Anthropometry, body fat composition and reproductive factors and risk of oesophageal and gastric cancer by subtype and subsite in the UK Biobank cohort

Abstract Background Controversies exist about the relationship between body habitus and mortality, especially for patients with cardiovascular disease. Purpose We evaluated the relations between different anthropometric indices and mortality amongst participants with and without cardiovascular (CV) risk factors, or established CV disease (stroke, myocardial infarction and/or heart failure), enrolled in the UK Biobank. Methods The UK Biobank is a large prospective study which, between 2006 and 2010, enrolled 502,620 participants aged 38–73 years. Participants filled questionnaires and had a medical history recorded, physical measurements done and biological samples taken. The UK Biobank is routinely linked to national death registries and updated on a quarterly basis. Data on death were coded according to the International Classification of Diseases, 10th Revision (ICD-10). The primary end-point was all-cause mortality (ACM) across three subgroups of men and women: those with, or without, one or more CV risk factors (smoking, diabetes and/or hypertension), and those with CV disease (history of stroke, myocardial infarction and/or heart failure) at recruitment. Presence, or absence, of CV risk factors and diagnoses of CV disease were self-reported by participants at enrolment. Associations between anthropometric indices (body mass index (BMI), waist circumference (WC), waist to hip ratio (WHiR), and waist to height ratio (WHeR)) and the risk of all-cause mortality were analysed using Cox regression models. Results After excluding those with history of cancer at baseline (n=45,222), 453,046 participants were included (median age: 58 (interquartile range: 50 - 63) years; 53% women), of whom 150,732 had at least one CV risk factor, and 17,884 established CV disease. During a median follow-up of 5 years, 6,319 participants died. Baseline BMI had a U-shaped relationship with ACM, with higher nadir-values for those with CV risk factors or CV disease, for both sexes (figure). WC, WHiR and WHeR (measures of central distribution of body fat) had more linear associations with ACM, regardless of CV risk factors, CV disease and sex. Conclusions For adults with or without CV risk factors or established CV disease, measures of central distribution of body fat are more strongly and more linearly associated with ACM than BMI. WC, or WHiR, rather than BMI, appear to be more appropriate variables for risk stratification.

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Association between severe sarcopenic obesity and respiratory incidence and mortality: an obesity paradox.

Proceedings of The Nutrition Society ◽

10.1017/s0029665120000531 ◽

2020 ◽

Vol 79 (OCE2) ◽

Author(s):

Fanny Petermann-Rocha ◽

Stuart R. Gray ◽

Jill P. Pell ◽

Carlos Celis-Morales

Keyword(s):

Respiratory Disease ◽

Body Fat ◽

Protective Factor ◽

Disease Incidence ◽

Positive Association ◽

Sarcopenic Obesity ◽

Uk Biobank ◽

Respiratory Mortality ◽

Incidence And Mortality ◽

The Uk

IntroductionObesity remains one of the biggest health challenges worldwide. Sarcopenia, a progressive loss of muscle strength, is associated with a higher risk of disability and lower quality of life. Both conditions can occur independently of each other; however, share a common inflammatory pathway, leading to serious health problems. Previous studies have shown a positive association between severe sarcopenia and respiratory disease incidence/mortality, however, it is unclear if this association is modified by obesity. The aim of this work, therefore, was to investigate the association of severe sarcopenia and severe sarcopenic-obesity with respiratory incidence and mortality in the UK Biobank cohort.Material and methods242,572 white participants from the UK biobank study were included. Severe sarcopenia was defined as the combination of low muscle mass, low grip strength and slow gait speed. Severe sarcopenic-obesity was defined, using 3 different criteria. The combination of severe sarcopenia plus at least one of the following criteria: BMI ≥ 30 kg/m2, waist circumference (WC) > 88 cm in women and > 102 cm in men, or the two highest quintiles of body fat (60%). Associations between severe sarcopenic and severe sarcopenic-obesity and respiratory incidence and mortality were investigated using Cox-proportional hazard models.ResultsIn people without sarcopenia, high BMI, WC and body fat were associated with a reduced risk of respiratory disease mortality (HR: 0.70 [0.52; 0.85], HR: 0.74 [95%CI: 062: 088] and HR: 0.74 [95%CI: 0.63; 0.88], respectively). In comparison to people without sarcopenia or obesity, those with severe sarcopenia had three times higher risk of respiratory disease incidence (HR: 3.13 [95%CI: 2.25; 4.35]) and five times higher risk of mortality (HR: 5.37 [95%CI: 2.96: 9.74]). However, sarcopenic-obesity, based on WC and body fat, was only associated with a moderately increased respiratory disease incidence (HR 1.60 [95%CI: 1.04; 2.46] and HR: 1.52 [1.04: 2.22], respectively). There were no associations between respiratory mortality and sarcopenic-obesity.DiscussionHigher levels of adiposity may be a protective factor against respiratory mortality and could reduce the effect of severe sarcopenia over this disease. However, the mechanism behind this association needs to elucidate.

