Low plasma adiponectin levels and risk of colorectal cancer in men: A prospective study
Low plasma adiponectin levels and risk of colorectal cancer in men: A prospective study
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DOI：
10.1093/jnci/dji376
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发表时间：
2005-11-16
影响因子：
10.3
通讯作者：
Mantzoros, CS
中科院分区：
文献类型：
--
作者：
Wei, EK;Giovannucci, E;Mantzoros, CS
背景脂联素是脂肪细胞分泌的一种胰岛素增敏激素。脂联素水平与肥胖和胰岛素抵抗呈负相关。由于肥胖和胰岛素抵抗都与结直肠癌的风险有关，我们假设脂联素与结直肠癌的发生有关。研究方法：我们在1994年提供血液样本的健康专业人员随访研究中评估了18225名男性的脂联素与结直肠癌之间的关系。从血液采集到2002年1月31日，发生了179例结肠直肠癌病例。每个病例患者与两名对照受试者的出生年份和抽血日期相匹配。使用两年一次的问卷和食物频率问卷收集有关生活方式因素和饮食的信息。Logistic回归模型用于估计相对风险（RR）和置信区间（CI）。所有统计学检验均为双侧检验。结果如下：我们观察到血浆脂联素水平与结直肠癌风险之间存在统计学显著负相关（对于最高五分位数[Q5]与最低五分位数[Q1]，RR = 0.42，95%CI = 0.23至0.78; P趋势= 0.01）。在调整体重指数后，这种关联仅略有减弱（Q5与Q1，RR = 0.48，95% CI = 0.25至0-90; P-趋势= .04）或体重指数和结直肠癌的其他主要风险因素（家族史、体力活动、多种维生素使用、吸烟、饮酒、阿司匹林使用、内窥镜检查史、膳食钙、叶酸、维生素E和维生素D; Q5与Q1，多变量RR = 0.50，95% CI = 0.26至0.97; P趋势= 0.08）。在任何分析中，相对风险都不是线性的;第二个五分位数的相对风险低于最低的五分位数，但随着脂联素水平的增加，风险的进一步降低并不明显。结论：在这项前瞻性巢式病例对照研究中，血浆脂联素水平低的男性比血浆脂联素水平高的男性患结直肠癌的风险更高。更多的前瞻性观察性研究，特别是在妇女，和机制的研究，需要充分了解脂联素和致癌之间的关系。
Background. Adiponectin is an insulin-sensitizing hormone secreted by adipocytes. Levels of adiponectin are inversely associated with adiposity and insulin resistance. Because both adiposity and insulin resistance have been associated with risk of colorectal cancer, we hypothesized that adiponectin is associated with colorectal carcinogenesis. Methods: We evaluated the association between adiponectin and colorectal cancer among 18 225 men in the Health Professionals Follow-up Study who provided blood samples in 1994. Between blood collection and January 31, 2002, 179 incident colorectal cancer cases occurred. Each case patient was matched to two control subjects on year of birth and date of blood draw. Information on lifestyle factors and diet was collected using biennial questionnaires and food frequency questionnaires. Logistic regression models were used to estimate relative risks (RRs) and confidence intervals (CIs). All statistical tests were two-sided. Results: We observed a statistically significant inverse association between plasma adiponectin levels and risk of colorectal cancer (for the highest quintile [Q5] versus the lowest quintile [Q1], RR = 0.42, 95% CI = 0.23 to 0.78; P-trend = .01). The association was only slightly attenuated after adjustment for body mass index (Q5 versus Q1, RR = 0.48, 95% CI = 0.25 to 0-90; P-trend = .04) or for body mass index and other major risk factors for colorectal cancer (family history, physical activity, multivitamin use, smoking, alcohol, aspirin use, history of endoscopy, dietary calcium, folate, vitamin E, and vitamin D; Q5 versus Q1, multivariable RR = 0.50, 95% CI = 0.26 to 0.97; P-trend = .08). Relative risks were not linear in any of the analyses; the second quintile had a lower relative risk than the lowest quintile, but further decreases in risk were not evident with increasing levels of adiponectin. Conclusions: In this prospective nested case-control study, men with low plasma adiponectin levels had a higher risk of colorectal cancer than men with higher levels. More prospective observational studies, particularly in women, and mechanistic studies are required to fully understand the relationship between adiponectin and carcinogenesis.