Feng Xiaoshuang, Wang Gang, Li Ni, Lyu Zhangyan, Chen Shuohua, Wei Luopei, Chen Yuheng, Xie Shuanghua, Yang Wenjing, Yin Jian, Cui Hong, Chen Hongda, Ren Jiansong, Shi Jufang, Wu Shouling, Dai Min, He Jie
National Cancer Centre/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100021, China.
Department of Oncology, Kailuan General Hospital, Tangshan 063000, China.
Br J Cancer. 2017 Oct 24;117(9):1405-1411. doi: 10.1038/bjc.2017.296. Epub 2017 Sep 5.
To investigate the association between fasting blood glucose (FBG) levels and the risk of incident primary liver cancer (PLC) in Chinese males, a large prospective cohort was performed in the current study.
A total of 109 169 males participating in the routine checkups every two years were recruited in the Kailuan male cohort study since May 2006. Cox proportional hazards regression models and restricted cubic spline (RCS) were used to evaluate the association between levels of baseline FBG and the risk of incident PLC.
Compared to the males with normal FBG (3.9⩽FBG<6.1 mmol l), the males with impaired fasting glucose (IFG: 6.1⩽FBG<7.0 mmol l) and diabetes mellitus (DM: FBG ⩾7.0 mmol l) had a 60% (95% CI: 1.09-2.35) and a 58% (95% CI: 1.07-2.34) higher risk of incident PLC, respectively. Subgroup analysis found that IFG increased the risk of PLC among the non-smoker (HR=1.73, 95% CI: 1.01-2.98) and current alcohol drinker (HR=1.80, 95% CI: 1.03-3.16). While DM increased the risk of PLC especially among the males with normal BMI (<25 kg m) (HR=1.76, 95% CI: 1.05-2.94) and the HBV negativity (HR=1.89, 95% CI: 1.16-3.09), RCS analysis showed a positive non-linearly association between the FBG levels and the risk of PLC (p-overall=0.041, p-non-linear=0.049).
Increased FBG may be an important and potentially modifiable exposure that could have key scientific and clinical importance for preventing PLC development.
为了研究中国男性空腹血糖（FBG）水平与原发性肝癌（PLC）发病风险之间的关联，本研究开展了一项大型前瞻性队列研究。
自2006年5月起，开滦男性队列研究招募了总共109169名每两年参加一次常规体检的男性。采用Cox比例风险回归模型和限制性立方样条（RCS）来评估基线FBG水平与PLC发病风险之间的关联。
与空腹血糖正常（3.9⩽FBG<6.1 mmol/l）的男性相比，空腹血糖受损（IFG：6.1⩽FBG<7.0 mmol/l）和糖尿病（DM：FBG⩾7.0 mmol/l）的男性发生PLC的风险分别高60%（95%CI：1.09 - 2.35）和58%（95%CI：1.07 - 2.34）。亚组分析发现，IFG增加了非吸烟者（HR = 1.73，95%CI：1.01 - 2.98）和当前饮酒者（HR = 1.80，95%CI：1.03 - 3.16）发生PLC的风险。而DM增加了PLC的风险，尤其是在体重指数正常（<25 kg/m）的男性（HR = 1.76，95%CI：1.05 - 2.94）和乙肝病毒阴性的男性（HR = 1.89，95%CI：1.16 - 3.09）中。RCS分析显示FBG水平与PLC风险之间存在正的非线性关联（总体p = 0.041，非线性p = 0.049）。
空腹血糖升高可能是一种重要且潜在可改变的暴露因素，对于预防PLC的发生可能具有关键的科学和临床意义。
