CASE SERIES

CASE SERIES ARTICLE 23(95), January - February, 2019

Medical Science
ISSN
2321–7359
EISSN
2321–7367

Communication between body mass index and the

risk of obesity-related cancer: A 5-year study on
patients with cancer
Mostafa Madmoli1, Mehran Yarbig2, Negin Sedighi3, Pouriya Darabiyan4, Fariba
Mobarez4
Introduction: Cancer is one of the chronic and non-communicable diseases that include a wide range of diseases considering that,
significant correlation was found in some studies between cancer and BMI higher than normal, and so far in this field few studies
have been done in Khuzestan province and Ahwaz city. Also, planning to increase the health level of cancer patients in khuzestan
province, it needs to know all the risk factors for the disease in this province. Therefore, this 5-year study on cancer patients referred
to Shafa Hospital in Ahvaz, with the goal Determine the communication between body mass index and the risk of obesity-related
cancer. Materials and Methods: In this retrospective cross-sectional descriptive-analytic study, 1346 cases of patients with different
types of cancer with BMI> 30, admitted to Shafa Hospital, Ahvaz city which for 5 years, with the diagnosis of any cancer and history
of the disease with a BMI of over 30, And referring to the Ahvaz Shafa hospital, from 2012 to 2016, entered the study. The inclusion
criteria included all patients with a medical diagnosis and history of any type of cancer with a BMI> 30, and in each age group and
sex, and the exit criteria included other records of patients who had non-cancer medical diagnosis, cases with a BMI of less than 30,
as well as incomplete cases. The data in this study included demographic, laboratory and clinical data of patients. Data were then
entered into SPSS software version 20 and analyzed by descriptive statistics, analytical tests and significant level of P <0.05. Results:
This study included 1346 individuals with different types of cancer with an average age of 64.08±88.52 years and 754 (56.0%) were
female and the rest were male. Also, the mean BMI in these patients was 33.16 ± 5.08, that indicating patients with moderately obese
(Obese Class I). In this study, the relationship between BMI and education was significant (p = 0.002). Also, 944 (70.1%) patients had
malignant tumors and the rest were benign. The highest prevalence of cancer in this study was related to gastrointestinal cancers
with 55.5%. In this study, also was calculated BMI for different types of cancer, that the highest incidence was related to
gastrointestinal cancer (BMI = 35.57 ± 9.06). In this study, 456 (33.8%) patients had a history of diabetes. There was a significant
relationship between the history of diabetes and gastrointestinal cancers (p = 0.008). Conclusion: In this study, the average body
mass index of patients was moderately obese (obese class I). Also, the highest incidence of cancer in this study was related to
gastrointestinal cancers, and there was a significant relationship between the history of diabetes and gastrointestinal cancer.
Therefore, it is necessary to make changes in the lifestyle of people living in Khuzestan province. Also can prevented from
developing obesity and diabetes which provides the ground for all types of cancer, especially gastrointestinal, with doing aerobic
exercise, nutrition correction and not taking foods high in fat and high cholesterol.

INTRODUCTION health organization statistics, the mortality rate from cancer will rise
Cancer is one of the chronic and non-communicable diseases that from 45% in 2007 to 65% in 2030 (2). Unlimited proliferation potential,
include a wide range of illnesses. This disease like other chronic reduced apoptosis, increased angiogenesis, invasive tissue and
diseases, in each person, the age group and any race occur and is metastasis are factors of cancer progression (3). The increasing
considered as a major health problem affecting community health (1). importance of investigating changes in the expression of genes in the
The mortality rate due to cancer is increasing And at least about 8 creation of various types of cancers, and the emergence of new
million people die every year because of cancer; According to world biotechnology methods has led to in recent years in studies on the
etiology of this disease, are of particular importance such molecular
1
Emergency Medical Technician, Dezful University of Medical Sciences, Dezful,
Iran; 2Msc of Pediatric Nursing, Islamic Azad University, Khorasgan Branch,
studies (4). Meanwhile, obesity and diabetes increase the risk of cancer
69

Isfahan, Iran; 3Bachelor student of nursing, Student Research Committee, Shahid (5). Diabetes is the most common endocrine disorder in the world (6).
Sadoughi University of Medical Sciences, Yazd, Iran; 4Student Research
And a metabolic disorder characterized by chronic hyperglycemia and
Page

Committee, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran;


