title: Body mass index and von Hippel-Lindau gene mutations in clear-cell renal cancer: Results of the Netherlands Cohort Study on diet and cancer.
abstract: OBJECTIVE
  Body mass index (BMI) is an important risk factor for clear-cell renal cancer (cc-RCC). A common molecular alteration in cc-RCC is loss-of-function of the von Hippel-Lindau (VHL) gene. We evaluated the association between BMI and VHL mutations in cc-RCC by using data from the Netherlands Cohort Study (NLCS), a prospective study, which comprises 120,852 persons.
  
  
  METHODS
  After 11.3 years of follow-up, 337 incident RCC cases were identified; 185 cc-RCC cases were included for analyses.
  
  
  RESULTS
  A high BMI at baseline was associated with an increased risk of cc-RCC with or without VHL mutations (per 1 kg/m(2): hazard ratio [HR] = 1.09, 95% confidence interval [CI]: 1.02-1.16 and HR = 1.08, 95%CI: 1.01-1.15, respectively). BMI at age 20 was only associated with an increased risk of cc-RCC with VHL mutations (per 1 kg/m(2): HR =1.09, 95% CI: 1.03-1.16). In contrast, BMI gain since age 20 was only associated with an increased risk in VHL wild-type cases (per 1 kg/m(2): HR = 1.10, 95% CI: 1.03-1.19).
  
  
  CONCLUSIONS
  Our findings indicate that BMI may be differently associated with subtypes of RCC based on VHL mutations.
authors.affiliation: Department of Epidemiology, Maastricht University, the Netherlands. kim.smits@epid.unimaas.nl
authors.forename: Kim M
authors.initials: KM
authors.lastname: Smits
authors.forename: Leo J
authors.initials: LJ
authors.lastname: Schouten
authors.forename: Eszter
authors.initials: E
authors.lastname: Hudak
authors.forename: Bas
authors.initials: B
authors.lastname: Verhage
authors.forename: Boukje A C
authors.initials: BA
authors.lastname: van Dijk
authors.forename: Christina A
authors.initials: CA
authors.lastname: Hulsbergen-van de Kaa
authors.forename: R Alexandra
authors.initials: RA
authors.lastname: Goldbohm
authors.forename: Egbert
authors.initials: E
authors.lastname: Oosterwijk
authors.forename: Piet A
authors.initials: PA
authors.lastname: van den Brandt
mesh_terms: D000328:Adult; D015992:Body Mass Index; D002292:Carcinoma, Renal Cell / Q000453:epidemiology / Q000235:genetics*; D015331:Cohort Studies; D016001:Confidence Intervals; D004032:Diet; D005260:Female; D006801:Humans; D007680:Kidney Neoplasms / Q000453:epidemiology / Q000235:genetics*; D008297:Male; D008875:Middle Aged; D009154:Mutation; D009426:Netherlands / Q000453:epidemiology; D009752:Nutritional Status; D012307:Risk Factors; D055815:Young Adult; D006623:von Hippel-Lindau Disease / Q000235:genetics*