An inverse association between body mass index (BMI) and risk of lung cancer has been reported. However, the association of body composition such as fat mass (FM) and lean body mass (LBM) with risk of lung cancer has not been fully investigated. Using two large prospective cohort studies (Nurses' Health Study, 1986-2014; Health Professionals Follow-up Study, 1987-2012) in the United States, we included 100,985 participants who were followed for occurrence of lung cancer. Predicted FM and LBM derived from validated anthropometric prediction equations were categorized by sex-specific deciles. During an average 22.3-year follow-up, 2615 incident lung cancer cases were identified. BMI showed an inverse association with lung cancer risk. Participants in the 10th decile of predicted FM and LBM had a lower risk of lung cancer compared with those in the 1st decile, but when mutually adjusted for each other, predicted FM was not associated with lung cancer risk (adjusted hazard ratio [aHR] = 0.98, 95% confidence interval [CI] 0.72-1.35; P(trend) = 0.97) whereas predicted LBM had an inverse association (aHR = 0.73, 95% CI 0.53-1.00; P(trend) = 0.03), especially among participants who were current smokers or had smoked in the previous 10 years (aHR = 0.55, 95% CI 0.36-0.84; P(trend) = 0.008). In conclusion, BMI was inversely associated with lung cancer risk. Based on anthropometric prediction equations, low LBM rather than low FM accounted for the inverse association between BMI and lung cancer risk.

中文翻译：

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预测的瘦体重，脂肪量和患肺癌的风险：前瞻性美国队列研究。

据报道，体重指数（BMI）与肺癌风险呈负相关。但是，尚未充分研究诸如脂肪量（FM）和瘦体重（LBM）之类的身体成分与肺癌风险之间的关系。在美国使用两项大型前瞻性队列研究（Nurses的健康研究，1986-2014； Health Professionals随访研究，1987-2012），我们纳入了100,985名因肺癌发生而接受随访的参与者。从验证的人体测量学预测方程式得出的预测FM和LBM按性别特定的分类进行分类。在平均22.3年的随访期间，确定了2615例肺癌事件。BMI与肺癌风险呈负相关。与预测的FM和LBM十分位数的参加者相比，预测的FM和LBM的十分之一的参加者与肺癌的患病风险相比较低，但是在相互调整后，预测的FM与肺癌的风险无关（调整后的危险比[aHR] = 0.98，95％置信区间[CI] 0.72-1.35; P（趋势）= 0.97），而预测的LBM具有反相关性（aHR = 0.73，95％CI 0.53-1.00; P（趋势）= 0.03），特别是在参与者中谁是当前吸烟者或在过去10年内吸烟过（aHR = 0.55，95％CI 0.36-0.84； P（趋势）= 0.008）。总之，BMI与肺癌风险呈负相关。根据人体测量学预测方程式，低LBM而非低FM解释了BMI与肺癌风险之间的负相关关系。预测的FM与肺癌风险无关（调整后的危险比[aHR] = 0.98，95％置信区间[CI] 0.72-1.35; P（趋势）= 0.97），而预测的LBM具有反相关性（aHR = 0.73，95 ％CI 0.53-1.00; P（趋势）= 0.03），尤其是当前吸烟者或在过去10年内吸烟的参与者（aHR = 0.55，95％CI 0.36-0.84; P（趋势）= 0.008）。总之，BMI与肺癌风险呈负相关。根据人体测量学预测方程式，低LBM而非低FM解释了BMI与肺癌风险之间的负相关关系。预测的FM与肺癌风险无关（调整后的危险比[aHR] = 0.98，95％置信区间[CI] 0.72-1.35; P（趋势）= 0.97），而预测的LBM具有反相关性（aHR = 0.73，95 ％CI 0.53-1.00; P（趋势）= 0.03），尤其是当前吸烟者或在过去10年内吸烟的参与者（aHR = 0.55，95％CI 0.36-0.84; P（趋势）= 0.008）。总之，BMI与肺癌风险呈负相关。根据人体测量学预测方程式，低LBM而非低FM解释了BMI与肺癌风险之间的负相关关系。尤其是在当前吸烟者或过去10年内吸烟的参与者中（aHR = 0.55，95％CI 0.36-0.84； P（趋势）= 0.008）。总之，BMI与肺癌风险呈负相关。根据人体测量学预测方程式，低LBM而非低FM解释了BMI与肺癌风险之间的负相关关系。尤其是在当前吸烟者或过去10年内吸烟的参与者中（aHR = 0.55，95％CI 0.36-0.84； P（趋势）= 0.008）。总之，BMI与肺癌风险呈负相关。根据人体测量学预测方程式，低LBM而非低FM解释了BMI与肺癌风险之间的负相关关系。