Corresponding Author: Fariba Mobarez, Student Research Committee, Ahvaz leads to damage to the various organs of the affected person and reduces
Jundishapur University of Medical Sciences, Ahvaz, Iran; Email:
faribamobarez@gmail.com.
her longevity (7). Diabetes is also a major cause of morbidity and

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 CASE SERIES ARTICLE

mortality in the industrialized world and developing countries (8). than 30, as well as incomplete cases. To study cases and collect data,
According to the world health organization statistics by 2020, are first, introduction letter of written on behalf of deputy of education and
affected by the disease about 333 million people worldwide (9). research Ahwaz University of Medical Sciences was taken then, the
Diabetes also accounts for 15 percent of health care spending in the records of patients referring to the hospital in the archives section were
United States (10). Diabetes complications, in addition to high costs for used. The required information was collected through a researcher
individuals and society, also increase mortality in people with diabetes checklist from the records.
(11). Patients with diabetes are at greater risk than the general Was the information studied in this study includes demographic
population of the growing urinary tract, liver, biliary, pancreatic, colon, information, laboratory and clinical patients such as gender, age, BMI,
endometrial, and kidney cancer. Several confounding factors are directly marital, ethnicity, occupation, economic status, level of education,
related to clinical differences in diabetes at various levels of metabolic having or not having a family history of cancer and history of diabetes,
control, diabetes duration, anti-diabetic treatment profiles, and the type of cancer, type of tumor, Having or not having a history of
presence of complications or association with disease (12). Therefore, it chemotherapy, a history of drug use or smoking and alcoholic drinks.
is difficult to accuracy in evaluation the risk of incidence cancer in Then, the data were entered into SPSS version 20. Data were analyzed
diabetes. In addition, common risk factors for both illnesses such as age, by descriptive statistics including enumerated tables, mean, standard
sex, ethnicity, alcohol, tobacco, diet, obesity and physical activity, and deviation and variance, and analytical tests including T-test, Anova, chi-
body mass index seem to make the relationship more complicated square and Chi-square Pearson and at the significant level of P <0.05.
(13,23,24).
Considering that in the study of renehan et al. (14), in men, increase RESULTS
in BMI at a rate of 5 kg per square meter, were associated strongly with This study included 1346 individuals with different types of cancer with
esophageal adenocarcinoma, and cancer of thyroid, colon and kidney. an average age of 64.08±88.52 years. 754 (56.0%) were female and the
As well as in women strong communication between 5 kg / m 2 increase rest were male. The mean glucose level of these patients was 266.78 ±
in BMI and endometrial cancer, gallbladder, esophageal 94.61. Also, the mean BMI in these patients was 33.16 ± 5.08, that
adenocarcinoma, and kidney cancer have been recorded. And also indicating patients with moderately obese (Obese Class I).
because there was a probability association between cancer and BMI In terms of ethnicity, 527 people (39.1%) were Lor. 479 people
higher than normal in Khuzestan province, and that studies should be (35.5%) were Arabs, 247 (18.3%) were Shoushtari-Dezfuli and 93
conducted in this regard and in order to help continue studies in this (6.9%) were kord. As well as in terms of marital status, 745 (55.3%)
field, to be more aware of this connection. Also, planning to increase the were married, 425 (31.5%) were single and 176 (13.0%) died of their
health level of cancer patients in Khuzestan province, it needs to know husbands. Also, 852 people (63.2%) rights were monthly less than 1 and
all the risk factors for the disease in this province and so far, few studies a half million toman, and the rest were above that amount. A statistically
have been carried in this field in khuzestan province and Ahwaz city. significant relationship was found between gender and family history of
Therefore, this 5-year study on cancer patients referred to Shafa Hospital cancer (p <0.0001). Also was significant relationship between job and
in Ahvaz, with the goal determine the Communication between body family history of cancer (P = 0.009) and the significant relationship
mass index and the risk of obesity-related cancer. between BMI and educational level (p = 0.002). Table 1 shows the
demographic information of these individuals.
MATERIALS AND METHODS In this study, 944 (70.1%) patients had malignant tumors and the
In this retrospective cross-sectional descriptive-analytic study, 1346 rest were benign (Figure 1). Also, 1152 patients (85.5%) had a history of
cases of patients with different types of cancer with BMI> 30, chemotherapy and the rest had no history (Figure 2). 748 (55.5%) of the
hospitalized in Shafa Hospital in Ahvaz city, which resided in Ahvaz, patients in this study were gastrointestinal cancers, also 322 (23.9%)
Masjed Soleyman, Shoushtar, Dezful, Behbahan, Abadan, Izeh, patients had genital cancers, of these types of cancer in women, was
Khorramshahr, Lali and Andika, which has been studied for 5 years most ovarian cancer and men were more prostate cancer. Of the other
from 2012 to 2016. The files were investigated by ten researchers who types of cancers, 89 (6.6%) of lung cancer patients, 78 (5.7) bone
were in the medical records of the hospital. These patients that with a marrow cancer, 64 (4.7%) of leukemia, and 45 (3.3%) were kidney
diagnosis of any cancer and a history of the disease with a BMI of above cancer (Figure 3). In this study also, the average BMI for different types
30, And referring to the Ahvaz Shafa Hospital, from 2012 to 2016 and of cancer was calculated, the highest BMI was for gastrointestinal
entered the study. cancers (BMI = 35.57 ± 9.06), (Figure 4).
This article is the result of the research project of Behbahan In this study, 456 (33.8%) patients had a history of diabetes. There
University of Medical Sciences with the code IR.BHN.REC.1397.9582. was a significant relationship between the history of diabetes and
After obtaining the necessary permissions and financial support from gastrointestinal cancers (p = 0.008). In this study, 244 people (18.1%)
Behbahan University of Medical Sciences, this license was referred to had a history of drug or smoking use. And 49 (3.6%) had a history of
the research department of Ahvaz University of medical sciences, then alcohol consumption, and the relationship between alcohol consumption
Ahvaz University of Medical Sciences Research Committee issued the with a history of chemotherapy was significant, that is, people who
necessary permission to the Shafa hospital and then patients through consumed more alcohol, they had more chemotherapy (p = 0.002).
written informed consent and their cases were used for this study.
The data needed for the study were extracted from patients' medical DISCUSSION
records during the years mentioned in the medical records section of the The results of this study showed that 55.5% of patients had
70

