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Height, weight in adolescence may contribute to non-Hodgkin’s lymphoma risk
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Higher body weight and taller stature in adolescence appeared associated with an increased risk for non-Hodgkin’s lymphoma, according to the results of a registry study conducted in Israel.
These factors may contribute to the increasing incidence of the disease, according to the researchers.
“The etiology of non-Hodgkin’s lymphoma is poorly understood,” Merav Leiba, MD, head of the multiple myeloma unit at Sheba Medical Center in Tel Aviv, and colleagues wrote. “A sharp, unexplained increase in incidence rates has been observed for more than 30 years.”
Previous studies have suggested links between obesity and stature and risk for non-Hodgkin’s lymphoma, possibly stemming from chronic inflammation.
Thus, Leiba and colleagues sought to observe the association between BMI and height in adolescents with subtypes of non-Hodgkin’s lymphoma.
The researchers accessed health-related data from 2,352,988 Israeli adolescents (aged 16 years to 19 years) examined between 1967 and 2011. They linked these data to the Israeli National Cancer Registry, which identified 4,021 patients with non-Hodgkin’s lymphoma (mean age at diagnosis, 41.4 ± 11.4 years).
Most of these patients had diffuse large B-cell lymphoma (DLBCL; n = 1,402); other subtypes included primary cutaneous lymphoma (n = 553), follicular lymphoma (n = 528), chronic lymphocytic leukemia or small lymphocytic lymphoma (n = 340) and marginal zone lymphoma (n = 246).
Overall, 8.6% of the cohort was overweight (BMI ≥ 85th percentile, ˂ 95th percentile) and 3.8% were obese (BMI ˃ 95th percentile).
Being overweight or obese appeared associated with a greater risk for non-Hodgkin's lymphoma compared with normal weight (HR = 1.25; 95% CI, 1.13-1.37; P = 1.14 x 10-5).
The strongest associations for weight occurred in patients with DLBCL (P = .001), primary cutaneous lymphoma (P = .003) and marginal zone lymphoma (P = .004).
Height also demonstrated a graded association with non-Hodgkin’s lymphoma (P = 4.29 x 10-9). Adolescents in the tallest percentile (≥ 95th percentile vs. 25th to < 50th percentile, as defined by the CDC) had an HR for non-Hodgkin’s lymphoma of 1.28 (95% CI, 1.04-1.56).
The strongest height associations occurred in patients with DLBCL (P ≤ .01) and primary cutaneous lymphoma (P = .003).
Study limitations included lack of data on cell of origin for DLBCL, lack of information on patients who emigrated from Israel, and the availability of BMI data only from patients aged 16 years to 19 years.
“The prevalence of overweight and obesity has increased substantially in the U.S. and Israel since the 1980s, and this is concurrent with increased incidence of non-Hodgkin’s lymphoma,” Leiba and colleagues wrote. “However, the fraction of non-Hodgkin’s lymphoma attributable to overweight or obesity is modest. Nevertheless, the potential role of height and obesity in non-Hodgkin’s lymphoma etiology is of public health relevance, and some excess weight may be preventable. Further studies are needed to elucidate the biological mechanisms through which weight and height in adolescence influence the future risk for developing specific non-Hodgkin’s lymphoma subtypes.” – by Cameron Kelsall
Disclosure: The researchers report no relevant financial disclosures.
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