Brauer Paula M, McKeown-Eyssen Gail E, Jazmaji Vartouhi, Logan Alexander G, Andrews David F, Jenkins David, Marcon Norman, Saibil Fred, Cohen Lawrence, Stern Hartley, Baron David, Greenberg Gordon, Diamandis Eleftherios, Kakis Gary, Singer William, Steiner George
Department of Public Health Sciences, University of Toronto, Ontario, Canada.
Am J Epidemiol. 2002 Oct 15;156(8):702-13. doi: 10.1093/aje/kwf112.
Familial aggregation of diseases potentially associated with metabolic syndrome (diabetes mellitus, hypertension, and cardiovascular diseases) was assessed in a colonoscopy-based case-control study of colorectal neoplasia in Toronto and Ottawa, Canada, in 1993-1996. Each familial disease was analyzed by logistic regression using generalized estimating equations. Case probands had incident adenomatous polyps (n = 172) or incident (n = 25) or prevalent (n = 132) colorectal cancer (CRC), while control probands (n = 282) had a negative colonoscopy and no history of CRC or polyps. Significant effect modification was evident in the data, with the strongest positive associations between familial diabetes and colorectal neoplasia among older probands with symptoms (parents: odds ratio (OR) = 2.4, 95% confidence interval (CI): 1.2, 4.8; siblings: OR = 5.8, 95% CI: 2.6, 13.3). Familial hypertension was also associated with colorectal neoplasia among probands with symptoms (OR = 1.7, 95% CI: 1.1, 2.6). In stratified analyses, familial diabetes, hypertension, and stroke were positively associated with adenomatous polyps in subgroups of probands who were older and/or had symptoms, while only familial diabetes was possibly associated with CRC. Associations in other proband groups may have been obscured by high cumulative incidence of parental CRC. Family studies are needed to understand the contribution of specific environmental and genetic factors in accounting for the disease aggregations.
1993 - 1996年在加拿大多伦多和渥太华进行的一项基于结肠镜检查的结直肠肿瘤病例对照研究中，评估了与代谢综合征（糖尿病、高血压和心血管疾病）潜在相关疾病的家族聚集性。每种家族性疾病均使用广义估计方程通过逻辑回归进行分析。病例组先证者患有新发腺瘤性息肉（n = 172）或新发（n = 25）或现患（n = 132）结直肠癌（CRC），而对照组先证者（n = 282）结肠镜检查结果为阴性且无CRC或息肉病史。数据中存在明显的显著效应修正，在有症状的老年先证者中，家族性糖尿病与结直肠肿瘤之间的正相关性最强（父母：比值比（OR）= 2.4，95%置信区间（CI）：1.2，4.8；兄弟姐妹：OR = 5.8，95% CI：2.6，13.3）。家族性高血压在有症状的先证者中也与结直肠肿瘤相关（OR = 1.7，95% CI：1.1，2.6）。在分层分析中，家族性糖尿病、高血压和中风在年龄较大和/或有症状的先证者亚组中与腺瘤性息肉呈正相关，而只有家族性糖尿病可能与CRC相关。其他先证者组中的关联可能因父母CRC的高累积发病率而被掩盖。需要进行家族研究以了解特定环境和遗传因素在解释疾病聚集方面的作用。
