Population-attributable fractions of risk factors for hepatocellular carcinoma in the United States.
Population-attributable fractions of risk factors for hepatocellular carcinoma in the United States.
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DOI：
10.1038/ajg.2013.160
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发表时间：
2013-08
影响因子：
9.8
通讯作者：
McGlynn, Katherine A.
中科院分区：
文献类型：
--
作者：
Welzel, Tania M.;Graubard, Barry I.;Quraishi, Sabah;Zeuzem, Stefan;Davila, Jessica A.;El-Serag, Hashem B.;McGlynn, Katherine A.
肝细胞癌（HCC）的风险因素包括B和C型肝炎病毒（HBV、HCV）、过量饮酒、罕见遗传疾病和糖尿病/肥胖。然而，这些因素的人群归因分数（PAF）尚未在美国的基于人群的研究中进行研究。1994年至2007年期间诊断为HCC的≥ 68岁患者（n = 6，991）在SEER-Medicare数据库中确定。选择居住在SEER地点的5%随机样本（n = 255，702）进行比较。对于每个风险因素，计算比值比（OR）、95%置信区间（95% CI）和PAF。正如预期的那样，HCC的风险增加与以下每个因素有关：（OR 39.89，95% CI：36.29-43.84），HBV（OR 11.17，95% CI：9.18-13.59），酒精相关疾病（OR 4.06，95% CI：3.82-4.32）、罕见代谢紊乱（OR 3.45，95% CI：2.97-4.02）和糖尿病和/或肥胖（OR 2.47，95% CI：2.34-2.61）。所有因素合并的PAF为64.5%（男性65.6%;女性62.2%）。PAF在亚洲人中最高（70.1%），在黑人中最低（52.4%）。在个体因素中，糖尿病/肥胖具有最大的PAF（36.6%），其次是酒精相关疾病（23.5%）、HCV（22.4%）、HBV（6.3%）和罕见遗传疾病（3.2%）。虽然糖尿病/肥胖在男性（36.4%）和女性（36.7%）中具有最大的PAF，但酒精相关疾病在男性（27.8%）中具有第二大PAF，HCV在女性中具有第二大PAF（28.1%）。糖尿病/肥胖在白人（38.9%）和西班牙裔（38.1%）中具有最大的PAF，而HCV在亚洲人（35.4%）和黑人（34.9%）中具有最大的PAF。第二大PAF是白人（25.6%）、西班牙裔（30.1%）和黑人（18.5%）的酒精相关疾病，以及亚洲人（28.5%）的HBV。美国≥68岁人群中HCC的主要风险因素因性别和人种/种族而异。总的来说，消除糖尿病/肥胖可以降低HCC的发病率，而不是消除任何其他因素。
Risk factors for hepatocellular carcinoma (HCC) include hepatitis B and C viruses (HBV, HCV), excessive alcohol consumption, rare genetic disorders and diabetes/obesity. The population attributable fractions (PAF) of these factors, however, have not been investigated in population-based studies in the United States. Persons ≥ 68 years diagnosed with HCC (n = 6,991) between 1994 and 2007 were identified in the SEER-Medicare database. A 5 % random sample (n = 255,702) of persons residing in SEER locations were selected for comparison. For each risk factor, odds ratios (ORs), 95 % confidence intervals (95 % CI) and PAFs were calculated. As anticipated, the risk of HCC was increased in relationship to each factor: HCV (OR 39.89, 95 % CI: 36.29–43.84), HBV (OR 11.17, 95 % CI: 9.18–13.59), alcohol-related disorders (OR 4.06, 95 % CI: 3.82–4.32), rare metabolic disorders (OR 3.45, 95 % CI: 2.97–4.02), and diabetes and/or obesity (OR 2.47, 95 % CI: 2.34–2.61). The PAF of all factors combined was 64.5 % (males 65.6 % ; females 62.2 %). The PAF was highest among Asians (70.1 %) and lowest among black persons (52.4 %). Among individual factors, diabetes/obesity had the greatest PAF (36.6 %), followed by alcohol-related disorders (23.5 %), HCV (22.4 %), HBV (6.3 %) and rare genetic disorders (3.2 %). While diabetes/obesity had the greatest PAF among both males (36.4 %) and females (36.7 %), alcohol-related disorders had the second greatest PAF among males (27.8 %) and HCV the second greatest among females (28.1 %). Diabetes/obesity had the greatest PAF among whites (38.9 %) and Hispanics (38.1 %), while HCV had the greatest PAF among Asians (35.4 %) and blacks (34.9 %). The second greatest PAF was alcohol-related disorders in whites (25.6 %), Hispanics (30.1 %) and blacks (and 18.5 %) and HBV in Asians (28.5 %). The dominant risk factors for HCC in the United States among persons ≥68 years differ by sex and race/ethnicity. Overall, eliminating diabetes/obesity could reduce the incidence of HCC more than the elimination of any other factor.
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DOI：
10.1136/bmj.d1584
发表时间：
2011-04-07
期刊：
BMJ (Clinical research ed.)
影响因子：
--
作者：
Schütze M;Boeing H;Pischon T;Rehm J;Kehoe T;Gmel G;Olsen A;Tjønneland AM;Dahm CC;Overvad K;Clavel-Chapelon F;Boutron-Ruault MC;Trichopoulou A;Benetou V;Zylis D;Kaaks R;Rohrmann S;Palli D;Berrino F;Tumino R;Vineis P;Rodríguez L;Agudo A;Sánchez MJ;Dorronsoro M;Chirlaque MD;Barricarte A;Peeters PH;van Gils CH;Khaw KT;Wareham N;Allen NE;Key TJ;Boffetta P;Slimani N;Jenab M;Romaguera D;Wark PA;Riboli E;Bergmann MM
通讯作者：
Bergmann MM
影响因子：
8.4
作者：
Braga, C;LaVecchia, C;Franceschi, S
通讯作者：
Franceschi, S
影响因子：
5
作者：
MIETTINE.OS
通讯作者：
MIETTINE.OS
影响因子：
12.7
作者：
McQuillan, GM;Kruszon-Moran, D;Kington, RS
通讯作者：
Kington, RS
影响因子：
13.5
作者：
Donato, F;Tagger, A;Nardi, G
通讯作者：
Nardi, G