Correlation of obesity and cholangiocarcinoma: a Meta analysis

doi:10.3877/cma.j.issn.2095-2015.2017.02.004

Abstract

Abstract:

Objective

To assess the association between overweight or obesity and the incidence of cholangiocarcinoma.

Methods

Using PubMed, Cochrane, EMBase and CBM databases, studies were included if they reported cholangiocarcinoma with respect to obesity or overweight.

Results

Sixteen studies met the inclusion criteria, which included five cohort and eleven case-control studies.Compared with normal weight, being overweight(pooled OR: 1.20, 95% CI: 1.07-1.34), obesity(pooled OR: 1.66, 95% CI: 1.31-2.11), and excess body weight(pooled OR: 1.33, 95% CI: 1.18-1.49)were significantly associated with cholangiocarcinoma.The funnel plot revealed no evidence for publication bias.

Conclusion

Obesity is associated with the increased risk of cholangiocarcinoma, which needs to be confirmed by long-term cohort studies.

Key words: Bile duct neoplasms, Overweight, Obesity, Cohort study, Case-control study, Meta-analysis

Junshan Li, Tianjie Han, Jing Nie, Jian Gong, Xinying Gao, Fuchun Ying, Qingcai Wang. Correlation of obesity and cholangiocarcinoma: a Meta analysis[J]. Chinese Journal of Digestion and Medical Imageology(Electronic Edition), 2017, 07(02): 60-65.

