Association between anthropometry and lifestyle factors and risk of B-cell lymphoma: An exposome-wide analysis

Abstract

To better understand the role of individual and lifestyle factors in human disease, an exposome-wide association study was performed to investigate within a single-study anthropometry measures and lifestyle factors previously associated with B-cell lymphoma (BCL). Within the European Prospective Investigation into Cancer and nutrition study, 2402 incident BCL cases were diagnosed from 475 426 participants that were followed-up on average 14 years. Standard and penalized Cox regression models as well as principal component analysis (PCA) were used to evaluate 84 exposures in relation to BCL risk. Standard and penalized Cox regression models showed a positive association between anthropometric measures and BCL and multiple myeloma/plasma cell neoplasm (MM). The penalized Cox models additionally showed the association between several exposures from categories of physical activity, smoking status, medical history, socioeconomic position, diet and BCL and/or the subtypes. PCAs confirmed the individual associations but also showed additional observations. The PC5 including anthropometry, was positively associated with BCL, diffuse large B-cell lymphoma (DLBCL) and MM. There was a significant positive association between consumption of sugar and confectionary (PC11) and follicular lymphoma risk, and an inverse association between fish and shellfish and Vitamin D (PC15) and DLBCL risk. The PC1 including features of the Mediterranean diet and diet with lower inflammatory score showed an inverse association with BCL risk, while the PC7, including dairy, was positively associated with BCL and DLBCL risk. Physical activity (PC10) was positively associated with DLBCL risk among women. This study provided informative insights on the etiology of BCL.

Keywords: exposome; exposome-wide association study; lifestyle; lymphoma; prospective study.

FIGURE 1

Standard Cox regression for individual exposure adjusted for country, age and sex in total BCL and subtypes. Vertical axis shows the −Log10 p FDR value and blue line shows pFDR = 0.05. See Table S2 for name, type and unit of the exposures. BCL, B‐cell lymphoma; FDR, false discovery rate [Color figure can be viewed at wileyonlinelibrary.com]

FIGURE 2

A heatmap for the correlation of each exposure with each principal component. The color of the intersection of an exposure (vertical axis) and a principal component (horizontal axis) indicates the dimension of the correlation: dark blue indicates a highly negative correlation; dark red indicates a highly positive correlation; The staircase‐like high correlation line in the figure indicates that all exposures are correlated with one of the principal components without much overlap. See Table S2 for name, type and unit of the exposures [Color figure can be viewed at wileyonlinelibrary.com]