Hang Junjie, Cai Binxin, Xue Peng, Wang Lei, Hu Hai, Zhou Yangyang, Ren Shujuan, Wu Jiajin, Zhu Meiying, Chen Donghui, Yang Haiyan, Wang Liwei
Department of Oncology and Pancreatic Cancer Center, Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.
Shanghai Key Laboratory of Pancreatic Disease, Shanghai, China.
PLoS One. 2015 Dec 28;10(12):e0143696. doi: 10.1371/journal.pone.0143696. eCollection 2015.
Colorectal cancer (CRC) is a major cause of cancer morbidity and mortality. In previous epidemiologic studies, the respective correlation between lifestyle factors and comorbidity and CRC has been extensively studied. However, little is known about their joint effects on CRC.
We conducted a retrospective case-control study of 1,144 diagnosed CRC patients and 60,549 community controls. A structured questionnaire was administered to the participants about their socio-demographic factors, anthropometric measures, comorbidity history and lifestyle factors. Logistic regression model was used to calculate the odds ratio (ORs) and 95% confidence intervals (95%CIs) for each factor. According to the results from logistic regression model, we further developed healthy lifestyle index (HLI) and comorbidity history index (CHI) to investigate their independent and joint effects on CRC risk.
Four lifestyle factors (including physical activities, sleep, red meat and vegetable consumption) and four types of comorbidity (including diabetes, hyperlipidemia, history of inflammatory bowel disease and polyps) were found to be independently associated with the risk of CRC in multivariant logistic regression model. Intriguingly, their combined pattern- HLI and CHI demonstrated significant correlation with CRC risk independently (ORHLI: 3.91, 95%CI: 3.13-4.88; ORCHI: 2.49, 95%CI: 2.11-2.93) and jointly (OR: 10.33, 95%CI: 6.59-16.18).
There are synergistic effects of lifestyle factors and comorbidity on the risk of colorectal cancer in the Chinese population.
结直肠癌（CRC）是癌症发病和死亡的主要原因。在以往的流行病学研究中，生活方式因素与合并症和结直肠癌之间的各自相关性已得到广泛研究。然而，它们对结直肠癌的联合影响却知之甚少。
我们对1144例确诊的结直肠癌患者和60549名社区对照进行了一项回顾性病例对照研究。通过结构化问卷向参与者询问其社会人口统计学因素、人体测量指标、合并症病史和生活方式因素。使用逻辑回归模型计算每个因素的比值比（OR）和95%置信区间（95%CI）。根据逻辑回归模型的结果，我们进一步制定了健康生活方式指数（HLI）和合并症病史指数（CHI），以研究它们对结直肠癌风险的独立和联合影响。
在多变量逻辑回归模型中，发现四种生活方式因素（包括体育活动、睡眠、红肉和蔬菜消费）和四种合并症类型（包括糖尿病、高脂血症、炎症性肠病病史和息肉）与结直肠癌风险独立相关。有趣的是，它们的组合模式——HLI和CHI分别（ORHLI：3.91，95%CI：3.13 - 4.88；ORCHI：2.49，95%CI：2.11 - 2.93）和联合（OR：10.33，95%CI：6.59 - 16.18）与结直肠癌风险呈现出显著相关性。
在中国人群中，生活方式因素和合并症对结直肠癌风险存在协同作用。
