Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institute of Health, Bethesda, MD, USA.
Br J Cancer. 2010 Jun 29;103(1):115-9. doi: 10.1038/sj.bjc.6605706. Epub 2010 Jun 1.
Biliary tract cancers are rare but fatal malignancies. Diabetes has been related to biliary stones, but its association with biliary tract cancers is less conclusive.
In a population-based case-control study of 627 cancers, 1037 stones, and 959 controls in Shanghai, China, we examined the association between diabetes and the risks of biliary tract cancer and stones, as well as the effect of potential mediating factors, including serum lipids and biliary stones (for cancer), contributing to the causal pathway from diabetes to biliary diseases.
Independent of body mass index (BMI), diabetes was significantly associated with gallbladder cancer and biliary stones ((odds ratio (OR) (95% confidence interval)=2.6 (1.5-4.7) and 2.0 (1.2-3.3), respectively). Biliary stones and low serum levels of high-density lipoprotein (HDL) were significant mediators of the diabetes effect on gallbladder cancer risk, accounting for 60 and 17% of the diabetes effect, respectively. High-density lipoprotein was also a significant mediator of the diabetes effect on biliary stones, accounting for 18% of the diabetes effect.
Independent of BMI, diabetes is a risk factor for gallbladder cancer, but its effect is mediated in part by biliary stones and serum HDL levels, suggesting that gallbladder cancer risk may be reduced by controlling diabetes, stones, and HDL levels.
胆道癌是罕见但致命的恶性肿瘤。糖尿病与胆石症有关，但与胆道癌的关系尚不太明确。
在中国上海进行的一项基于人群的病例对照研究中，共纳入了 627 例癌症、1037 例胆石症和 959 例对照，我们研究了糖尿病与胆道癌和胆石症风险之间的关系，以及潜在的中介因素（包括血清脂质和胆石症（用于癌症））对糖尿病导致胆道疾病的因果途径的影响。
独立于体重指数（BMI），糖尿病与胆囊癌和胆石症显著相关（比值比（OR）（95%置信区间）分别为 2.6（1.5-4.7）和 2.0（1.2-3.3））。胆石症和血清高密度脂蛋白（HDL）水平低是糖尿病对胆囊癌风险影响的重要中介因素，分别占糖尿病影响的 60%和 17%。高密度脂蛋白也是糖尿病对胆石症影响的重要中介因素，占糖尿病影响的 18%。
独立于 BMI，糖尿病是胆囊癌的一个危险因素，但它的作用部分通过胆石症和血清 HDL 水平来介导，这表明通过控制糖尿病、胆石症和 HDL 水平可能降低胆囊癌风险。
