BACKGROUND The risk of colon or breast cancer in metabolically healthy obese (MHO) were lower than that in metabolically abnormal obese (MAO). We hypothesized that the risk of incident gastric cancer in MHO is lower than that in MAO. METHODS This historical cohort study included 19,685 Japanese individuals who received health-checkup programs from 2003 to 2016. Each subject was classified as metabolically healthy (MH) (no metabolic abnormalities) or metabolically abnormal (MA) (one or more metabolic abnormalities), according to four metabolic factors (hypertension, impaired fasting glucose, hypertriglyceridemia and low HDL-cholesterol). Obese (O) or non-obese (NO) was classified by a BMI cutoff of 25.0 kg/m2. Hazard ratios of metabolic phenotypes for incident gastric cancer were calculated by the Cox proportional hazard model with adjustments for age, sex, alcohol consumption, smoking and exercise. RESULTS Over the median follow-up period of 5.5 (2.9-9.4) years, incident rate of gastric cancer was 0.65 per 1000 persons-years. Incident rate of MHNO, MHO, MANO and MAO were 0.33, 0.25, 0.80 and 1.21 per 1000 persons-years, respectively. Compared with MHNO, the adjusted hazard ratios for development of gastric cancer were 0.69 (95% CI 0.04-3.39, p = 0.723) in MHO, 1.16 (95% CI 0.63-2.12, p = 0.636) in MANO and 2.09 (95% CI 1.10-3.97, p = 0.024) in MAO. CONCLUSIONS This study shows that individuals with MAO, but not those with MHO, had an elevated risk for incident gastric cancer. Thus, we should focus more on the presence of metabolic abnormalities rather than obesity itself for incident gastric cancer.

中文翻译：

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代谢健康肥胖对发生胃癌风险的影响：一项基于人群的队列研究。

背景技术代谢健康肥胖（MHO）患结肠癌或乳腺癌的风险低于代谢异常肥胖（MAO）患结肠癌或乳腺癌的风险。我们假设MHO发生胃癌的风险低于MAO。方法这项历史性队列研究纳入了2003年至2016年接受健康检查计划的19,685名日本人。根据该研究，每个受试者被分类为代谢健康（MH）（无代谢异常）或代谢异常（MA）（一个或多个代谢异常）。到四个代谢因子（高血压，空腹血糖受损，高甘油三酸酯血症和低HDL-胆固醇）。肥胖（O）或非肥胖（NO）的BMI临界值为25.0 kg / m2。通过Cox比例风险模型计算了发生性胃癌的代谢表型的危险比，并根据年龄，性别，饮酒，吸烟和运动进行了调整。结果在5.5（2.9-9.4）年的中位随访期内，胃癌的发生率为每1000人年0.65。每1000人年的MHNO，MHO，MANO和MAO的发生率分别为0.33、0.25、0.80和1.21。与MHNO相比，MHO调整后的胃癌危险比为0.69（95％CI 0.04-3.39，p = 0.723），MANO为1.16（95％CI 0.63-2.12，p = 0.636）和2.09（95％） CI 1.10-3.97，p = 0.024）。结论本研究表明，患有MAO的患者而非患有MHO的患者发生胃癌的风险较高。从而，