Cancer risk in relation to body fat distribution, evaluated by DXA-scans, in postmenopausal women \u2013 the Prospective Epidemiological Risk Factor (PERF) study

Line Mærsk Staunstrup,Henning Bay Nielsen,Bente Klarlund Pedersen,Cecilie Liv Bager,Joseph Patrick Michele Blair,Morten Karsdal,Jesper Frank Christensen

doi:10.1038/s41598-019-41550-1

Line Mærsk Staunstrup, Henning Bay Nielsen + Show 5 more

Open Access

https://doi.org/10.1038/s41598-019-41550-1

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Abstract

Studies with direct measures of body fat distribution are required to explore the association between central and general obesity to cancer risk in postmenopausal women. This study investigates the association between central obesity and general obesity to overall/site-specific cancer risk in postmenopausal women. The analysis included 4,679 Danish postmenopausal women. Body fat distribution was evaluated by whole-body dual-energy X-ray absorptiometry scanners. Cancer diagnoses were extracted from the Danish Cancer Registry and multivariable Cox regression models explored the association between cancer risk and central obesity after adjusting for BMI. Our results showed that high central obese women had a 50% increased risk of overall cancer relative to low central obese women (Q1vs.Q4: [HR:1.50, CI:1.20–1.88]). For site-specific cancers, central obesity was significantly associated with Respiratory (Q1vs.Q4: [HR:2.01, CI:1.17–3.47]), Gastrointestinal (Q1vs.Q4: [HR:1.55, CI:0.99–2.41]) and Female genital organs (Q1vs.Q4: [HR:1.95, CI:1.00–3.78]) cancer diagnoses. Sub-analyses stratified by smoking-habits found a significant association between central obesity and a cancer diagnosis for current (Q1vs.Q4: [HR:1.93, CI:1.25–2.99]) and former smokers (Q1vs.Q4: [HR:1.90, CI:1.23–2.94]). These analyses suggest that central obesity is associated with some cancers in postmenopausal women independent of BMI.

Highlights

Several epidemiological studies have evaluated the link between obesity and cancer risk4–6
Of the 4,679 women who were dual-energy X-ray absorptiometry (DXA)-scanned in the Prospective Epidemiological Risk Factor (PERF) I study, 809 were diagnosed with cancer at least 6 months after baseline and 3870 women had no history of cancer (Fig. 1)
Age at baseline, smoking habits and central obesity were significantly different between women with a cancer diagnosis and non-cases

Summary

Introduction

Several epidemiological studies have evaluated the link between obesity and cancer risk. Studies with direct measures of body fat distribution are required to explore the association between body fat distribution and cancer risk in postmenopausal women To this end, dual-energy X-ray absorptiometry (DXA) scanning is the gold standard www.nature.com/scientificreports/. Www.nature.com/scientificreports for direct determination of whole-body and regional distribution of lean and fat mass, but only a few large-scale epidemiological studies have applied this method. The present study explored the association between body fat distribution in postmenopausal women and cancer risk using data from the Prospective Epidemiological Risk Factor (PERF) study. We examined the association between obesity and overall cancer risk in the postmenopausal women included in the PERF cohort Obesity was measured both by BMI and trunk-to-peripheral fat ratio, to reflect overall and central obesity respectively. We further explored the association between obesity and site-specific cancer risk, and stratified our analyses by smoking habits as a potential moderating factor

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