Mainous Arch G, Wells Brian J, Koopman Richelle J, Everett Charles J, Gill James M
Department of Family Medicine, Medical University of South Carolina, 295 Calhoun Street, Charleston, SC 29425, USA.
Am J Epidemiol. 2005 Jun 15;161(12):1115-22. doi: 10.1093/aje/kwi131.
Iron and lipids combine to create oxidative stress, and oxidative stress has a role in the development of cancer. The objective was to determine the risk of cancer among persons who had both elevated iron and lipids. The authors conducted an analysis of the cohort available in the Framingham Offspring Study. Adults aged 30 or more years at baseline had serum iron and high density lipoprotein cholesterol (HDL-C), low density lipoprotein cholesterol, and very low density lipoprotein cholesterol (VLDL-C) assessed in 1979-1982 and were followed for development of cancer until 1996-1997 (n = 3,278). Cox regression models were computed while controlling for age, gender, smoking status, and body mass index. In adjusted models, both elevated iron (hazard ratio (HR) = 1.66, 95% confidence interval (CI): 1.11, 2.46; 29 cases) and VLDL-C (HR = 1.54, 95% CI: 1.04, 2.28; 93 cases) had significant independent risks for development of cancer. When elevated iron was combined with elevated VLDL-C, the adjusted relative risk of cancer increased (HR = 2.68, 95% CI: 1.49, 4.83; 18 cases). Elevated iron and low HDL-C also had a significant adjusted relative risk of cancer (HR = 2.82, 95% CI: 1.50, 5.28; 14 cases). The results suggest that elevated serum iron levels coupled with either high VLDL-C or low HDL-C appear to interact to increase cancer risk in this cohort.
铁与脂质结合会产生氧化应激,而氧化应激在癌症发展过程中发挥作用。目的是确定铁和脂质均升高的人群患癌症的风险。作者对弗雷明汉后代研究中的队列进行了分析。基线时年龄在30岁及以上的成年人于1979 - 1982年进行了血清铁、高密度脂蛋白胆固醇(HDL - C)、低密度脂蛋白胆固醇和极低密度脂蛋白胆固醇(VLDL - C)的评估,并随访至1996 - 1997年以观察癌症发生情况(n = 3278)。在控制年龄、性别、吸烟状况和体重指数的同时计算了Cox回归模型。在调整模型中,铁升高(风险比(HR)= 1.66,95%置信区间(CI):1.11,2.46;29例)和VLDL - C升高(HR = 1.54,95% CI:1.04,2.28;93例)在癌症发生方面均具有显著的独立风险。当铁升高与VLDL - C升高同时存在时,癌症的调整后相对风险增加(HR = 2.68,95% CI:1.49,4.83;18例)。铁升高和HDL - C降低在调整后也具有显著的癌症相对风险(HR = 2.82,95% CI:1.50,5.28;14例)。结果表明,在该队列中,血清铁水平升高与高VLDL - C或低HDL - C似乎相互作用增加了癌症风险。