Association of Obesity and Type 2 Diabetes with Non-Hodgkin Lymphoma: The Multiethnic Cohort
Menée à l'aide de donnée de la "Multiethnic Cohort" portant 192 424 personnes (durée moyenne de suivi : 19,2 ans), cette étude analyse l'association entre l'indice de masse corporelle, un diabète de type 2 et le risque de lymphome non hodgkinien (3 472 cas)
Background: Given the role of the immune system in Non-Hodgkin Lymphoma (NHL) etiology, obesity and type 2 diabetes (T2D) may impact NHL development. We examined the association of body mass index (BMI) and T2D with NHL in the Multiethnic Cohort (MEC). Methods: The MEC recruited >215,000 participants in Hawaii and Los Angeles from five racial/ethnic groups; NHL cases were identified through cancer registry linkages. T2D status, and BMI at age 21 and cohort entry were derived from repeated self-reports; for T2D, Medicare claims were also applied. Hazard ratios (HR) and 95% confidence intervals (CI) for BMI and T2D as predictors of NHL were determined using Cox regression adjusted for relevant covariates. Results: Among 192,424 participants, 3,472 (1.8%) with NHL and 68,850 (36%) with T2D after 19.2±6.6 years follow-up, no significant association between T2D and NHL (HR 1.04; 95%CI 0.96-1.13) was observed. Stratification by BMI at cohort entry showed a significant association of T2D with NHL among individuals with normal weight only (HR 1.18; 95%CI 1.03-1.37). In a model with both BMI values plus T2D, only overweight (HR 1.13; 95%CI 1.01-1.26) and obesity (HR 1.25; 95%CI 0.99-1.59) at age 21 were associated with NHL incidence. Stratification by sex, race/ethnicity , and NHL subtype indicated no differences. Conclusions: Our findings suggest an association between T2D and NHL incidence in several subgroups but not in the total population and an elevated risk related to early-life BMI. Impact: Excess body weight in early life, rather than T2D, may be a predictor of NHL incidence.