Cancer Res Treat.  2019 Jul;51(3):1107-1116. 10.4143/crt.2018.182.

Association between Body Mass Index and Gastric Cancer Risk According to Effect Modification by Helicobacter pylori Infection

Affiliations
  • 1Department of Preventive Medicine, Seoul National University College of Medicine, Seoul, Korea. suepark@snu.ac.kr
  • 2Cancer Research Institute, Seoul National University, Seoul, Korea.
  • 3Department of Biomedical Science, Seoul National University Graduate School, Seoul, Korea.
  • 4Department of Public Health, Graduate School, Catholic University, Seoul, Korea.
  • 5Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden.
  • 6Department of Community Medicine, Faculty of Health Sciences, University of Tromsø, Norway.
  • 7Department of Research, Cancer Registry of Norway – Institute of Population-Based Cancer Research, Oslo, Norway.
  • 8Genetic Epidemiology Group, Folkhälsan Research Center, Helsinki, Finland.
  • 9Faculty of Medicine, University of Helsinki, Helsinki, Finland.
  • 10Department of Preventive Medicine, Konkuk University, Chungju, Korea.
  • 11Non-communicable Disease and Health Promotion, Western Pacific Regional Office, World Health Organization, Manila, Philippines.
  • 12Department of Cancer Control and Population Health, Graduate School of Cancer Science & Policy, National Cancer Center, Goyang, Korea.
  • 13Cancer Risk Appraisal and Prevention Branch, National Cancer Control Institute, National Cancer Center, Goyang, Korea.
  • 14The Armed Forces Capital Hospital, Seongnam, Korea.

Abstract

PURPOSE
Few studies investigated roles of body mass index (BMI) on gastric cancer (GC) risk according to Helicobacter pylori infection status. This study was conducted to evaluate associations between BMI and GC risk with consideration of H. pylori infection information.
MATERIALS AND METHODS
We performed a case-cohort study (n=2,458) that consists of a subcohort, (n=2,193 including 67 GC incident cases) randomly selected from the Korean Multicenter Cancer Cohort (KMCC) and 265 incident GC cases outside of the subcohort. H. pylori infection was assessed using an immunoblot assay. GC risk according to BMI was evaluated by calculating hazard ratios (HRs) and their 95% confidence intervals (95% CIs) using weighted Cox hazard regression model.
RESULTS
Increased GC risk in lower BMI group (< 23 kg/m²) with marginal significance, (HR, 1.32; 95% CI, 0.98 to 1.77) compared to the reference group (BMI of 23-24.9 kg/m²) was observed. In the H. pylori non-infection, both lower (< 23 kg/m²) and higher BMI (≥ 25 kg/m²) showed non-significantly increased GC risk (HR, 10.82; 95% CI, 1.25 to 93.60 and HR, 11.33; 95% CI, 1.13 to 113.66, respectively). However, these U-shaped associations between BMI and GC risk were not observed in the group who had ever been infected by H. pylori.
CONCLUSION
This study suggests the U-shaped associations between BMI and GC risk, especially in subjects who had never been infected by H. pylori.

Keyword

Stomach neoplasms; Body mass index; Helicobacter pylori; Cohort studies; Case-cohort; Effect modification

MeSH Terms

Body Mass Index*
Cohort Studies
Helicobacter pylori*
Helicobacter*
Stomach Neoplasms*

Reference

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