hospital. The inclusion criteria included all patients with a medical gastrointestinal cancers. In this study, the average body mass index was
diagnosis and a history of any type of cancer with a BMI> 30, and in calculated for different types of cancer, which was the highest amount
Page

each age group and sex. The exit criteria included other records of for gastrointestinal cancers. In this study, 33.8% of the patients had a
patients with non-cancer medical diagnosis, records with a BMI less history of diabetes. There was a significant relationship between the

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 CASE SERIES ARTICLE

Table 1 Demographic characteristics of cancer patients and its relevance to family history of cancer, history of diabetes and BMI using T-test, ANOVA,
Chi-square and Chi-square Pearson
Relationship with Relationship
Relationship
family history of with history of
Variable Classification Number Percentage with BMI
cancer diabetes
(P value)
(P value) (P value)
Male 592 43.9
sex p <0.0001 p=0.008 p <0.0001
Female 754 56.0
Under the diploma 847 62.9
Education p=0.05 p=0.06 p=0.002
Diploma and higher 499 37.0
Free 563 41.8
Housewife 342 25.4
Occupation P=0.009 p=0.06 p=0.03
Unemployed 241 17.9
Employee 200 14.8
* A significant level below 0.05 is considered.

144
Female
527

258
Male
417

0 100 200 300 400 500 600

Benign tumor Malignant tumor

Figure 1 Frequency comparison Type of cancer tumor according to gender

194, 14%

1152, 86%
71

With a history of chemotherapy Without a history of chemotherapy

Page

Figure 2 Frequency of chemotherapy history in cancer patients

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 CASE SERIES ARTICLE

Gastrointestinal
800 748
cancer
700
Genital tract
600 cancer
500
Lung cancer
400 322
300
Bone marrow
200
cancer
89
100 78
64
0 45 Leukemia

Frequency of Cancer Types kidney cancer

Figure 3 Frequency of cancer types in patients with this disease

36 35.57

35

34
33.12
33
32.23
32
31.29
30.94
31 30.67

30

29

28
The Average BMI in different types of cancer

Gastrointestinal cancer Genital tract cancer Lung cancer Bone marrow cancer Leukemia kidney cancer

Figure 4 The Average BMI in different types of cancer (For ease of writing the numbers on the Diagram, the standard deviation is set aside). It should
also be noted that; BMI More than 25 to 29.9 = represents a person overweight, in the range of 30 to 34.9 = signs of moderately obese (Obese Class I)
and in the range of 35 to 39.9= signs severe obesity (Obese Class II).

