来计算合并的HR以及95%置信区间(CI)。
结果:73项队列研究纳入荟萃分析。与正常体重相比,超重或肥胖是乳腺癌患者总生存期(OS)的危险因素(HR1.37,95%CI1.22-1.53;P<0.0001),与无肥胖患者相比,肥胖是胃肠道肿瘤患者(HR0.67,95%CI0.56-0.80;P<0.0001)和肺癌患者(HR0.67,95%CI0.48-0.92;P=0.01)的OS保护因素。与正常体重相比,体重过轻是乳腺癌患者OS的危险因素(HR1.15,95%CI0.98-1.35;P=0.08),胃肠道肿瘤(HR1.54,95%CI1.32-1.80;P<0.0001),和肺癌(HR1.28,95%CI1.22-1.35;P<0.0001)。与非体重变化相比,体重减轻是胃肠道肿瘤患者OS的危险因素.
结论:根据荟萃分析的结果,我们的结论是BMI,体重变化,与肿瘤预后显著相关。这些发现可能为开发更有效的肿瘤治疗方案提供更可靠的论据。