Non-Hodgkin lymphoma and obesity: a pooled analysis from the InterLymph Consortium.
Nutritional status is known to alter immune function, a suspected risk factor for non-Hodgkin lymphoma (NHL). To investigate whether long-term over, or under, nutrition is associated with NHL, self-reported anthropometric data on weight and height from over 10,000 cases of NHL and 16,000 controls were pooled across 18 case-control studies identified through the International Lymphoma Epidemiology Consortium. Study-specific odds ratios (OR) were estimated using logistic regression and combined using a random-effects model. Severe obesity, defined as BMI of 40 kg m(-2) or more, was not associated with NHL overall (pooled OR = 1.00, 95% confidence interval (CI) 0.70-1.41) or the majority of NHL subtypes. An excess was however observed for diffuse large B-cell lymphoma (pooled OR = 1.80, 95% CI 1.24-2.62), although not all study-specific ORs were raised. Among the overweight (BMI 25-29.9 kg m(-2)) and obese (BMI 30-39.9 kg m(-2)), associations were elevated in some studies and decreased in others, while no association was observed among the underweight (BMI < 18.5 kg m(-2)). There was little suggestion of increasing ORs for NHL or its subtypes with every 5 kg m(-2) rise in BMI above 18.5 kg m(-2). BMI components height and weight were also examined, and the tallest men, but not women, were at marginally increased risk (pooled OR = 1.19, 95% CI 1.06-1.34). In summary, whilst we conclude that there is no evidence to support the hypothesis that obesity is a determinant of all types of NHL combined, the association between severe obesity and diffuse large B-cell lymphoma may warrant further investigation.
Willett
Eleanor V
EV
Epidemiology and Genetics Unit, Department of Health Sciences, University of York, Heslington, York YO10 5DD, United Kingdom. eleanor.willett@egu.york.ac.uk
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Paolo
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Brian C-H
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Dal Maso
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Scott
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Silvia
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Karin Ekstrom
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Maria Grazia
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La Vecchia
Carlo
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Matsuo
Keitaro
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Maynadie
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Weisenburger
Dennis D
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D000328:Adult; D000368:Aged; D001827:Body Height; D015992:Body Mass Index; D001835:Body Weight; D005260:Female; D006801:Humans; D007391:International Cooperation; D016403:Lymphoma, Large B-Cell, Diffuse / Q000453:epidemiology; D008228:Lymphoma, Non-Hodgkin / Q000453:epidemiology* / Q000209:etiology; D008297:Male; D008875:Middle Aged; D009765:Obesity / Q000150:complications* / Q000453:epidemiology; D016017:Odds Ratio; D018570:Risk Assessment; D012307:Risk Factors