history of diabetes and gastrointestinal cancers. Hyperglycemia can have diabetic people than in healthy people. The risk of rectal cancer in
a direct effect on tumor growth, because cancer cells strongly emphasize people with diabetes is more than other people, although this increase
glycolysis. Findings from various studies have shown that excessive seems to be limited to men only (15-17).
obesity and diabetes increase the chances of developing colorectal In a study by Azizi et al. (18), which was called the risk of
72

cancer. Research also shows that People with over-obesity and diabetes colorectal cancer in type 2 diabetic patients, showed that diabetes and
are more at risk for colon cancer than non-diabetics, but so far, not obesity increases the risk of colorectal cancer. In this study, 207 patients
Page

specified the reasons for this connection and what to do to prevent colon with colorectal cancer with colonoscopy and positive pathology and
cancer in diabetics. Also, the risk of large bowel cancer is higher in cases of incidence and among patients referring to colonoscopy units of

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 CASE SERIES ARTICLE

reference hospitals in Tabriz city with 207 cases referring to the same living in khuzestan province. Also can prevented from developing
units with colonoscopy and negative pathology and without previous obesity and diabetes which provides the ground for all types of cancer,
history of polyps, neoplasms and other cancers were studied. In this especially gastrointestinal, with doing aerobic exercise, nutrition
study, 207 patients with colorectal cancer had 48 patients with diabetes correction and not taking foods high in fat and high cholesterol. And it's
in contrast, of the 207 controls, only 21 were diabetic. The final better that obese and overweight people; refer to a physician nutrition
analysis, in the presence of other effective factors, showed that diabetes specialist to determine the amount of your normal body mass index and
mellitus increases the chances of developing colorectal cancer. to get the appropriate diet.
In a study by manami Inoue et al. (19), entitled "Diabetes and the
risk of cancer, were diagnosed a total of 6462 new cases of cancer. In REFERENCES
men, the risk of general cancer has increased by 27% in those with a 1. Siegel R, Ward E, Brawley O, Jemal A. Cancer statistics, 2011: the
history of diabetes. HR was very high for people with liver, pancreatic impact of eliminating socioeconomic and racialdisparities on
and kidney cancer. In this study, we also saw increased risk of colon premature cancer deaths. CA Cancer J Clin. 2011; 61(4): 212-36.
2. Are the number of cancer cases increasing or decreasing in the
cancer and gastric cancer with marginal significance. In women, the
world? [Online]. 2008 [cited 2008 Apr 1]; Available from: URL:
incidence of cancer was significantly increased at the borderline while
http://www.who.int/features/qa/15/en/index.html/
the incidence of gastric cancer and liver cancer was statistically 3. Ahmadian M, Azizbeigi K, Delphan M, Atashak S. The Effect of High
significant. Also the incidence of ovarian cancer was observed at the Intensity Interval Training on STAT-3 and Angiopoietin-1 Gene
border. Expression, and tie-2 Protein in Mice with Breast Cancer. Iranian
In this study, gastrointestinal cancer was the highest percentage of Journal of Breast Diseases46-37: )1( 11 ;2018 .
cancer in both men and women. The results of lotfi et al. showed that the 4. Hadi Aghayari, Majid Hassanpuor-Ezatti, Hamid Reza Navidi, Said
gastric cancer was the highest incidence of cancer in men (13.7%), and Barjesteh. Determination of priority and contribution rate of genes
involved in breast stromal cells cancer on the basis of microarray
the breast cancer was the highest incidence of cancer in women
analysis by mathematical modeling. pajoohande. 2012; 17 (5) :228-
(11.7%). Bladder cancer and cervical lymphoma was not observed in
233.
women while cancer of the larynx, tongue, skin, myosarcoma and 5. Sona MF, Myung SK, Park K, Jargalsaikhan G. Type 1 diabetes
malignant tumor of the eye was not observed in men (20). Cause of mellitus and risk of cancer: a meta-analysis of observational studies.
gastrointestinal cancer was high in this study and also in many studies Japanese journal of clinical oncology. 2018 Apr 9;48(5):426-33.