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Figures/Tables 2

References 31

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作者/发表时间/国家	病例数(男性/女性)	对照组或队列人数(男性/女性)	BMI(kg/m²)划分标准	Odds Ratio(95% CI)		文献质量评分	匹配方式
作者/发表时间/国家	病例数(男性/女性)	对照组或队列人数(男性/女性)	BMI(kg/m²)划分标准	Men	Women	文献质量评分	匹配方式
队列研究	?	?	?	?	?	?	?
Wolk, et al. (2001) Sweden^[10]	ECC: 10 (3/7)	28，129(8165/ 19，964)	<25.0	6(0.5～7.6)	1.7(0.7～3.4)	8	Age, sex, hypertension; diabetes; osteoarthritis
			25.0～29.9
			≥30.0
Samanic, et al.(2004) USA^[11]	ECC：White men: 375Black men: 76	White men:366 8486/Black men：832 214	Non-obeseObese	White men：1.36(0.92～2.02)Black men：2.24(1.03～4.89)	NA	7	Age, calendar year
Oh, et al.(2005) Korea^[12]	CC: 517	781，283 men	18.5～22.9	1.0	NA	7	Age, area of residence, smoking, exercise, alcohol
			23.0～24.9	1.22(0.99～1.5)
			25.0～26.9	1.4(1.11～1.78)
			27.0～29.9	1.24(0.87～1.75)
			≥30.0	1.64(0.73～3.7)
Samanic, et al. (2006) Sweden^[13]	CC：39	362，552 men	18.5～24.9	1.14(0.56-2.32)	NA	7	Age, smoking
			25.0～29.9	3.78(1.59-8.96)
			≥30.0	?
Ishiguro, et al. (2008)Japan^[14]	ECC: 235 (129/106)	101，868 (48，681/ 53，187)	≤22.9	1.00	1.00	7	Age, sex
			23.0～24.9	1.09(0.71～1.68)	0.85(0.51～1.41)
			25.0-26.9	1.14(0.68-1.92)	0.98(0.56-1.71)
			≥27.0	1.62(0.93-2.84)	1.19(0.69-2.04)
kiyoshi, et al.(1989)Japan^[15]	CC：84(46/38)	168(92/76)	Non-obeseObese	Men and Women5.13(2.25～11.68)	?	8	Age, sex, liver diseases
Zhang, et al. (2005) China^[16]	ECC：14 (80/69)	1205	≤23	20～29Y	Women	8	Age, sex, diabetes
			23.0～24.9	Men	1.0
			≥25	1.0	0.52(0.21～1.31)
			≤23	1.76(0.67～4.65)	1.44(0.34～6.11)
			23.0～24.9	1.16(0.16～8.24)	Women
			≥25	30～39Y	1.0
			?	Men	0.66(0.31～1.42)
			?	1.0	0.77(0.32～1.87)
			?	0.84(0.37～1.86)	?
			?	0.77(0.22～2.73)	?
Ahrensa, et al. (2006) Germany^[17]	CC: 153	1421	18.5－<25	1.0	?	7	age, country and history of gallstones
			<18.5	－
			25－<27	1.3(0.77～2.21)
			27－<30	1(0.57～1.74)
			30＋	1.39(0.7～2.77)
Welzel, et al. (2006) USA^[18]	ICC: 764 (355/409)	3056 (1420/1636)	Non-obese	Men and Women	?	8	Age, sex, chronic liver diseases
Welzel, et al. (2006) USA^[18]	ICC: 764 (355/409)	3056 (1420/1636)	Obese	2.05(0.75～5.58)	?	8	Age, sex, chronic liver diseases
Welzel, et al. (2007) USA^[19]	ECC: 549 (280/269)	102782 (37，143/ 65，639)	Non-obese	Men and Women	?	8	Age, sex, race, smoking
	ECC: 549 (280/269)		Non-obese	ECC: 1.1(0.7～1.8)
	ICC: 535 (257/278)		Obese	ICC: 1.7(1.1～2.6)
	ICC: 535 (257/278)		Obese	?	?	?	?
Hsing, et al. (2008) China^[20]	ECC：191 (99/92)	959 (373/586)	<18.5	0.52(0.24～1.13)	?	7	Age, Sex. education
			18.5～22.9	1
			23.0～24.9	0.99(0.71～1.37)
			≥25	?
Grainge, et al. (2009) UK^[21]	CC: 372	5760	<25.0	Men and Women	?	8	Smoking, diabetes mellitus, cirrhosis, viral hepatitis
			25.0～30.0	1.00
			≥30.0	1.33(0.97～1.82)
			?	1.52(1.03～2.24)
Welzel, et al. (2011) USA^[22]	ICC：743 (353/393)	195，9 53 (71，158/ 12，4795)	Non-obese	Men and Women 1.71(1.30～2.23)	?	8	Age, sex, race, geographic region
Welzel, et al. (2011) USA^[22]	ICC：743 (353/393)	195，9 53 (71，158/ 12，4795)	Obese	Men and Women 1.71(1.30～2.23)	?	8	Age, sex, race, geographic region
Chaiteerakij, et al. (2013) USA^[23]	ICC：612 (421/191)	594 (291/303)	Non-obese	Men and Women 0.9(0.7～1.2)	?	8	Age, sex, race, hepatitis B
Chaiteerakij, et al. (2013) USA^[23]	ICC：612 (421/191)	594 (291/303)	Obese	Men and Women 0.9(0.7～1.2)	?	8	Age, sex, race, hepatitis B
Lee et al.(2015) Korea^[24]	ECC：193	552	<25.0	Men and Women	?	7	Age, sex，hepatitis B
	ECC：193		<25.0	ECC: 0.91
	ICC: 83		≥25	(0.59～1.4)
	ICC: 83		≥25	ICC: 1.0(0.56～1.8)
Kinoshita，et al. (2016)Japan^[25]	ICC：34 (19/15)	69(44/25)	<25.0	Men and Women	?	7	Age, sex, smoking
			≥25	1.0
			≥25	1.39(0.446～4.14)

