Aflatoxin B1 exposure, hepatitis B virus infection, and hepatocellular carcinoma in Taiwan.
Aflatoxin B1 exposure, hepatitis B virus infection, and hepatocellular carcinoma in Taiwan.
复制标题
DOI：
10.1158/1055-9965.epi-08-0697
复制
发表时间：
2009-03
期刊：
影响因子：
--
通讯作者：
Santella RM
中科院分区：
文献类型：
--
作者：
Wu HC;Wang Q;Yang HI;Ahsan H;Tsai WY;Wang LY;Chen SY;Chen CJ;Santella RM
为了评价黄曲霉毒素B1（AFB 1）暴露对肝细胞癌（HCC）风险的作用，进行了一项嵌套在社区队列中的病例对照研究。基线血液和尿液样本用于确定AFB 1-白蛋白加合物和尿AFB 1代谢产物的水平。条件Logistic回归分析用于计算比值比（OR）和95%置信区间（CI），以评估AFB 1暴露对HCC风险的影响。AFB 1-白蛋白加合物和尿AFB 1代谢物水平高于平均值的患者与低于平均值的患者相比，调整后OR（95%CI）分别为1.54（1.01-2.36）和1.76（1.18-2.58）。与尿AFB 1代谢物水平最低四分位数的受试者相比，非B型肝炎病毒（HBV）感染携带者发生HCC的风险增加，校正OR（95%CI）分别为0.57（0.14-2.43）、1.43（0.32-6.42）和4.91（1.18-20.48; Ptrend=0.02）。HBsAg携带者与非携带者相比的调整OR（95%CI）为7.49（5.13-10.93），无论AFB 1状态如何。黄曲霉毒素B1-白蛋白加合物和尿黄曲霉毒素B1代谢物水平高于平均值的HBsAg携带者的OR（95%CI）分别为10.38（5.73-18.82）和15.13（7.83-29.25）。黄曲霉毒素暴露和HBV感染的联合作用在随访期间没有差异。与我们之前较少受试者的研究一致，这些数据表明AFB 1暴露是HCC风险的风险因素。然而，在这项更大规模的研究中，AFB 1暴露和HBV感染的联合效应更符合加法模型而不是乘法模型。
To evaluate the role of aflatoxin B1 (AFB1) exposure on risk of hepatocellular carcinoma (HCC), a case-control study nested within a community-based cohort was conducted. Baseline blood and urine samples were used to determine the level of AFB1-albumin adducts and urinary AFB1 metabolites. Conditional logistic regression analysis was used to calculate odds ratios (ORs) and 95% confidence intervals (CIs) to assess the effect of AFB1 exposure on risk of HCC. The adjusted-ORs (95%CIs) were 1.54 (1.01–2.36) and 1.76 (1.18–2.58), respectively, for those with AFB1-albumin adducts and urinary AFB1 metabolites levels above the mean compared to those with levels below the mean. When compared to subjects in the lowest quartile of urinary AFB1 metabolites, there was an increase in risk of HCC, with adjusted ORs (95% CIs) of 0.57 (0.14–2.43), 1.43 (0.32–6.42) and 4.91 (1.18–20.48; Ptrend=0.02), respectively, among noncarriers of hepatitis B virus (HBV) infection. The adjusted OR (95%CI) was 7.49 (5.13–10.93) for carriers of HBsAg compared to noncarriers, regardless of AFB1 status. The ORs (95%CI) were 10.38 (5.73–18.82) and 15.13 (7.83–29.25), for carriers of HBsAg with levels of AFB1-albumin adducts and urinary AFB1 metabolites above the mean, respectively. The combined effect of aflatoxin exposure and HBV infection did not differ by duration of follow-up. Consistent with our previous study with fewer subjects, these data demonstrate that AFB1 exposure is a risk factor for HCC risk. However, in this larger study, the effect of combined AFB1 exposure and HBV infection is more consistent with an additive than a multiplicative model.