due to high risk factors for gastrointestinal cancers such as increased 6. Moslemirad M, Madmoli M, Madmoli Y, Niksefat M. Prevalence of
carbohydrate and fat intake, lifestyle changes, lack of mobility and type 1 and type 2 diabetes and its related factors in diabetic patients
obesity, and so on. hospitalized in Khatam-ol-Anbia hospital in Shoushtar, 2014-15: A
retrospective study. Journal of Research in Medical and Dental
The mean BMI in these patients was 33.16 ± 5.08, that indicating
Science. 2018;6(3):421-6.
patients with moderately obese (obese class I). However, patients with
7. Raisifar Z, Afshar Nia A, Madmoli M, Madmoli Y. The Relationship
gastrointestinal cancer had higher BMI (BMI = 35.57 ± 9.06), which between Using Insulin and Suffering Alzheimer's Disease in Patients
indicates severe obesity (Class II obesity). So we can say that in this with Diabetes: A Two-Year Study. International Journal of
study obesity has a direct impact on the types of cancer, especially Ecosystems and Ecology Science (IJEES). 2018 June; 8 (3): 623-28.
gastrointestinal cancer. In the study of renehan et al. (14), showed that in 8. Raisifar Z, Afshar Nia A, Maghamesi Moarrefi H, Madmoli M.
men increase in BMI at a rate of 5 kg per square meter, were associated Evaluation of gi Bleeding Prevalence and Its Related Factors in
strongly with esophageal adenocarcinoma, and cancer of thyroid, colon Diabetic Patients Hospitalized in KHatam-ol-Anbia Hospital During
2015-16: A Retrospective Study. International Journal of Ecosystems
and kidney. As well as in women have been recorded strong
and Ecology Science (IJEES). 2018 June; 8 (3): 609-14.
communication between 5 kg / m 2 increase in BMI with esophageal
9. Madmoli M Rostami F, Mirsami Yazdi N, Mosavi A, Baraz Sh.
adenocarcinoma and cancers of endometrial, gallbladder and kidney. Evaluation of Prevalence of Diabetic Foot Ulcer and Its Related
Also, the results of the study by Lynn et al. (21), showed that Factors in Diabetic Patients Admitted to KHatam-ol-Anbia Hospital in
overweight adults (BMI≥25) and increased glucose (≥125 mg / dL), Shoushtar During 2015-2016: A Retrospective Study. International
have doubled the risk of obesity-related cancer, while overweight adults Journal of Ecosystems and Ecology Science (IJEES). 2018 June; 8
with normal glucose increased the risk by 50%. Adults with normal (3): 545-52.
weight with increased glucose did not risk excessive cancer. 10. Rostami F, Madmoli M, Mirsami Yazdi N, Baraz Sh. Evaluation of The
Prevalence of Lower Limb Amputation and Its Related Factors in
Also, the study by schrijnders et al. (22) showed that women with
Diabetic Patients Admitted to KHatam-ol-Anbia Hospital in Shoushtar
type 2 diabetes, were at risk for obesity-related cancer compared to
During The 2015-2016: A Retrospective Study. International Journal
women in the general population for 5 years before diabetic diagnosis. of Ecosystems and Ecology Science (IJEES). 2018 June; 8 (3): 553-
In men and women, the peak incidence of obesity related cancer was 60.
observed, following the diagnosis of diabetes. From the second to fifth 11. Madmoli M, Eilami O, Rezaie K, Aliabad MA, Moslemirad M. Diabetes
year, after diagnosis of diabetes, the incidence of cancer related to and the risk of suffering cardiovascular Diseases: A two-year
obesity in women was higher than that of women in the general retrospective study. International Journal of Ecosystems and Ecology
population. Science (IJEES). 2018 Jun;8(3): 649-56.
12. Giovannucci E, Harlan DM, Archer MC, Bergenstal RM, Gapstur SM,
Habel LA, Pollak M, Regensteiner JG, Yee D. Diabetes and cancer: a
CONCLUSION
consensus report. CA: a cancer journal for clinicians. 2010
In this study, the average body mass index of patients was moderately Jul;60(4):207-21.
73

obese (obese class I). Also, the highest incidence of cancer in this study 13. Habib SL, Rojna M. Diabetes and risk of cancer. ISRN oncology.
was related to gastrointestinal cancers and there was a significant 2013 Feb 7;2013.
Page

relationship between the history of diabetes and gastrointestinal cancer. 14. Renehan AG, Tyson M, Egger M, Heller RF, Zwahlen M. Body-mass
Therefore, it is necessary to make changes in the lifestyle of people index and incidence of cancer: a systematic review and meta-analysis

© 2019 Discovery Publication. All Rights Reserved. www.discoveryjournals.org OPEN ACCESS

