Centre for Nutrition and Health, National Institute for Public Health and the Environment, 3720 BA Bilthoven, The Netherlands.
Gut. 2011 Aug;60(8):1094-102. doi: 10.1136/gut.2010.225011. Epub 2011 Mar 7.
To examine the association between serum concentrations of total cholesterol, high density lipoprotein cholesterol (HDL), low density lipoprotein cholesterol, triglycerides, apolipoprotein A-I (apoA), apolipoprotein B and the incidence of colorectal cancer (CRC).
Nested case-control study.
The study was conducted within the European Prospective Investigation into Cancer and Nutrition (EPIC), a cohort of more than 520,000 participants from 10 western European countries.
1238 cases of incident CRC, which developed after enrolment into the cohort, were matched with 1238 controls for age, sex, centre, follow-up time, time of blood collection and fasting status.
Serum concentrations were quantitatively determined by colorimetric and turbidimetric methods. Dietary and lifestyle data were obtained from questionnaires. Conditional logistic regression models were used to estimate incidence rate ratios (RRs) and 95% CIs which were adjusted for height, weight, smoking habits, physical activity, education, consumption of fruit, vegetables, meat, fish, alcohol, fibre and energy.
After adjustments, the concentrations of HDL and apoA were inversely associated with the risk of colon cancer (RR for 1 SD increase of 16.6 mg/dl in HDL and 32.0 mg/dl in apoA of 0.78 (95% CI 0.68 to 0.89) and 0.82 (95% CI 0.72 to 0.94), respectively). No association was observed with the risk of rectal cancer. Additional adjustment for biomarkers of systemic inflammation, insulin resistance and oxidative stress or exclusion of the first 2 years of follow-up did not influence the association between HDL and risk of colon cancer.
These findings show that high concentrations of serum HDL are associated with a decreased risk of colon cancer. The mechanism behind this association needs further elucidation.
探讨血清总胆固醇、高密度脂蛋白胆固醇（HDL）、低密度脂蛋白胆固醇、甘油三酯、载脂蛋白 A-I（apoA）、载脂蛋白 B 浓度与结直肠癌（CRC）发病风险的关系。
巢式病例对照研究。
本研究在欧洲癌症与营养前瞻性调查（EPIC）中进行，该队列纳入了来自 10 个西欧国家的 52 万余名参与者。
1238 例 CRC 病例为队列入组后新发 CRC，按年龄、性别、中心、随访时间、采血时间和禁食状态与 1238 例对照相匹配。
采用比色法和浊度法定量检测血清浓度。通过问卷收集饮食和生活方式数据。采用条件逻辑回归模型估计发病率比（RR）及其 95%置信区间（CI），并校正了身高、体重、吸烟习惯、体力活动、教育程度、水果、蔬菜、肉类、鱼类、酒精、纤维和能量的摄入量。
校正混杂因素后，HDL 和 apoA 浓度与结肠癌发病风险呈负相关（HDL 浓度每增加 16.6mg/dl 和 apoA 浓度每增加 32.0mg/dl，RR 分别为 0.78（95%CI 0.68 至 0.89）和 0.82（95%CI 0.72 至 0.94））。HDL 浓度与直肠癌发病风险无相关性。进一步校正全身炎症、胰岛素抵抗和氧化应激生物标志物或排除前 2 年随访数据，并不影响 HDL 与结肠癌发病风险之间的关联。
本研究结果表明，血清 HDL 浓度升高与结肠癌发病风险降低相关。其相关机制尚待进一步阐明。