作者/发表时间/国家	病例数(男性/女性)	对照组或队列人数(男性/女性)	BMI(kg/m²)划分标准	Odds Ratio(95% CI)		文献质量评分	匹配方式
作者/发表时间/国家	病例数(男性/女性)	对照组或队列人数(男性/女性)	BMI(kg/m²)划分标准	Men	Women	文献质量评分	匹配方式
队列研究	?	?	?	?	?	?	?
Wolk, et al. (2001) Sweden^[10]	ECC: 10 (3/7)	28，129(8165/ 19，964)	<25.0	6(0.5～7.6)	1.7(0.7～3.4)	8	Age, sex, hypertension; diabetes; osteoarthritis
			25.0～29.9
			≥30.0
Samanic, et al.(2004) USA^[11]	ECC：White men: 375Black men: 76	White men:366 8486/Black men：832 214	Non-obeseObese	White men：1.36(0.92～2.02)Black men：2.24(1.03～4.89)	NA	7	Age, calendar year
Oh, et al.(2005) Korea^[12]	CC: 517	781，283 men	18.5～22.9	1.0	NA	7	Age, area of residence, smoking, exercise, alcohol
			23.0～24.9	1.22(0.99～1.5)
			25.0～26.9	1.4(1.11～1.78)
			27.0～29.9	1.24(0.87～1.75)
			≥30.0	1.64(0.73～3.7)
Samanic, et al. (2006) Sweden^[13]	CC：39	362，552 men	18.5～24.9	1.14(0.56-2.32)	NA	7	Age, smoking
			25.0～29.9	3.78(1.59-8.96)
			≥30.0	?
Ishiguro, et al. (2008)Japan^[14]	ECC: 235 (129/106)	101，868 (48，681/ 53，187)	≤22.9	1.00	1.00	7	Age, sex
			23.0～24.9	1.09(0.71～1.68)	0.85(0.51～1.41)
			25.0-26.9	1.14(0.68-1.92)	0.98(0.56-1.71)
			≥27.0	1.62(0.93-2.84)	1.19(0.69-2.04)
kiyoshi, et al.(1989)Japan^[15]	CC：84(46/38)	168(92/76)	Non-obeseObese	Men and Women5.13(2.25～11.68)	?	8	Age, sex, liver diseases
Zhang, et al. (2005) China^[16]	ECC：14 (80/69)	1205	≤23	20～29Y	Women	8	Age, sex, diabetes
			23.0～24.9	Men	1.0
			≥25	1.0	0.52(0.21～1.31)
			≤23	1.76(0.67～4.65)	1.44(0.34～6.11)
			23.0～24.9	1.16(0.16～8.24)	Women
			≥25	30～39Y	1.0
			?	Men	0.66(0.31～1.42)
			?	1.0	0.77(0.32～1.87)
			?	0.84(0.37～1.86)	?
			?	0.77(0.22～2.73)	?
Ahrensa, et al. (2006) Germany^[17]	CC: 153	1421	18.5－<25	1.0	?	7	age, country and history of gallstones
			<18.5	－
			25－<27	1.3(0.77～2.21)
			27－<30	1(0.57～1.74)
			30＋	1.39(0.7～2.77)
Welzel, et al. (2006) USA^[18]	ICC: 764 (355/409)	3056 (1420/1636)	Non-obese	Men and Women	?	8	Age, sex, chronic liver diseases
Welzel, et al. (2006) USA^[18]	ICC: 764 (355/409)	3056 (1420/1636)	Obese	2.05(0.75～5.58)	?	8	Age, sex, chronic liver diseases
Welzel, et al. (2007) USA^[19]	ECC: 549 (280/269)	102782 (37，143/ 65，639)	Non-obese	Men and Women	?	8	Age, sex, race, smoking
	ECC: 549 (280/269)		Non-obese	ECC: 1.1(0.7～1.8)
	ICC: 535 (257/278)		Obese	ICC: 1.7(1.1～2.6)
	ICC: 535 (257/278)		Obese	?	?	?	?
Hsing, et al. (2008) China^[20]	ECC：191 (99/92)	959 (373/586)	<18.5	0.52(0.24～1.13)	?	7	Age, Sex. education
			18.5～22.9	1
			23.0～24.9	0.99(0.71～1.37)
			≥25	?
Grainge, et al. (2009) UK^[21]	CC: 372	5760	<25.0	Men and Women	?	8	Smoking, diabetes mellitus, cirrhosis, viral hepatitis
			25.0～30.0	1.00
			≥30.0	1.33(0.97～1.82)
			?	1.52(1.03～2.24)
Welzel, et al. (2011) USA^[22]	ICC：743 (353/393)	195，9 53 (71，158/ 12，4795)	Non-obese	Men and Women 1.71(1.30～2.23)	?	8	Age, sex, race, geographic region
Welzel, et al. (2011) USA^[22]	ICC：743 (353/393)	195，9 53 (71，158/ 12，4795)	Obese	Men and Women 1.71(1.30～2.23)	?	8	Age, sex, race, geographic region
Chaiteerakij, et al. (2013) USA^[23]	ICC：612 (421/191)	594 (291/303)	Non-obese	Men and Women 0.9(0.7～1.2)	?	8	Age, sex, race, hepatitis B
Chaiteerakij, et al. (2013) USA^[23]	ICC：612 (421/191)	594 (291/303)	Obese	Men and Women 0.9(0.7～1.2)	?	8	Age, sex, race, hepatitis B
Lee et al.(2015) Korea^[24]	ECC：193	552	<25.0	Men and Women	?	7	Age, sex，hepatitis B
	ECC：193		<25.0	ECC: 0.91
	ICC: 83		≥25	(0.59～1.4)
	ICC: 83		≥25	ICC: 1.0(0.56～1.8)
Kinoshita，et al. (2016)Japan^[25]	ICC：34 (19/15)	69(44/25)	<25.0	Men and Women	?	7	Age, sex, smoking
			≥25	1.0
			≥25	1.39(0.446～4.14)