 CASE SERIES ARTICLE

of prospective observational studies. The Lancet. 2008 Feb 24. Hadi Mashali, Fatemeh Toleideh, Rezvan Rahmani, Pouriya
16;371(9612):569-78. Darabiyan, Mostafa Madmoli. The predictive role of Hyperlipidemia in
15. Azizi H, Delpisheh A, Sayehmiri K, Asadollahi K, Esmaeili ED, the incidence of ACS in patients referring to Shahidzadeh Hospital in
Sharbafi J. Risk of Colorectal Cancer in Type2 Diabetic Patients. Behbahan in 2016 -2017. Medical Science, 2018; 22(94), 566-570
Majallah-i pizishki-i Danishgah-i Ulum-i Pizishki va Khadamat-i
Bihdashti-i Darmani-i Tabriz. 2016 Oct 1;38(4):56. Article Keywords
16. Wang JY, Chao TT, Lai CC, Wang CY, Wu VC, Wang SM, Lin HI, Cancer, Body Mass Index, Obesity-Related Cancer, Gastrointestinal
Tang SH, Lin HW. Risk of colorectal cancer in type 2 diabetic Cancer, Risk Factor
patients: a population-based cohort study. Japanese journal of clinical
oncology. 2013 Jan 3;43(3):258-63. Acknowledgment
17. Bosetti C, Rosato V, Polesel J, Levi F, Talamini R, Montella M, Negri The researchers in this study appreciated and thanked everyone who
E, Tavani A, Zucchetto A, Franceschi S, Corrao G. Diabetes mellitus cooperated with us. The names of the ten researchers who helped in
and cancer risk in a network of case-control studies. Nutrition and investigating cases and collecting data are as follows: Mostafa Madmoli,
cancer. 2012 Jul 1;64(5):643-51. Yaghoob Madmoli, Pouriya Darabiyan, Mohammad Madmoli, Iman
18. Azizi H, Delpisheh A, Sayehmiri K, Asadollahi K, Esmaeili ED, Madmoli, Mohsen Madmoli, Reza Madmoli, Karim Madmoli, Poya
Sharbafi J. Risk of Colorectal Cancer in Type2 Diabetic Patients. Madmoli and Parsa Madmoli.
Majallah-i pizishki-i Danishgah-i Ulum-i Pizishki va Khadamat-i
Bihdashti-i Darmani-i Tabriz. 2016 Oct 1;38(4):56. Conflict of interest
19. Inoue M, Iwasaki M, Otani T, Sasazuki S, Noda M, Tsugane S. There are no conflicts of interest in this study.
Diabetes mellitus and the risk of cancer: results from a large-scale
population-based cohort study in Japan. Archives of internal Article History
medicine. 2006 Sep 25;166(17):1871-7. Received: 09 October 2018
20. Lotfi, Y. and Feizi, A., 2018. a survey on the frequence of moderate Accepted: 02 December 2018
and severe during interaction and during operation among elderly Published: January-February 2019
patients with cancer under chemotrapy referred to amam khomeini
hospital, ardebil 2015-16. The J Urmia Nurs Midwifery Fac, 15(11), Citation
pp.815-825. Mostafa Madmoli, Mehran Yarbig, Negin Sedighi, Pouriya Darabiyan,
21. Moore LL, Chadid S, Singer MR, Kreger BE, Denis GV. Metabolic Fariba Mobarez. Communication between body mass index and the risk
health reduces risk of obesity-related cancer in framingham study of obesity-related cancer: A 5-year study on patients with cancer. Medical
adults. Cancer Epidemiology and Prevention Biomarkers. 2014 Jul Science, 2019, 23(95), 69-74
10: cebp-0240.
22. Schrijnders D, Hendriks SH, Kleefstra N, Vissers PA, Johnson JA, de Publication License
Bock GH, Bilo HJ, Landman GW. Sex differences in obesity related
cancer incidence in relation to type 2 diabetes diagnosis (ZODIAC- This work is licensed under a Creative Commons Attribution
49). PloS one. 2018 Jan 25;13(1): e0190870. 4.0 International License.
23. Mostafa Madmoli, Zahra Kord, Azita Bandani, Negin Sedighi, Mahla
Rezaei Shandiz, Pouriya Darabiyan, Alieh AfsharNia. Epidemiological
General Note
and clinical study of patients with Alzheimer's in Five Cities of
Khuzestan Province in 2016-2018. Medical Science, 2019; 23(95), 1- Article is recommended to print as color digital version in recycled
5. paper. Save trees, save nature

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