体重指数即体重除以身高平方，成年后体重指数18.5～23.9kg/m²属于正常、24～27.9kg/m²属于超重、≥28kg/m²属于肥胖。
2020年3月23日，英国癌症研究基金会《英国癌症杂志》在线发表英国曼彻斯特癌症研究中心、曼彻斯特生物医学研究中心、曼彻斯特大学、南曼彻斯特大学医院、伦敦大学玛丽王后学院、中曼彻斯特大学医院的研究报告，探讨了20岁体重指数对成年后体重增加与乳腺癌风险的影响。
该预测筛查时癌症风险（PROCAS）研究于2009～2013年从英国曼彻斯特入组年龄47～73岁女性4万7042例，通过入组时测定的体重指数、回忆20岁时的体重指数，计算体重变化。通过多因素比例风险回归模型，推算20岁体重指数与随后体重变化的新发乳腺癌风险比和95%置信区间。
结果，中位随访5.6年期间，新发乳腺癌1142例，其中绝经后新发乳腺癌829例。
对于入组时已绝经女性
20岁体重指数与新发乳腺癌风险成反比（风险比：0.87，95%置信区间：0.79～0.95）
体重增加绝对值与新发乳腺癌风险成正比（风险比：1.23，95%置信区间：1.14～1.32）
对于20岁体重指数<23.4kg/m²的绝经后女性，体重增加绝对值与新发乳腺癌风险成正比（风险比：1.31，95%置信区间：1.21～1.42）。
对于20岁体重指数>23.4kg/m²的绝经后女性，体重增加绝对值与新发乳腺癌风险无关（交互作用P<0.05）。
因此，该研究结果表明，成年后变胖仅对年轻时体重指数正常或偏瘦女性的绝经后新发乳腺癌风险有显著影响。当然，我们也不提倡20岁前就把自己吃成胖子，这样会增加其他疾病的风险。
Br J Cancer. 2020 Mar 23. [Epub ahead of print]
Young adulthood body mass index, adult weight gain and breast cancer risk: the PROCAS Study (United Kingdom).
Andrew G. Renehan, Mary Pegington, Michelle N. Harvie, Matthew Sperrin, Susan M. Astley, Adam R. Brentnall, Anthony Howell, Jack Cuzick, D. Gareth Evans.
Manchester Cancer Research Centre and NIHR Manchester Biomedical Research Centre, Manchester, UK; University of Manchester, Manchester, UK; University Hospital of South Manchester, Manchester, UK; Queen Mary University of London, London, UK; Central Manchester Foundation Trust, Manchester, UK.
BACKGROUND: We tested the hypothesis that body mass index (BMI) aged 20 years modifies the association of adult weight gain and breast cancer risk.
METHODS: We recruited women (aged 47-73 years) into the PROCAS (Predicting Risk Of Cancer At Screening; Manchester, UK: 2009-2013) Study. In 47,042 women, we determined BMI at baseline and (by recall) at age 20 years, and derived weight changes. We estimated hazard ratios (HRs) and 95% confidence intervals (CIs) for new breast cancer using Cox models and explored relationships between BMI aged 20 years, subsequent weight changes and breast cancer risk.
RESULTS: With median follow-up of 5.6 years, 1142 breast cancers (post-menopausal at entry: 829) occurred. Among post-menopausal women at entry, BMI aged 20 years was inversely associated [HR per SD: 0.87 (95% CI: 0.79-0.95)], while absolute weight gain was associated with breast cancer [HR per SD:1.23 (95% CI: 1.14-1.32)]. For post-menopausal women who had a recall BMI aged 20 years <23.4 kg/m2 (75th percentile), absolute weight gain was associated with breast cancer [HR per SD: 1.31 (95% CIs: 1.21-1.42)], but there were no associations for women with a recall BMI aged 20 years of >23.4 kg/m2 (Pinteraction values <0.05).
CONCLUSIONS: Adult weight gain increased post-menopausal breast cancer risk only among women who were <23.4 kg/m2 aged 20 years.
DOI: 10.1038/s41416-020-0807-9
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