Abstract
BackgroundLimited studies have compared the association between various physical measurements and the risk of cancer or cardiovascular disease (CVD). We aim to explore the best‐individualized indicators of cancer and CVD risk assessment.MethodsFrom May 2004 to December 2017, a community‐based cohort in China involving 100 280 participants were enrolled. BMI, height, body surface area (BSA), and body fat percentage (BFP) were compared in parallel about cancer and CVD risk with the multivariable‐adjusted Cox proportional hazard regression model.ResultsWithin the follow‐up period, 3107 (3.10%) were diagnosed with cancer and 3721 (3.71%) had CVD. Per‐level increased (in tertile: T1, T2, and T3 level) BSA, height, and BFP was positively associated with the risk of overall cancer [HR (95% CI): 1.10 (1.05‐1.15), 1.12 (1.07‐1.18), and 1.10 (1.03‐1.16), respectively], whereas BMI was insignificant. Compared with the reference group (T2), the highest BSA level (T3) was positively associated with overall cancer incidence for both male [HR (95% CI): 1.28 (1.13‐1.45)] and female [HR (95% CI): 1.13 (1.00‐1.28)]. The BSA, height, and BFP also significantly associated with some site‐specific cancers including thyroid, stomach, breast, urinary system, and skin cancer. Meanwhile, BFP presented a strong positive association with overall CVD [HR (95% CI): 1.22 (1.15‐1.30) in trend] in both gender and associated with nearly all CVD subtypes especially the myocardial infarction and heart failure.ConclusionBSA, height, and BFP have more sensitivity in assessing cancer risk and BFP shows the largest hazard ratios for CVD incident. We provided valuable evidence for the application of height, BSA, and BFP in routine healthcare practice. These encouraging findings should be tested in more well‐defined studies for risk prediction.
Highlights
Obesity and overweight defined by the body mass index (BMI) have been widely used and reported an increased risk of cancer or cardiovascular disease (CVD).[1,2,3,4,5] BMI may not be the best biomarker to assess some diseases risk since the confusion of the “obesity paradox”,6,7 that is, people with obesity usually showed more survival benefits such as lower mortality
BMI, body surface area (BSA), and body fat percentage (BFP) were positively related to total cholesterol (TC), TG, low-density lipoprotein cholesterol (LDL-C), systolic blood pressure (SBP), diastolic blood pressure (DBP), fasting blood glucose (FBG), as well as the incidence of hypertension, diabetes mellitus, and Chronic kidney disease (CKD)
Higher (>median) height, BSA, and BDP still increased the cancer risk which inconsistent with the results in trend, we further found that height will increase the risk of urinary system cancer [hazard ratios (HRs) (95%confidence intervals (CIs)), 1.51 (1.06-2.14)] (Table S3)
Summary
Obesity and overweight defined by the body mass index (BMI) have been widely used and reported an increased risk of cancer or cardiovascular disease (CVD).[1,2,3,4,5] BMI may not be the best biomarker to assess some diseases risk since the confusion of the “obesity paradox”,6,7 that is, people with obesity usually showed more survival benefits such as lower mortality. Some researchers explored the impact of height on various diseases,[5,10,11,12,13] and found that tall stature was associated with increased risk for some specific cancer, but opposite for CVD.[5,10,11,12,13] Besides, several studies have evaluated the effects of body fat percentage (BFP) and found a positive association with better survival (“obesity paradox”),[6,14,15,16,17] evidence on the risk of incidence of cancer and cardiovascular disease remains limited. Limited studies have compared the association between various physical measurements and the risk of cancer or cardiovascular disease (CVD). These encouraging findings should be tested in more well-defined studies for risk prediction
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