Time-dependent association of total serum cholesterol and cancer incidence in a cohort of 172 210 men and women: a prospective 19-year follow-up study
Time-dependent association of total serum cholesterol and cancer incidence in a cohort of 172 210 men and women: a prospective 19-year follow-up study
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DOI：
10.1093/annonc/mdn736
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发表时间：
2009-06-01
影响因子：
50.5
通讯作者：
Ulmer, H.
中科院分区：
文献类型：
--
作者：
Strasak, A. M.;Pfeiffer, R. M.;Ulmer, H.
背景：血清胆固醇与癌症发病率之间的关系仍存在争议。患者和方法：我们在一个由 172 210 名奥地利成年人组成的人群队列中研究了总血清胆固醇 (TSC) 与随后癌症发病率的关系，前瞻性随访中位数为 13.0 年。使用考虑到时间依赖性效应的 Cox 回归来估计 TSC 与癌症关联的调整后风险比 (HR)（95% 置信区间 (95% CI)）。结果：我们观察到男性和女性中 TSC 与总体癌症发病率之间存在显着的短期关联。对于基线 TSC 测量后不久（< 5 个月）诊断出的恶性肿瘤，与最低三分位数（男性 < 194.0 mg/dl，女性 < 190.0）相比，最高 TSC 三分位数（男性 > 235.0 mg/dl，女性 > 229.0）与显着较低的总体癌症风险相关 [HR = 0.58（95% CI 0.43-0.78，男性中 P-趋势 = 0.0001)，女性中 HR = 0.69 (95% CI 0.49-0.99，P-趋势 = 0.03)]。然而，在基线测量大约 5 个月后，总体癌症风险与 TSC 没有显着相关性。 TSC 与癌症的短期负相关主要是由消化器官、淋巴和造血组织的恶性肿瘤驱动的。结论：高水平 TSC 所见的癌症风险的短期下降可能在很大程度上反映了癌症对 TSC 的临床前影响。
Background: The relationship between serum cholesterol and cancer incidence remains controversial.Patients and methods: We investigated the association of total serum cholesterol (TSC) with subsequent cancer incidence in a population-based cohort of 172 210 Austrian adults prospectively followed up for a median of 13.0 years. Cox regression, allowing for time-dependent effects, was used to estimate adjusted hazard ratios (HRs) with 95% confidence intervals (95% CIs) for the association of TSC with cancer.Results: We observed pronounced short-term associations of TSC and overall cancer incidence in both men and women. For malignancies diagnosed shortly (< 5 months) after baseline TSC measurement, the highest TSC tertile (> 235.0 mg/dl in men and > 229.0 in women) compared with the lowest tertile (< 194.0 mg/dl in men and < 190.0 in women) was associated with a significantly lower overall cancer risk [HR = 0.58 (95% CI 0.43-0.78, P-trend = 0.0001) in men, HR = 0.69 (95% CI 0.49-0.99, P-trend = 0.03) in women]. However, after roughly 5 months from baseline measurement, overall cancer risk was not significantly associated with TSC. The short-term inverse association of TSC with cancer was mainly driven by malignancies of the digestive organs and lymphoid and hematopoietic tissue.Conclusion: The short-term decrease of cancer risk seen for high levels of TSC may largely capture preclinical effects of cancer on TSC.