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Adult body mass index and risk of ovarian cancer by subtype: a Mendelian randomization study.


ABSTRACT:

Background

Observational studies have reported a positive association between body mass index (BMI) and ovarian cancer risk. However, questions remain as to whether this represents a causal effect, or holds for all histological subtypes. The lack of association observed for serous cancers may, for instance, be due to disease-associated weight loss. Mendelian randomization (MR) uses genetic markers as proxies for risk factors to overcome limitations of observational studies. We used MR to elucidate the relationship between BMI and ovarian cancer, hypothesizing that genetically predicted BMI would be associated with increased risk of non-high grade serous ovarian cancers (non-HGSC) but not HGSC.

Methods

We pooled data from 39 studies (14 047 cases, 23 003 controls) in the Ovarian Cancer Association Consortium. We constructed a weighted genetic risk score (GRS, partial F-statistic = 172), summing alleles at 87 single nucleotide polymorphisms previously associated with BMI, weighting by their published strength of association with BMI. Applying two-stage predictor-substitution MR, we used logistic regression to estimate study-specific odds ratios (OR) and 95% confidence intervals (CI) for the association between genetically predicted BMI and risk, and pooled these using random-effects meta-analysis.

Results

Higher genetically predicted BMI was associated with increased risk of non-HGSC (pooled OR?=?1.29, 95% CI 1.03-1.61 per 5 units BMI) but not HGSC (pooled OR?=?1.06, 95% CI 0.88-1.27). Secondary analyses stratified by behaviour/subtype suggested that, consistent with observational data, the association was strongest for low-grade/borderline serous cancers (OR?=?1.93, 95% CI 1.33-2.81).

Conclusions

Our data suggest that higher BMI increases risk of non-HGSC, but not the more common and aggressive HGSC subtype, confirming the observational evidence.

SUBMITTER: Dixon SC 

PROVIDER: S-EPMC5644573 | biostudies-literature | 2016 Jun

REPOSITORIES: biostudies-literature

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Adult body mass index and risk of ovarian cancer by subtype: a Mendelian randomization study.

Dixon Suzanne C SC   Nagle Christina M CM   Thrift Aaron P AP   Pharoah Paul Dp PD   Pearce Celeste Leigh CL   Zheng Wei W   Painter Jodie N JN   Chenevix-Trench Georgia G   Fasching Peter A PA   Beckmann Matthias W MW   Lambrechts Diether D   Vergote Ignace I   Lambrechts Sandrina S   Van Nieuwenhuysen Els E   Rossing Mary Anne MA   Doherty Jennifer A JA   Wicklund Kristine G KG   Chang-Claude Jenny J   Rudolph Anja A   Moysich Kirsten B KB   Odunsi Kunle K   Goodman Marc T MT   Wilkens Lynne R LR   Thompson Pamela J PJ   Shvetsov Yurii B YB   Dörk Thilo T   Park-Simon Tjoung-Won TW   Hillemanns Peter P   Bogdanova Natalia N   Butzow Ralf R   Nevanlinna Heli H   Pelttari Liisa M LM   Leminen Arto A   Modugno Francesmary F   Ness Roberta B RB   Edwards Robert P RP   Kelley Joseph L JL   Heitz Florian F   Karlan Beth Y BY   Kjær Susanne K SK   Høgdall Estrid E   Jensen Allan A   Goode Ellen L EL   Fridley Brooke L BL   Cunningham Julie M JM   Winham Stacey J SJ   Giles Graham G GG   Bruinsma Fiona F   Milne Roger L RL   Southey Melissa C MC   Hildebrandt Michelle A T MA   Wu Xifeng X   Lu Karen H KH   Liang Dong D   Levine Douglas A DA   Bisogna Maria M   Schildkraut Joellen M JM   Berchuck Andrew A   Cramer Daniel W DW   Terry Kathryn L KL   Bandera Elisa V EV   Olson Sara H SH   Salvesen Helga B HB   Thomsen Liv Cecilie LC   Kopperud Reidun K RK   Bjorge Line L   Kiemeney Lambertus A LA   Massuger Leon F A G LF   Pejovic Tanja T   Cook Linda S LS   Le Nhu D ND   Swenerton Kenneth D KD   Brooks-Wilson Angela A   Kelemen Linda E LE   Lubiński Jan J   Huzarski Tomasz T   Gronwald Jacek J   Menkiszak Janusz J   Wentzensen Nicolas N   Brinton Louise L   Yang Hannah H   Lissowska Jolanta J   Høgdall Claus K CK   Lundvall Lene L   Song Honglin H   Tyrer Jonathan P JP   Campbell Ian I   Eccles Diana D   Paul James J   Glasspool Rosalind R   Siddiqui Nadeem N   Whittemore Alice S AS   Sieh Weiva W   McGuire Valerie V   Rothstein Joseph H JH   Narod Steven A SA   Phelan Catherine C   Risch Harvey A HA   McLaughlin John R JR   Anton-Culver Hoda H   Ziogas Argyrios A   Menon Usha U   Gayther Simon A SA   Ramus Susan J SJ   Gentry-Maharaj Aleksandra A   Wu Anna H AH   Pike Malcolm C MC   Tseng Chiu-Chen CC   Kupryjanczyk Jolanta J   Dansonka-Mieszkowska Agnieszka A   Budzilowska Agnieszka A   Spiewankiewicz Beata B   Webb Penelope M PM  

International journal of epidemiology 20160601 3


<h4>Background</h4>Observational studies have reported a positive association between body mass index (BMI) and ovarian cancer risk. However, questions remain as to whether this represents a causal effect, or holds for all histological subtypes. The lack of association observed for serous cancers may, for instance, be due to disease-associated weight loss. Mendelian randomization (MR) uses genetic markers as proxies for risk factors to overcome limitations of observational studies. We used MR to  ...[more]

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