组别		研究数目	Adjusted Odds Ratio(95% CI)	P值
所有研究		?	?	?
?	超重	9	1.20(1.07～1.34)	0.002
?	肥胖	10	1.66(1.31～2.11)	<0.001
?	过重	16	1.33(1.18～1.49)	<0.001
男性		?	?	?
?	超重	5	1.32(1.12～1.55)	0.001
?	肥胖	4	1.89(1.29～2.76)	0.001
?	过重	7	1.40(1.22～1.61)	<0.001
女性		?	?	?
?	超重	2	1.04(0.74～1.48)	0.804
?	肥胖	1	1.70(0.77～3.75)	0.188
?	过重	3	1.13(0.82～1.55)	0.450
亚洲		?	?	?
?	超重	6	1.17(1.03～1.33)	0.014
?	肥胖	2	2.89(0.95～8.85)	0.062
?	过重	7	1.22(1.04－1.44)	0.018
非亚洲		?	?	?
?	超重	3	1.28(0.94～1.75)	0.121
?	肥胖	8	1.53(1.22～1.91)	<0.001
?	过重	9	1.44(1.21－1.71)	<0.001
队列研究		?	?	?
?	超重	3	1.29(1.11～1.51)	0.001
?	肥胖	4	1.77(1.32～2.38)	<0.001
?	过重	5	1.38(1.21－1.59)	<0.001
病例对照研究		?	?	?
?	超重	6	1.06(0.88～1.28)	0.550
?	肥胖	6	1.56(1.12～2.17)	0.008
?	过重	10	1.28(1.07～1.53)	0. 008

组别		研究数目	Adjusted Odds Ratio(95% CI)	P值
所有研究		?	?	?
?	超重	9	1.20(1.07～1.34)	0.002
?	肥胖	10	1.66(1.31～2.11)	<0.001
?	过重	16	1.33(1.18～1.49)	<0.001
男性		?	?	?
?	超重	5	1.32(1.12～1.55)	0.001
?	肥胖	4	1.89(1.29～2.76)	0.001
?	过重	7	1.40(1.22～1.61)	<0.001
女性		?	?	?
?	超重	2	1.04(0.74～1.48)	0.804
?	肥胖	1	1.70(0.77～3.75)	0.188
?	过重	3	1.13(0.82～1.55)	0.450
亚洲		?	?	?
?	超重	6	1.17(1.03～1.33)	0.014
?	肥胖	2	2.89(0.95～8.85)	0.062
?	过重	7	1.22(1.04－1.44)	0.018
非亚洲		?	?	?
?	超重	3	1.28(0.94～1.75)	0.121
?	肥胖	8	1.53(1.22～1.91)	<0.001
?	过重	9	1.44(1.21－1.71)	<0.001
队列研究		?	?	?
?	超重	3	1.29(1.11～1.51)	0.001
?	肥胖	4	1.77(1.32～2.38)	<0.001
?	过重	5	1.38(1.21－1.59)	<0.001
病例对照研究		?	?	?
?	超重	6	1.06(0.88～1.28)	0.550
?	肥胖	6	1.56(1.12～2.17)	0.008
?	过重	10	1.28(1.07～1.53)	0. 008

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