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Reproductive Factors and the Risk of Incident Dementia: Results From the UK Biobank

10.21203/rs.3.rs-359787/v1 ◽

2021 ◽

Author(s):

Jessica Gong ◽

Katie Harris ◽

Sanne A E Peters ◽

Mark Woodward

Keyword(s):

Smoking Status ◽

Hormone Replacement ◽

Reproductive Factors ◽

Uk Biobank ◽

Oral Contraceptive Pills ◽

Number Of Children ◽

Estrogen Exposure ◽

Contraceptive Pills ◽

Endogenous Estrogen ◽

The Uk

Abstract Background: To examine the risk of incident all-cause dementia associated with reproductive factors in women, and the number of children in both sexes; and whether the effects vary by age, socioeconomic status (SES), smoking status and body mass index in the UK Biobank.Methods: A total of 273,265 women and 228,966 men without prevalent dementia from the UK Biobank were included in the analyses. Cox proportional hazard regressions estimated hazard ratios (HRs) for reproductive factors with incident all-cause dementia.Results: Over a median of 11.3 years follow-up, 1,680 dementia were recorded in women and 2,021 in men. Adjusted HRs (95% confidence intervals (CIs)) for dementia were 1.20 (1.08, 1.35) for menarche <12 years, and 1.24 (1.10, 1.39) for menarche ≥15 years compared to 13 years; 0.86 (0.74, 1.00) for ever been pregnant; 0.80 (0.69, 0.93) for each abortion; 1.29 (1.12, 1.49) for menopause at <47 compared to 50 years; 1.13 (1.01, 1.27) for hysterectomy; 0.80 (0.72, 0.90) for oral contraceptive pills use; and 1.56 (1.40, 1.73) for hormone replacement therapy (HRT) use. The U-shaped associations between the number of children and the risk of dementia were similar for both sexes. There was evidence for early (natural and artificial) menopause, and a greater number of children were associated with a higher risk of dementia among women of relatively lower SES only.Conclusions: Shorter cumulative endogenous estrogen exposure in women is associated with higher dementia risk, although female biological factors involved in childbearing are unlikely to account for risk variation.

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Associations of six adiposity-related markers with incidence and mortality from 24 cancers—findings from the UK Biobank prospective cohort study

BMC Medicine ◽

10.1186/s12916-020-01848-8 ◽

2021 ◽

Vol 19 (1) ◽

Author(s):

Solange Parra-Soto ◽

Emma S. Cowley ◽

Leandro F. M. Rezende ◽

Catterina Ferreccio ◽

John C. Mathers ◽

...

Keyword(s):

Breast Cancer ◽

Cohort Study ◽

Body Fat ◽

Cancer Incidence ◽

Body Fat Percentage ◽

Uk Biobank ◽

Fat Percentage ◽

Incidence And Mortality ◽

The Uk

Abstract Background Adiposity is a strong risk factor for cancer incidence and mortality. However, most of the evidence available has focused on body mass index (BMI) as a marker of adiposity. There is limited evidence on relationships of cancer with other adiposity markers, and if these associations are linear or not. The aim of this study was to investigate the associations of six adiposity markers with incidence and mortality from 24 cancers by accounting for potential non-linear associations. Methods A total of 437,393 participants (53.8% women; mean age 56.3 years) from the UK Biobank prospective cohort study were included in this study. The median follow-up was 8.8 years (interquartile range 7.9 to 9.6) for mortality and 9.3 years (IQR 8.6 to 9.9) for cancer incidence. Adiposity-related exposures were BMI, body fat percentage, waist-hip ratio, waist-height ratio, and waist and hip circumference. Incidence and mortality of 24 cancers sites were the outcomes. Cox proportional hazard models were used with each of the exposure variables fitted separately on penalised cubic splines. Results During follow-up, 47,882 individuals developed cancer and 11,265 died due to cancer during the follow-up period. All adiposity markers had similar associations with overall cancer incidence. BMI was associated with a higher incidence of 10 cancers (stomach cardia (hazard ratio per 1 SD increment 1.35, (95% CI 1.23; 1.47)), gallbladder (1.33 (1.12; 1.58)), liver (1.27 (1.19; 1.36)), kidney (1.26 (1.20; 1.33)), pancreas (1.12 (1.06; 1.19)), bladder (1.09 (1.04; 1.14)), colorectal (1.10 (1.06; 1.13)), endometrial (1.73 (1.65; 1.82)), uterine (1.68 (1.60; 1.75)), and breast cancer (1.08 (1.05; 1.11))) and overall cancer (1.03 (1.02; 1.04)). All these associations were linear except for breast cancer in postmenopausal women. Similar results were observed when other markers of central and overall adiposity were used. For mortality, nine cancer sites were linearly associated with BMI and eight with waist circumference and body fat percentage. Conclusion Adiposity, regardless of the marker used, was associated with an increased risk in 10 cancer sites.

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