Wulaningsih Wahyu, Garmo Hans, Holmberg Lars, Hammar Niklas, Jungner Ingmar, Walldius Göran, Van Hemelrijck Mieke
Cancer Epidemiology Group, Division of Cancer Studies, School of Medicine, King's College London, London, UK.
J Cancer Epidemiol. 2012;2012:792034. doi: 10.1155/2012/792034. Epub 2012 Aug 30.
Background. Metabolic syndrome has been linked to an increased cancer risk, but the role of dyslipidaemia in gastrointestinal malignancies is unclear. We aimed to assess the risk of oesophageal, stomach, colon, and rectal cancers using serum levels of lipid components. Methods. From the Swedish Apolipoprotein Mortality Risk (AMORIS) study, we selected 540,309 participants (> 20 years old) with baseline measurements of total cholesterol (TC), triglycerides (TG), and glucose of whom 84,774 had baseline LDL cholesterol (LDL), HDL cholesterol (HDL), apolipoprotein B (apoB), and apolipoprotein A-I (apoA-I). Multivariate Cox proportional hazards regression was used to assess glucose and lipid components in relation to oesophageal, stomach, colon, and rectal cancer risk. Results. An increased risk of oesophageal cancer was observed in persons with high TG (e.g. HR: 2.29 (95% CI: 1.42-3.68) for the 4th quartile compared to the 1st) and low LDL, LDL/HDL ratio, TC/HDL ratio, log (TG/HDL), and apoB/apoA-I ratio. High glucose and TG were linked with an increased colon cancer risk, while high TC levels were associated with an increased rectal cancer risk. Conclusion. The persistent link between TC and rectal cancer risk as well as between TG and oesophageal and colon cancer risk in normoglycaemic individuals may imply their substantiality in gastrointestinal carcinogenesis.
背景。代谢综合征与癌症风险增加有关，但血脂异常在胃肠道恶性肿瘤中的作用尚不清楚。我们旨在利用血脂成分的血清水平评估食管癌、胃癌、结肠癌和直肠癌的风险。方法。从瑞典载脂蛋白死亡率风险（AMORIS）研究中，我们选取了540309名参与者（年龄>20岁），他们有总胆固醇（TC）、甘油三酯（TG）和血糖的基线测量值，其中84774人有低密度脂蛋白胆固醇（LDL）、高密度脂蛋白胆固醇（HDL）、载脂蛋白B（apoB）和载脂蛋白A-I（apoA-I）的基线测量值。多变量Cox比例风险回归用于评估血糖和血脂成分与食管癌、胃癌、结肠癌和直肠癌风险的关系。结果。在高TG人群中观察到食管癌风险增加（例如，与第一四分位数相比，第四四分位数的风险比：2.29（95%置信区间：1.42-3.68）），以及低LDL、LDL/HDL比值、TC/HDL比值、log（TG/HDL）和apoB/apoA-I比值。高血糖和高TG与结肠癌风险增加有关，而高TC水平与直肠癌风险增加有关。结论。在血糖正常的个体中，TC与直肠癌风险以及TG与食管癌和结肠癌风险之间的持续关联可能意味着它们在胃肠道致癌过程中的重要性。
