Abdominal Obesity and Lung Cancer Risk: Systematic Review and Meta-Analysis of Prospective Studies.

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obesity 54 endocrinologydiseases
hyperinsulinemia 1 endocrinologydiseases

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hyperinsulinemia 17463 abdominal obesity and general obesity to lung cancer may involve complex biologic pathways, such as hyperinsulinemia , decreased levels of sex hormone binding globulin (SBHG), and increased levels of unbound androgens
obesity 794 meta-analyses of observational studies have been performed to examine the association between general obesity , as measured by body mass index (BMI), and lung cancer. These meta-analyses suggest an inverse relation
obesity 963 meta-analyses suggest an inverse relation between high BMI and this cancer. In contrast to general obesity , abdominal obesity appears to play a role in the development of lung cancer. However, the association
obesity 982 suggest an inverse relation between high BMI and this cancer. In contrast to general obesity, abdominal obesity appears to play a role in the development of lung cancer. However, the association between abdominal
obesity 1091 appears to play a role in the development of lung cancer. However, the association between abdominal obesity (as measured by waist circumference (WC) (BMI adjusted) and waist to hip ratio (WHR)) and lung cancer
obesity 1392 and Web of Science databases were searched for studies assessing the association between abdominal obesity and lung cancer up to October 2016. The summary relative risks (RRs) with 95% confidence intervals (CIs)
obesity 2527 1.10 (95% CI 1.00, 1.23; I2 = 24.2%, p-heterogeneity = 0.211), respectively. In summary, abdominal obesity may play an important role in the development of lung cancer.1. IntroductionLung cancer is the most
obesity 2926 in 2012, accounting for 19.4% of total cancer deaths [[1]]. There is emerging evidence that general obesity and/or abdominal obesity is associated with increased risk of certain types of cancers, including postmenopausal
obesity 2951 19.4% of total cancer deaths [[1]]. There is emerging evidence that general obesity and/or abdominal obesity is associated with increased risk of certain types of cancers, including postmenopausal breast cancer,
obesity 3387 meta-analyses of observational studies have been performed to examine the association between general obesity , as measured by body mass index (BMI), and lung cancer. These meta-analyses suggest an inverse relation
obesity 3879 smoking habits may affect both body weight and body composition [[15],[16],[17]]. In contrast to general obesity , body fat distribution—particularly abdominal obesity—appears to play a role in the development
obesity 3935 composition [[15],[16],[17]]. In contrast to general obesity, body fat distribution—particularly abdominal obesity —appears to play a role in the development of lung cancer [[18],[19],[20],[21]]. Abdominal obesity
obesity 4035 obesity—appears to play a role in the development of lung cancer [[18],[19],[20],[21]]. Abdominal obesity is reflected by a higher waist to hip ratio (WHR) and a higher waist circumference (WC) relative to
obesity 4391 WHR and/or WC after adjustment for BMI [[18],[19],[20],[21]]. While unadjusted WC reflects general obesity , only adjusted WC reflects abdominal obesity [[21]]. Furthermore, another study has also found a positive
obesity 4436 [[18],[19],[20],[21]]. While unadjusted WC reflects general obesity, only adjusted WC reflects abdominal obesity [[21]]. Furthermore, another study has also found a positive association between higher WC and lung
obesity 4613 association between higher WC and lung cancer mortality [[22]]. Thus far, the association between abdominal obesity and lung cancer is not fully understood due to sparse available evidence regarding this association
obesity 4965 objectives: (1) provide insight into and robust evidence concerning the association between abdominal obesity and lung cancer by using published prospective data; and (2) investigate and quantify the potential
obesity 5512 and Web of Science databases were searched for studies assessing the association between abdominal obesity and lung cancer up to October 2016. The following search terms were employed to retrieve the relevant
obesity 5706 retrieve the relevant literature in the databases: (adiposity OR body size OR anthropometric OR abdominal obesity OR central obesity OR obese OR abdominal adiposity OR obesity OR body composition OR body fat distribution
obesity 5725 literature in the databases: (adiposity OR body size OR anthropometric OR abdominal obesity OR central obesity OR obese OR abdominal adiposity OR obesity OR body composition OR body fat distribution OR body fat
obesity 5768 body size OR anthropometric OR abdominal obesity OR central obesity OR obese OR abdominal adiposity OR obesity OR body composition OR body fat distribution OR body fat patterning OR retroperitoneal fat OR visceral
obesity 7149 case-control study, and case-cohort study); (b) examined the association between measures of abdominal obesity (WC and/or WHR) and risk of lung cancer; and (c) relative risks (RRs) or hazard ratios (HRs) or odds
obesity 9789 summary risk estimates. The degree of heterogeneity in the relationship between measures of abdominal obesity and lung cancer across studies was assessed using Q and I2 statistics. For the Q statistic, p < 0.1
obesity 10850 We performed a linear dose-response analysis examining the association between measures of abdominal obesity and lung cancer risk according to the method proposed by Greenland and Longnecker [[30]] and Orsini
obesity 11252 categories. For the studies that did not provide the number of cases and/or person-years in each abdominal obesity measure category, we estimated these data from total number of cases and person-years. For each study,
obesity 11401 from total number of cases and person-years. For each study, the median or mean level of abdominal obesity measures for each category was assigned to each corresponding risk estimate. When the median or mean
obesity 11520 for each category was assigned to each corresponding risk estimate. When the median or mean abdominal obesity measures per category were not provided, we considered the midpoint of the upper and lower boundaries
