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| 基于扬中市胃镜筛查人群的新型肥胖相关指标与胃部疾病的关联性分析 |
| Analysis on the Association Between Novel Obesity-Related Indices and Gastric Diseases Among Gastroscopy Screening Population in Yangzhong City |
| 投稿时间：2026-03-03 修订日期：2026-06-20 |
| DOI： |
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| 中文关键词: 肥胖 脂质相关指标 胃部 疾病 关联 |
| 英文关键词:Obesity Lipid-related Indicators Stomach Diseases Association |
| 基金项目:江苏省预防医学课题面上项目 (YM2023031) |
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| 中文摘要: |
| 目的 分析5种新型肥胖相关指标（novel obesity-related indices, NORI）与胃部疾病的关联。方法 基于上消化道癌人群筛查及食管癌专病队列基线数据，采用无序多分类logistic回归模型，分别探讨脂质蓄积指数（lipid accumulation product, LAP）、内脏脂肪指数（visceral adiposity index, VAI）、中国内脏脂肪指数（Chinese visceral adiposity index, CVAI）、腰部甘油三酯指数（waist triglyceride index, WTI）和心脏代谢指数（cardiometabolic index, CMI）与胃癌、癌前病变（高级别/低级别上皮内瘤变）及癌前疾病（萎缩性胃炎/肠上皮化生）的独立关联。结果 9243名研究对象中，经病理确诊的胃癌、癌前病变、癌前疾病患病率分别为0.48%、1.95%和36.59%。无序多分类logistic回归分析结果显示，在整体人群中，与第一分位数（quartile 1, Q1）相比，LAP和CVAI的Q4人群患癌前疾病的风险分别降低13.6%（OR=0.864, 95%CI: 0.761~0.981）和16.1%（OR=0.839, 95%CI: 0.736~0.957）。同时，LAP、VAI、CVAI和CMI每增加一个标准差，癌前疾病的风险分别降低5.1%（OR=0.949, 95%CI: 0.905~0.994）、5.1%（OR=0.949, 95%CI: 0.904~0.995）、6.2%（OR=0.938, 95%CI: 0.896~0.983）和4.9%（OR=0.951, 95%CI: 0.906~0.998）。未发现WTI与胃部疾病存在显著关联（P0.05）。然而，与Q1人群相比，CMI的Q4人群患胃癌的风险显著升高（OR=3.262, 95%CI: 1.133~9.397）。分层分析显示，VAI和CVAI仅是非贲门癌前疾病的显著保护因素（P均<0.05）。CMI仅是贲门胃癌的显著危险因素（P<0.05）。结论 在扬中市40~69岁筛查人群中，LAP、VAI、CVAI及CMI水平升高与癌前疾病风险降低独立相关，但CMI水平过高会增加胃癌风险，且不同NORI对胃部疾病的影响存在部位特异性。 |
| 英文摘要: |
| Abstract: [Objective] To analyze the association between five novel obesity-related indices (NORI) and gastric diseases. [Methods] Based on baseline data from population-based screening for upper gastrointestinal cancer and the esophageal cancer-specific cohort, this study employed a multinomial logistic regression model to investigate the independent associations between lipid accumulation product (LAP), visceral adiposity index (VAI), Chinese visceral adiposity index (CVAI), waist triglyceride index (WTI), and cardiometabolic index (CMI) and gastric cancer, precancerous lesions (high-grade/low-grade intraepithelial neoplasia), and precancerous diseases (atrophic gastritis/intestinal metaplasia). [Results] Among 9,243 study participants, the prevalence rates of histopathologically confirmed gastric cancer, precancerous lesions, and precancerous diseases were 0.48%, 1.95%, and 36.59%, respectively. Results of the multinomial logistic regression analysis showed that, in the overall population, compared with the first quartile (Q1), individuals in the Q4 group of LAP and CVAI had a 13.6% (OR=0.864, 95%CI: 0.761–0.981) and 16.1% (OR=0.839, 95%CI: 0.736–0.957) reduction in the risk of precancerous diseases, respectively. For each one-standard-deviation increase in LAP, VAI, CVAI and CMI, the risk of precancerous diseases decreased by 5.1% (OR=0.949, 95%CI: 0.905–0.994), 5.1% (OR=0.949, 95%CI: 0.904–0.995), 6.2% (OR=0.938, 95%CI: 0.896–0.983) and 4.9% (OR=0.951, 95%CI: 0.906–0.998), respectively. No significant association was found between WTI and gastric diseases (P>0.05). However, compared with the Q1 population, the Q4 population in CMI showed a significantly higher risk of gastric cancer (OR=3.262, 95%CI: 1.133–9.397). Stratified analysis showed that VAI and CVAI were significant protective factors against non-cardia gastric precancerous diseases (all P<0.05). In contrast, CMI was a significant risk factor for cardia gastric cancer (P<0.05). [Conclusions] Among the screened participants aged 40–69 years in Yangzhong City, elevated levels of LAP, VAI, CVAI, and CMI were independently associated with a decreased risk of precancerous diseases; however, markedly elevated CMI levels are associated with an increased risk of gastric cancer. Furthermore, different NORIs exert site-specific effects on gastric diseases. |
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