【摘要】 目的 分析扬中市40～69岁人群11种人体测量指标(AIs)与胃癌及癌前病变的关联。方法 采用整群抽样方法，选取2017年11月至2022年12月，扬中市10698名参与上消化癌筛查的40～69岁居民进行问卷调查、体格检查、内镜检查及病理学诊断。采用多因素logistics回归分别分析体质量指数(BMI)、腰围(WC)、腰臀比(WHR)、腰高比(WHtR)、体脂百分比(BF%)、锥度指数(CI)、身体肥胖估计量(BAE)、身体形态指数(ABSI)、身体肥胖指数(BAI)、身体圆度指数(BRI)和腹部容积指数(AVI)与胃癌及癌前病变的关联。结果 10115名调查对象胃癌及癌前病变的患病率为39.37%。多因素logistics回归结果显示，与第1分位数(Q1)相比，BMI的Q3和Q4人群患胃癌及癌前病变风险分别降低11.1%(OR=0.889,0.791～0.999)和12.4%(OR=0.876,0.779～0.984)。BF%的Q2,Q3和Q4人群患胃癌及癌前病变风险分别降低14.2%(OR=0.858,0.756～0.974)、17.4%(OR=0.826,0.689～0.991)和26.6%(OR=0.734,0.603～0.893)。BAE的Q2和Q4人群患胃癌及癌前病变风险分别降低13.2%(OR=0.868,0.766～0.983)和21.3%(OR=0.787,0.648～0.957)。BAI的Q2和Q3人群患胃癌及癌前病变风险分别降低13.7%(OR=0.863,0.767～0.970)和13.1%(OR=0.869,0.769～0.983)。分层分析显示，BMI、BF%、BAE和BAI与非贲门胃癌及癌前病变风险降低有关(均P<0.05)。但与Q1相比，仅BAE的Q2水平与贲门胃癌及癌前病变的风险降低有关(P<0.05)。结论 扬中市40～69岁人群BMI、BF%、BAE和BAI水平的增加与胃癌及癌前病变患病风险降低相关。这种关联大多适用于非贲门而不是贲门。更多还原

【Abstract】 Objective To analyze the association of 11 anthropometric indicators(AIs) with gastric cancer and precancerous lesions in people aged 40-69 years in Yangzhong City. Methods Using the cluster sampling method, 10 698 residents aged 40-69 years who participated in upper gastrointestinal cancer screening in Yangzhong City from November 2017 to December 2022 were selected for questionnaire survey, physical examination, endoscopy and pathological diagnosis. Multivariate logistic regression was used to analyze the association between AIs [body mass index(BMI), waist circumference(WC), waist-to-hip ratio(WHR), waist-to-height ratio(WHtR), body fat percentage(BF%), conicity index(CI), body adiposity estimator(BAE), a body shape index(ABSI), body adiposity index(BAI), body roundness index(BRI) and abdominal volumetric index(AVI)] and gastric cancer and precancerous lesions. Results The prevalence of gastric cancer and precancerous lesions was 39.37% among 10 115 residents. The results of multivariate logistic regression showed that compared with those in quartile 1(Q1), the Q3 and Q4 populations of BMI had an 11.1%(OR=0.889, 0.791-0.999) and 12.4%(OR=0.876, 0.779-0.984) lower risk of gastric cancer and precancerous lesions, respectively. The Q2, Q3 and Q4 populations of BF% had 14.2%(OR=0.858, 0.756-0.974), 17.4%(OR=0.826, 0.689-0.991) and 26.6%(OR=0.734, 0.603-0.893) lower risk of gastric cancer and precancerous lesions risk, respectively. The Q2 and Q4 populations of the BAE had reduced the risk of gastric cancer and precancerous lesions by 13.2%(OR=0.868, 0.766-0.983) and 21.3%(OR=0.787, 0.648-0.957). The risk of gastric cancer and precancerous lesions in BAI’s Q2 and Q3 populations was reduced by 13.7%(OR=0.863, 0.767-0.970) and 13.1%(OR=0.869, 0.769-0.983), respectively. Stratified analysis showed that BMI, BF%, BAE and BAI were associated with a reduced risk of non-cardia gastric cancer and precancerous lesions(all P<0.05). However, only the Q2 level of BAE was associated with a reduced risk of cardia gastric cancer and precancerous lesions compared to the Q1(P<0.05). Conclusion Increased levels of BMI, BF%, BAE, and BAI among residents aged 40-69 years in Yangzhong City are associated with a reduced risk of gastric cancer and precancerous lesions. However, most of this association apply to non-cardia but not cardia.更多还原