Association of body mass index with bladder cancer risk in men depends on abdominal obesity
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The previous epidemiological studies about the associations between obesity and bladder cancer risk have reported inconsistent results. Therefore, we analyzed whether the abdominal obesity effected on the risk of developing bladder cancer according to body mass index (BMI) using nationally representative data from the National Health Insurance System (NHIS).
Patients and methods
Among people who underwent at least one health examination from 2009 to 2012 in Korea, 11,823,876 men without a previous diagnosis of bladder cancer were followed up until December 2015. Multiple Cox regression analysis was conducted to determine the hazard ratio (HR) and 95% confidence interval (CI) for the association between bladder cancer and BMI or waist circumference (WC).
Significant upward trends in the risk of bladder cancer were observed with increasing BMI or WC according to the multivariate-adjusted model. However, the association between BMI and bladder cancer is influenced by the presence of abdominal obesity. In the group with WC < 90 cm, there was no significant change in the HRs for bladder cancer development beyond the reference BMI. In contrast, the HRs for bladder cancer showed statistically significant increase as the BMI increased beyond the reference BMI in the group with WC ≥ 90 cm.
This population-based study showed that increasing BMI and increasing WC were risk factors for developing bladder cancer in men, independent of confounding variables. However, there was a discrepancy in the trend of bladder cancer development according to BMI between the groups with abdominal obesity and without abdominal obesity.
KeywordsBladder cancer Body mass index Waist circumference
JBC and U-SH conceived and designed the experiments. Choi and Kim performed the experiments. JHK and S-HH were involved in samples recruitment. K-DH analyzed the data. JBC and U-SH wrote the first draft of the manuscript. All the authors reviewed and edited the manuscript and approved the final version of the manuscript.
This research was supported by National Research Foundation of Korea (Grant number: NRF-2015R1C1A1A01051802).
Compliance with ethical standards
Conflict of interest
The authors declare no competing financial interests.
This study was approved by the Institutional Review Board of the Catholic University of Korea (KC16RISI0944).
- 5.Cantiello F, Cicione A, Salonia A, Autorino R, De Nunzio C, Briganti A, Gandaglia G, Dell’Oglio P, Capogrosso P, Damiano R (2015) Association between metabolic syndrome, obesity, diabetes mellitus and oncological outcomes of bladder cancer: a systematic review. Int J Urol 22:22–32. https://doi.org/10.1111/iju.12644 CrossRefPubMedGoogle Scholar
- 7.Choi JB, Moon HW, Park YH, Bae WJ, Cho HJ, Hong SH, Lee JY, Kim SW, Han KD, Ha US (2016) The impact of diabetes on the risk of prostate cancer development according to body mass index: a 10-year nationwide cohort study. J Cancer 7:2061–2066. https://doi.org/10.7150/jca.16110 CrossRefPubMedPubMedCentralGoogle Scholar
- 10.Carlsson AC, Riserus U, Arnlov J, Borne Y, Leander K, Gigante B, Hellenius ML, Bottai M, de Faire U (2014) Prediction of cardiovascular disease by abdominal obesity measures is dependent on body weight and sex–results from two community based cohort studies. Nutr Metab Cardiovasc Dis 24:891–899. https://doi.org/10.1016/j.numecd.2014.02.001 CrossRefPubMedGoogle Scholar
