Hematological Research Group (HERG), Department of Clinical Medicine, University of Tromsø, N-9037, Tromsø, Norway,
Eur J Epidemiol. 2015 Mar;30(3):219-30. doi: 10.1007/s10654-014-9975-3. Epub 2014 Dec 2.
The purpose was to investigate the association between serum osteoprotegerin (OPG) and risk of incident cancer and cancer mortality in a general population. OPG was measured in serum collected from 6,279 subjects without prior cancer recruited from a general population. Incident cancer and cancer-related mortality were registered from inclusion in 1994-95 until end of follow-up December 31, 2008. Cox regression models were used to estimate crude and adjusted (for age, sex and other confounders) hazard ratios and 95% confidence intervals (HR 95% CI). There were 948 incident cancers and 387 deaths in the cohort during 71,902 person-years of follow up (median 13.5 years). Subjects with serum OPG in the upper tertile had 79% higher risk of incident gastrointestinal cancer than those in the lowest tertile (HR 1.79, 95% CI 1.19-2.67). In women <60 years, serum OPG (per SD 0.81 ng/ml) was associated with reduced risk of incident cancer (all cancers merged; 0.73; 0.57-0.94) and breast cancer (0.51; 0.31-0.83) after adjustment. Subjects in the upper tertile of OPG had higher risk of cancer-related mortality (1.63; 1.16-2.28), particularly mortality from cancer in the gastrointestinal system (2.28; 1.21-4.28) compared to those in the lowest OPG tertile. No significant association was detected between OPG and risk of death from cancer in the respiratory system or death from prostatic cancer. Our findings from a large population based cohort study suggest that serum OPG was associated with increased risk of incident gastrointestinal cancer, inversely associated with breast cancer, and predicts cancer-related mortality.
目的在于探究在一般人群中，血清护骨素（OPG）与癌症发病风险和癌症死亡率之间的相关性。研究人员在一个普通人群中，从 6279 名未患有癌症的研究对象采集血清样本，并测量其中的 OPG 水平。从 1994 年 9 月至 1995 年 1 月开始纳入研究对象，随访直至 2008 年 12 月 31 日。采用 Cox 回归模型估计了粗风险比（HR）和调整后风险比（校正年龄、性别和其他混杂因素）及 95%置信区间（95%CI）。在 71902 人年的随访期间，队列中共有 948 例新发癌症和 387 例癌症相关死亡。与血清 OPG 最低三分位组相比，血清 OPG 最高三分位组的新发胃肠道癌症风险增加 79%（HR 1.79，95%CI 1.19-2.67）。对于年龄<60 岁的女性，血清 OPG（每 SD 0.81ng/ml）与癌症总发病风险降低相关（所有癌症合并；0.73，0.57-0.94），与乳腺癌发病风险降低相关（0.51，0.31-0.83）。OPG 最高三分位组的癌症相关死亡率更高（1.63，1.16-2.28），尤其是胃肠道系统癌症相关死亡率（2.28，1.21-4.28）高于 OPG 最低三分位组。OPG 与呼吸系统癌症死亡风险或前列腺癌死亡风险之间未检测到显著相关性。本大规模基于人群的队列研究结果表明，血清 OPG 与新发胃肠道癌症风险增加相关，与乳腺癌发病风险降低相关，并可预测癌症相关死亡率。
