Lipid biomarkers and long-term risk of cancer in the Women's Health Study
Lipid biomarkers and long-term risk of cancer in the Women's Health Study
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DOI：
10.3945/ajcn.115.124321
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发表时间：
2016-06-01
影响因子：
7.1
通讯作者：
Wang, Lu
中科院分区：
文献类型：
--
作者：
Chandler, Paulette D.;Song, Yiqing;Wang, Lu
背景资料：脂质生物标志物，如HDL-胆固醇浓度，已被证明与总风险、乳腺癌风险和结直肠癌风险有正相关、负相关和零相关。载脂蛋白A-I和载脂蛋白B-100等新型脂质生物标志物的研究（apo B-100），和癌症的风险已经稀疏，据我们所知。目的：我们评估了15个受试者的总癌、乳腺癌、结直肠癌和肺癌以及癌症死亡率与循环脂质生物标志物的前瞻性相关性，女性健康研究中的602名女性卫生专业人员（年龄≥ 45岁，无心血管疾病和癌症，基线时未接受激素替代疗法或降脂药物）。设计图：考克斯回归模型估计HR的癌症终点（19年的中位数随访）跨四分位数1（参考）至4的每种脂质生物标志物调整后的癌症风险factors.Results：确认的情况下，包括2163例癌症事件（864乳腺癌，198结直肠癌，190肺癌）和647癌症死亡。载脂蛋白A-I（校正HR：0.79; 95% CI：0.70，0.90; P趋势= 0.0008）和HDL胆固醇（HR：0.85; 95% CI：0.75，0.97; P趋势= 0.01）的最高四分位数的总癌症风险显著降低。对于特定部位的癌症，显着的关联包括结直肠癌风险与HDL胆固醇（HR：0.63; 95% CI; 0.41，0.98; P趋势= 0.03），甘油三酯（HR：1.86; 95% CI：1.17，2.97; P趋势= 0.02），载脂蛋白B-100（HR：1.60; 95% CI：1.03，2.49; P趋势= 0.006）和肺癌风险与HDL胆固醇（HR：0.59; 95% CI：0.38，0.93; P趋势= 0.01）。LDL胆固醇与总癌症或任何部位特异性癌症的风险无显著相关性。在调整基线后使用降脂药物的时间依赖性模型中，这些关联仍然存在。结论：血脂与女性总的肺癌和结直肠癌风险相关。为预防心脏病而进行的生活方式干预，降低载脂蛋白B-100或升高高密度脂蛋白胆固醇，可能与降低癌症风险有关。
Background: Lipid biomarkers, such as HDL-cholesterol concentrations, have been shown to have positive, inverse, and null associations with total, breast, and colorectal cancer risks. Studies of novel lipid biomarkers, such as apolipoprotein A-I (apo A-I) and apolipoprotein B-100 (apo B-100), and cancer risk have been sparse, to our knowledge.Objectives: We evaluated the prospective association of total, breast, colorectal, and lung cancers and cancer mortality with circulating lipid biomarkers in 15,602 female health professionals in the Women's Health Study (aged >= 45 y, free of cardiovascular disease and cancer, and without hormone replacement therapy or lipid-lowering medications at baseline). Design: Cox regression models estimated HRs of cancer endpoints (19 y median follow-up) across quartiles 1 (reference) to 4 of each lipid biomarker after adjustment for cancer risk factors.Results: Confirmed cases included 2163 incident cancer cases (864 breast, 198 colorectal, and 190 lung cancers) and 647 cancer deaths. Total cancer risk was significantly lower in the highest quartile of apo A-I (adjusted HR: 0.79; 95% CI: 0.70, 0.90; P-trend = 0.0008) and HDL cholesterol (HR: 0.85; 95% CI: 0.75, 0.97; P-trend = 0.01). For site-specific cancers, significant associations included colorectal cancer risk with HDL cholesterol (HR: 0.63; 95% CI; 0.41, 0.98; P-trend = 0.03), triglycerides (HR: 1.86; 95% CI: 1.17, 2.97; P-trend = 0.02), and apo B-100 (HR: 1.60; 95% CI: 1.03, 2.49; P-trend = 0.006) and lung cancer risk with HDL cholesterol (HR: 0.59; 95% CI: 0.38, 0.93; P-trend = 0.01). LDL cholesterol was not significantly associated with risk of total cancer or any site-specific cancers. In time-dependent models that were adjusted for the use of a lipid-lowering medication after baseline, these associations remained.Conclusions: Lipids were associated with total, lung, and colorectal cancer risks in women. Lifestyle interventions for heart-disease prevention, which reduce apo B-100 or raise HDL cholesterol, may be associated with reduced cancer risk.