A retrospective cohort study for investigating a high risk association of serum lipid, gluclose tolerace to cancer incidence among A-bomb survivors

脂质或葡萄糖代谢与癌症之间的关系尚未阐明。我们在1983年至1985年期间对516名长崎原子弹爆炸幸存者进行了75克口服葡萄糖耐量试验（75克OGTT）和血脂测定。不包括那些在基线检查时已经患有癌症的人和那些在基线检查后五年内患上癌症或死于任何原因的人，我们确定了2000年之前剩下的451名受试者的癌症发病率，（214名男性和237名女性），并通过考克斯比例风险模型评估葡萄糖或脂质代谢是否预测癌症发展。癌症发生的校正相对危险度为0.903（95%置信区间（95%CI），0.842-0.968），1.740（95% CI，1.238-2.446），1.653（95% CI，0.922-2.965）和1.024总胆固醇（10 mg/dl）、辐射剂量（1 Sv，吸烟）和75 g OGTT时1小时血糖（1h BG; 10 mg/dl）的95% CI分别为0.996-1.053。对年龄、性别、吸烟、体重指数、lh血糖、甘油三酯、总胆固醇、高密度脂蛋白胆固醇和辐射剂量的多元回归分析也显示，总胆固醇与辐射剂量呈负相关，（RR，0.876; 95% CI，0.791-0.957）与放射剂量呈正相关（RR，1.809; 95% CI，1.252-2.613），胆固醇与肿瘤发生呈负相关，放射剂量与肿瘤发生呈独立正相关。

The relationship between lipid or glucose metabolism and cancer has not yet been elucidated. We conducted 75g oral glucose tolerance tests (75g OGTT) and lipid measurements between 1983 and 1985 in 516 Nagasaki atomic bomb survivors. Excluding those who already had cancer at the baseline examinations and those who developed cancers or died of any cause within five years after the baseline examinations, we determined incident cancer cases until 2000 in the remaining 451 subjects (214 males and 237 females) and evaluated whether glucose or lipid metabolism predicts cancer development by means of Cox proportional hazard model.The age- and sex-adjusted relative risk (RR) for incident cancer was 0.903 (95% confidence interval (95%CI), 0.842-0.968), 1.740 (95% CI, 1.238-2.446), 1.653 (95% CI, 0.922-2.965) and 1.024 (95% CI, 0.996-1.053) for total cholesterol (10mg/dl), radiation dose (1Sv, smoking and 1-hour blood glucose (1h BG; 10mg/dl) in 75g OGTT, respectively. Multiple regression analysis of age, sex, smoking, body mass index, lh BG, triglycerides, total cholesterol, HDL cholesterol, and radiation dose also showed that total cholesterol was negatively (RR, 0.876; 95% CI, 0.791-0.957) and radiation dose positively (RR, 1.809; 95% CI, 1.252-2.613) related to incident cancer.Cholesterol could be negatively and radiation dose positively associated with cancer development independently.