Associations between body mass index and the risk of mortality from lung cancer: A dose–response PRISMA-compliant meta-analysis of prospective cohort studies
Whether body mass index (BMI) is associated with the risk of mortality from lung cancer (LC) is controversial, and the shape of dose–response relationship on this topic is not well-established. Thus, a dose–response meta-analysis was performed to clarify this association.Methods:
A search of PubMed and EMBASE was conducted, and 2-stage random-effect dose–response model was used to yield summary relative risks and its shape.Results:
Fifteen prospective cohort studies were eligible for inclusion criteria. The combined relative risks per 5 kg/m2 in BMI for risk of LC mortality is 0.94 (95% confidence interval] 0.92–0.96), and nonlinear association was found (Pnonlinearity < .0001), which indicated that compared with higher BMI, lower BMI showed higher LC mortality risk. Subgroup analyses revealed that this obesity paradox remained regardless of number of cases, follow-up duration, and study location, but this relationship was not observed among nonsmokers.Conclusion:
A nonlinear association between BMI and the risk of LC mortality was found, and higher BMI participants have a lower risk of LC death than slim people.