- 12.Song SO, Jung CH, Song YD, Park CY, Kwon HS, Cha BS, Park JY, Lee KU, Ko KS, Lee BW (2014) Background and data configuration process of a nationwide population-based study using the korean national health insurance system. Diabetes Metab J 38:395–403. https://doi.org/10.4093/dmj.2014.38.5.395 CrossRefPubMedPubMedCentralGoogle Scholar
- 13.Lee SR, Choi EK, Han KD, Cha MJ, Oh S (2017) Trends in the incidence and prevalence of atrial fibrillation and estimated thromboembolic risk using the CHA2DS2-VASc score in the entire Korean population. Int J Cardiol. https://doi.org/10.1016/j.ijcard.2017.02.039 CrossRefPubMedPubMedCentralGoogle Scholar
- 15.Korean Society for the Study of Obesity (2018) Clinical practice guidelines for overweight and obesity in Korea. Korean Society for the Study of Obesity, SeoulGoogle Scholar
- 21.Canonici A, Steelant W, Rigot V, Khomitch-Baud A, Boutaghou-Cherid H, Bruyneel E, Van Roy F, Garrouste F, Pommier G, Andre F (2008) Insulin-like growth factor-I receptor, E-cadherin and alpha v integrin form a dynamic complex under the control of alpha-catenin. Int J Cancer 122:572–582. https://doi.org/10.1002/ijc.23164 CrossRefPubMedGoogle Scholar
- 22.Juul A, Bang P, Hertel NT, Main K, Dalgaard P, Jorgensen K, Muller J, Hall K, Skakkebaek NE (1994) Serum insulin-like growth factor-I in 1030 healthy children, adolescents, and adults: relation to age, sex, stage of puberty, testicular size, and body mass index. J Clin Endocrinol Metab 78:744–752. https://doi.org/10.1210/jcem.78.3.8126152 CrossRefPubMedGoogle Scholar
- 25.Haggstrom C, Stocks T, Rapp K, Bjorge T, Lindkvist B, Concin H, Engeland A, Manjer J, Ulmer H, Selmer R, Tretli S, Hallmans G, Jonsson H, Stattin P (2011) Metabolic syndrome and risk of bladder cancer: prospective cohort study in the metabolic syndrome and cancer project (Me-Can). Int J Cancer 128:1890–1898. https://doi.org/10.1002/ijc.25521 CrossRefPubMedGoogle Scholar
- 26.Koebnick C, Michaud D, Moore SC, Park Y, Hollenbeck A, Ballard-Barbash R, Schatzkin A, Leitzmann MF (2008) Body mass index, physical activity, and bladder cancer in a large prospective study. Cancer Epidemiol Biomarkers Prev 17:1214–1221. https://doi.org/10.1158/1055-9965.epi-08-0026 CrossRefPubMedGoogle Scholar
- 27.Roswall N, Freisling H, Bueno-de-Mesquita HB, Ros M, Christensen J, Overvad K, Boutron-Ruault MC, Severi G, Fagherazzi G, Chang-Claude J, Kaaks R, Steffen A, Boeing H, Arguelles M, Agudo A, Sanchez MJ, Chirlaque MD, Barricarte Gurrea A, Amiano P, Wareham N, Khaw KT, Bradbury KE, Trichopoulou A, Papatesta HM, Trichopoulos D, Palli D, Pala V, Tumino R, Sacerdote C, Mattiello A, Peeters PH, Ehrnstrom R, Brennan P, Ferrari P, Ljungberg B, Norat T, Gunter M, Riboli E, Weiderpass E, Halkjaer J (2014) Anthropometric measures and bladder cancer risk: a prospective study in the EPIC cohort. Int J Cancer 135:2918–2929. https://doi.org/10.1002/ijc.28936 CrossRefPubMedGoogle Scholar
- 29.Robertson AG, Kim J, Al-Ahmadie H, Bellmunt J, Guo G, Cherniack AD, Hinoue T, Laird PW, Hoadley KA, Akbani R, Castro MAA, Gibb EA, Kanchi RS, Gordenin DA, Shukla SA, Sanchez-Vega F, Hansel DE, Czerniak BA, Reuter VE, Su X, de Sa Carvalho B, Chagas VS, Mungall KL, Sadeghi S, Pedamallu CS, Lu Y, Klimczak LJ, Zhang J, Choo C, Ojesina AI, Bullman S, Leraas KM, Lichtenberg TM, Wu CJ, Schultz N, Getz G, Meyerson M, Mills GB, McConkey DJ, Weinstein JN, Kwiatkowski DJ, Lerner SP (2018) Comprehensive molecular characterization of muscle-invasive bladder cancer. Cell 174:1033. https://doi.org/10.1016/j.cell.2018.07.036 CrossRefPubMedGoogle Scholar