title: Non-Hodgkin lymphoma and obesity: a pooled analysis from the InterLymph Consortium.
abstract: 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.
authors.affiliation: Epidemiology and Genetics Unit, Department of Health Sciences, University of York, Heslington, York YO10 5DD, United Kingdom. eleanor.willett@egu.york.ac.uk
authors.forename: Eleanor V
authors.initials: EV
authors.lastname: Willett
authors.forename: Lindsay M
authors.initials: LM
authors.lastname: Morton
authors.forename: Patricia
authors.initials: P
authors.lastname: Hartge
authors.forename: Nikolaus
authors.initials: N
authors.lastname: Becker
authors.forename: Leslie
authors.initials: L
authors.lastname: Bernstein
authors.forename: Paolo
authors.initials: P
authors.lastname: Boffetta
authors.forename: Paige
authors.initials: P
authors.lastname: Bracci
authors.forename: James
authors.initials: J
authors.lastname: Cerhan
authors.forename: Brian C-H
authors.initials: BC
authors.lastname: Chiu
authors.forename: Pierluigi
authors.initials: P
authors.lastname: Cocco
authors.forename: Luigino
authors.initials: L
authors.lastname: Dal Maso
authors.forename: Scott
authors.initials: S
authors.lastname: Davis
authors.forename: Silvia
authors.initials: S
authors.lastname: De Sanjose
authors.forename: Karin Ekstrom
authors.initials: KE
authors.lastname: Smedby
authors.forename: Maria Grazia
authors.initials: MG
authors.lastname: Ennas
authors.forename: Lenka
authors.initials: L
authors.lastname: Foretova
authors.forename: Elizabeth A
authors.initials: EA
authors.lastname: Holly
authors.forename: Carlo
authors.initials: C
authors.lastname: La Vecchia
authors.forename: Keitaro
authors.initials: K
authors.lastname: Matsuo
authors.forename: Marc
authors.initials: M
authors.lastname: Maynadie
authors.forename: Mads
authors.initials: M
authors.lastname: Melbye
authors.forename: Eva
authors.initials: E
authors.lastname: Negri
authors.forename: Alexandra
authors.initials: A
authors.lastname: Nieters
authors.forename: Richard
authors.initials: R
authors.lastname: Severson
authors.forename: Susan L
authors.initials: SL
authors.lastname: Slager
authors.forename: John J
authors.initials: JJ
authors.lastname: Spinelli
authors.forename: Anthony
authors.initials: A
authors.lastname: Staines
authors.forename: Renato
authors.initials: R
authors.lastname: Talamini
authors.forename: Martine
authors.initials: M
authors.lastname: Vornanen
authors.forename: Dennis D
authors.initials: DD
authors.lastname: Weisenburger
authors.forename: Eve
authors.initials: E
authors.lastname: Roman
mesh_terms: 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