obesity 12745 articles, two articles were conducted in the same populations [[15],[32]], one article examined central obesity and lung cancer mortality [[22]], and the remaining 11 studies were excluded because the risk estimate
obesity 16125 is the first quantitative review of prospective studies concerning the association between abdominal obesity and lung cancer risk. Our dose-response analysis revealed that each 10 cm increase in WC and 0.1 unit
obesity 16426 In contrast, observational studies have reported a consistent inverse relationship between general obesity , as measured by BMI, and lung cancer [[12],[13],[14]]. Thus, our findings suggest that an excess of
obesity 17243 nonsmokers do with similar BMI [[33],[34],[35]].The exact mechanisms for the association between abdominal obesity and lung cancer remain poorly understood. One speculative biological mechanism for the contrary associations
obesity 17373 poorly understood. One speculative biological mechanism for the contrary associations of abdominal obesity and general obesity to lung cancer may involve complex biologic pathways, such as hyperinsulinemia,
obesity 17393 One speculative biological mechanism for the contrary associations of abdominal obesity and general obesity to lung cancer may involve complex biologic pathways, such as hyperinsulinemia, decreased levels of
obesity 18094 [[41],[42],[43]]. Nevertheless, the biologic mechanism underlying the association between abdominal obesity and lung cancer warrants further research.Furthermore, there are several reasonable explanations for
obesity 18243 research.Furthermore, there are several reasonable explanations for the contrary relationships of abdominal obesity and general obesity to lung cancer in regard to the residual confounding by smoking. The interrelations
obesity 18263 are several reasonable explanations for the contrary relationships of abdominal obesity and general obesity to lung cancer in regard to the residual confounding by smoking. The interrelations between general
obesity 18385 in regard to the residual confounding by smoking. The interrelations between general and abdominal obesity measures and smoking are complex and are subject to change over time. Smoking is a well-established
obesity 19059 smoked may help to overcome the issue of residual confounding by smoking in regard to both general obesity and abdominal obesity.A dose-response meta-analysis by Duan et al. [[14]] did not find inverse association
obesity 19081 overcome the issue of residual confounding by smoking in regard to both general obesity and abdominal obesity .A dose-response meta-analysis by Duan et al. [[14]] did not find inverse association of high BMI and
obesity 19333 non-smokers. Thus far, only a few prospective studies have examined the association between abdominal obesity and risk of lung cancer among never smokers [[18],[19],[20],[21]]. Olson et al. [[18]], Kabat et al.
obesity 20102 merely due to residual confounding by smoking. Nevertheless, data on an association between abdominal obesity and risk of non-smoking lung cancer remains inconclusive. Therefore, further large prospective studies
obesity 20846 surprising and challenging to explain since both WC (BMI adjusted) and WHR are measures of abdominal obesity . There are several explanations for the discrepancies between measures of abdominal obesity. First,
obesity 20938 abdominal obesity. There are several explanations for the discrepancies between measures of abdominal obesity . First, WC (BMI adjusted) may be a better predictor of abdominal obesity than WHR [[47],[48]]. Second,
obesity 21011 between measures of abdominal obesity. First, WC (BMI adjusted) may be a better predictor of abdominal obesity than WHR [[47],[48]]. Second, the null association of lung cancer and WHR among never smokers and current
obesity 22017 the true effect. Nevertheless, both WC (BMI adjusted) and WHR are both crude measures of abdominal obesity and cannot distinguish between subcutaneous fat and visceral fat. Therefore, future studies with advanced
obesity 23145 associations from these studies [[21]].Finally, it is worth taking into consideration that abdominal obesity and cancer share many risk factors, such as smoking, physical inactivity, and poor diet [[51],[52]].
obesity 23678 contribute to lung carcinogenesis. Given these considerations, the observed association between abdominal obesity and lung cancer may be partly due to similar confounding factors shared by both conditions. Further
obesity 23835 confounding factors shared by both conditions. Further clarification for the issue of whether abdominal obesity itself is associated with increased risk of lung cancer, rather than a proxy for another cancer risk
obesity 24598 recall and selection biases). Furthermore, given the considerably heterogeneous categories of abdominal obesity measures among included studies, a dose-response meta-analysis is necessary since it provides better
obesity 25232 distribution between men and women may influence the overall positive association between abdominal obesity and risk of lung cancer. Further studies focusing on the influence of sex differences on this association
obesity 25703 example, confounding from smoking may have contributed to observed positive association of abdominal obesity and lung cancer. Third, our analysis was limited by the number of included studies, which limits our
obesity 26085 self-measurement have led to overestimation or underestimation of the true association between abdominal obesity and lung cancer. Fifth, the possible dose-response meta-analysis measurement error should also be acknowledged,
obesity 26395 highest boundaries from the closest category and assigning the midpoint of each category of abdominal obesity measures to corresponding relative risk. Sixth, because the findings of the current meta-analysis were
obesity 26807 results from our meta-analysis should always be treated with caution. 5. ConclusionsIn summary, abdominal obesity may play an important role in the development of lung cancer. Further large prospective studies conducted
obesity 27782 confidence interval; RR relative risk.nutrients-08-00810-t001_Table 1Table 1Prospective studies of abdominal obesity and lung cancer. All risk estimates for waist circumference were additionally adjusted for body mass

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