Metabolic risk factors and primary liver cancer in a prospective study of 578,700 adults
Metabolic risk factors and primary liver cancer in a prospective study of 578,700 adults
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DOI：
10.1002/ijc.26338
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发表时间：
2012-07-01
影响因子：
6.4
通讯作者：
Ulmer, Hanno
中科院分区：
文献类型：
--
作者：
Borena, Wegene;Strohmaier, Susanne;Ulmer, Hanno
初步研究表明糖尿病和肥胖是肝细胞癌的危险因素；但其他代谢危险因素与原发性肝癌(PLC)之间的关系尚未被调查。代谢综合征和癌症项目(Me-Can)包括来自挪威、奥地利和瑞典的队列，数据涉及578,700名受试者。采用COX比例风险模型，以体重指数(BMI)、血压、血糖、胆固醇、甘油三酯水平为连续标准化变量(Z分均值为0，标准差(SD)=1)及其代谢综合征标准化总和(METS)Z分计算肝癌的相对危险度(RR)。对RR进行校正，以消除测量中的随机误差。在平均12.0年的随访中(SD=7.8)，队列成员中有266例被诊断为原发性肝癌。校正了年龄、吸烟状况和体重指数，并按出生年份、性别和亚队列进行分层后，单位z分数增量的肝癌RR为BMI 1.39(95%可信区间1.241.58)，中等血压2.08(0.954.73)，血糖2.13(1.552.94)，胆固醇0.62(0.510.76)，血清甘油三酯0.85(0.651.10)。Mets z分数每增加一个单位的相对危险度为1.35(1.121.61)。体重指数、血糖和蛋氨酸综合评分与患肝癌的风险呈正相关，与胆固醇呈负相关。
Initial studies have indicated diabetes and obesity to be risk factors for hepatocellular carcinoma; but the association between other metabolic risk factors and primary liver cancer (PLC) has not been investigated. The metabolic syndrome and cancer project (Me-Can) includes cohorts from Norway, Austria and Sweden with data on 578,700 subjects. We used Cox proportional hazard models to calculate relative risks (RRs) of PLC by body mass index (BMI), blood pressure and plasma levels of glucose, cholesterol and triglycerides as continuous standardized variables (z-score with mean = 0 and standard deviation (SD) = 1) and their standardized sum of metabolic syndrome (MetS) z-score. RRs were corrected for random error in measurements. During an average follow-up of 12.0 years (SD = 7.8), 266 PLCs were diagnosed among cohort members. RR of liver cancer per unit increment of z-score adjusted for age, smoking status and BMI and stratified by birth year, sex and sub-cohorts, was for BMI 1.39 (95% confidence interval (CI) 1.241.58), mid blood pressure 2.08 (0.954.73), blood glucose 2.13 (1.552.94) cholesterol 0.62 (0.510.76) and serum triglycerides 0.85 (0.651.10). The RR per one unit increment of the MetS z-score was 1.35 (1.121.61). BMI, glucose and a composite MetS score were positively and cholesterol negatively associated with risk of liver cancer.