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Adolescent weight and height are predictors of specific non-Hodgkin lymphoma subtypes among a cohort of 2,352,988 individuals aged 16 to 19 years.

Abstract

BACKGROUND

The age-adjusted annual incidence of non-Hodgkin lymphoma (NHL) has risen worldwide. This trend may be affected by the secular increase in height and the sharp upswing in adolescent overweight; these drive increased insulinlike growth factor 1 and chronic inflammation, which may play an etiologic role. This study examined the association of the body mass index (BMI) and height of adolescents with NHL subtypes, which have been insufficiently evaluated.

METHODS

Health-related data on 2,352,988 Israeli adolescents, aged 16 to 19 years, who were examined between 1967 and 2011 were linked to the Israel National Cancer Registry to derive the NHL incidence up to December 31, 2012 (4021 cases). Cox proportional hazards modeling was used to estimate the multivariate-adjusted hazard ratio (HR) for NHL subtypes associated with the BMI and height of adolescents.

RESULTS

Adolescent overweight and obesity were associated with an HR of 1.25 (95% confidence interval [CI], 1.13-1.37; P = 1.14 × 10(-5) ) for NHL in comparison with normal weight. There was a graded association of height with NHL (P = 4.29 × 10(-9) ), with the tallest adolescents (≥ 95th percentile vs 25th to < 50th percentiles [US Centers for Disease Control and Prevention]) exhibiting an HR of 1.28 (95% CI, 1.04-1.56). Marginal zone lymphoma, primary cutaneous lymphoma (PCL), and diffuse large B-cell lymphoma (DLBCL) showed the strongest associations for overweight/obesity, and DLBCL and PCL showed the strongest associations for height.

CONCLUSIONS

The findings of this large cohort study add to the growing body of evidence showing that higher body weight and taller stature during adolescence are associated with an increased risk of NHL and may modestly contribute to its increasing incidence. Further studies are needed to elucidate the mechanisms linking anthropometric measures and NHL risk.

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  • Authors+Show Affiliations

    ,

    Division of Hematology and Bone Marrow Transplantation, Sheba Medical Center, Ramat Gan, Israel. Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel.

    ,

    Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel. Surgeon General Headquarters, Medical Corps, Israel Defense Forces, Haifa, Israel.

    ,

    Israel National Cancer Registry, Israel Center for Disease Control, Ministry of Health, Ramat Gan, Israel. School of Public Health, University of Haifa, Haifa, Israel.

    ,

    Division of Hematology and Bone Marrow Transplantation, Sheba Medical Center, Ramat Gan, Israel. Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel.

    ,

    Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel. Surgeon General Headquarters, Medical Corps, Israel Defense Forces, Haifa, Israel.

    ,

    Hebrew University-Hadassah School of Public Health and Community Medicine, Jerusalem, Israel. Department of Preventive Medicine, Icahn School of Medicine at Mount Sinai, New York, New York.

    Hebrew University-Hadassah School of Public Health and Community Medicine, Jerusalem, Israel.

    Source

    Cancer 122:7 2016 Apr 01 pg 1068-77

    MeSH

    Adolescent
    Body Height
    Body Mass Index
    Body Weight
    Cohort Studies
    Female
    Humans
    Incidence
    Israel
    Lymphoma, Non-Hodgkin
    Male
    Obesity
    Overweight
    Proportional Hazards Models
    Registries
    Risk Factors
    Young Adult

    Pub Type(s)

    Journal Article
    Research Support, Non-U.S. Gov't

    Language

    eng

    PubMed ID

    26900677

    Citation

    Leiba, Merav, et al. "Adolescent Weight and Height Are Predictors of Specific non-Hodgkin Lymphoma Subtypes Among a Cohort of 2,352,988 Individuals Aged 16 to 19 Years." Cancer, vol. 122, no. 7, 2016, pp. 1068-77.
    Leiba M, Leiba A, Keinan-Boker L, et al. Adolescent weight and height are predictors of specific non-Hodgkin lymphoma subtypes among a cohort of 2,352,988 individuals aged 16 to 19 years. Cancer. 2016;122(7):1068-77.
    Leiba, M., Leiba, A., Keinan-Boker, L., Avigdor, A., Derazne, E., Levine, H., & Kark, J. D. (2016). Adolescent weight and height are predictors of specific non-Hodgkin lymphoma subtypes among a cohort of 2,352,988 individuals aged 16 to 19 years. Cancer, 122(7), pp. 1068-77. doi:10.1002/cncr.29792.
    Leiba M, et al. Adolescent Weight and Height Are Predictors of Specific non-Hodgkin Lymphoma Subtypes Among a Cohort of 2,352,988 Individuals Aged 16 to 19 Years. Cancer. 2016 Apr 1;122(7):1068-77. PubMed PMID: 26900677.
    * Article titles in AMA citation format should be in sentence-case
    TY - JOUR T1 - Adolescent weight and height are predictors of specific non-Hodgkin lymphoma subtypes among a cohort of 2,352,988 individuals aged 16 to 19 years. AU - Leiba,Merav, AU - Leiba,Adi, AU - Keinan-Boker,Lital, AU - Avigdor,Abraham, AU - Derazne,Estela, AU - Levine,Hagai, AU - Kark,Jeremy D, Y1 - 2016/02/22/ PY - 2015/06/25/received PY - 2015/10/15/revised PY - 2015/10/20/accepted PY - 2016/2/23/entrez PY - 2016/2/24/pubmed PY - 2016/8/10/medline KW - adolescence KW - epidemiology KW - height KW - non-Hodgkin lymphoma (NHL) KW - obesity KW - risk factors SP - 1068 EP - 77 JF - Cancer JO - Cancer VL - 122 IS - 7 N2 - BACKGROUND: The age-adjusted annual incidence of non-Hodgkin lymphoma (NHL) has risen worldwide. This trend may be affected by the secular increase in height and the sharp upswing in adolescent overweight; these drive increased insulinlike growth factor 1 and chronic inflammation, which may play an etiologic role. This study examined the association of the body mass index (BMI) and height of adolescents with NHL subtypes, which have been insufficiently evaluated. METHODS: Health-related data on 2,352,988 Israeli adolescents, aged 16 to 19 years, who were examined between 1967 and 2011 were linked to the Israel National Cancer Registry to derive the NHL incidence up to December 31, 2012 (4021 cases). Cox proportional hazards modeling was used to estimate the multivariate-adjusted hazard ratio (HR) for NHL subtypes associated with the BMI and height of adolescents. RESULTS: Adolescent overweight and obesity were associated with an HR of 1.25 (95% confidence interval [CI], 1.13-1.37; P = 1.14 × 10(-5) ) for NHL in comparison with normal weight. There was a graded association of height with NHL (P = 4.29 × 10(-9) ), with the tallest adolescents (≥ 95th percentile vs 25th to < 50th percentiles [US Centers for Disease Control and Prevention]) exhibiting an HR of 1.28 (95% CI, 1.04-1.56). Marginal zone lymphoma, primary cutaneous lymphoma (PCL), and diffuse large B-cell lymphoma (DLBCL) showed the strongest associations for overweight/obesity, and DLBCL and PCL showed the strongest associations for height. CONCLUSIONS: The findings of this large cohort study add to the growing body of evidence showing that higher body weight and taller stature during adolescence are associated with an increased risk of NHL and may modestly contribute to its increasing incidence. Further studies are needed to elucidate the mechanisms linking anthropometric measures and NHL risk. SN - 1097-0142 UR - https://www.unboundmedicine.com/medline/citation/26900677/Adolescent_weight_and_height_are_predictors_of_specific_non_Hodgkin_lymphoma_subtypes_among_a_cohort_of_2352988_individuals_aged_16_to_19_years_ L2 - https://doi.org/10.1002/cncr.29792 DB - PRIME DP - Unbound Medicine ER -