Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, Massachusetts.
Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, Massachusetts.
Cancer Epidemiol Biomarkers Prev. 2018 Jul;27(7):719-727. doi: 10.1158/1055-9965.EPI-17-1052. Epub 2018 Apr 10.
Circadian misalignment may increase the risk of developing hepatocellular carcinoma (HCC). The aim of this study was to examine the association between distance from time zone meridian, a proxy for circadian misalignment, and HCC risk in the United States adjusting for known HCC risk factors. Surveillance, Epidemiology, and End Results (SEER) provided information on 56,347 HCC cases diagnosed between 2000 and 2014 from 16 population-based cancer registries in the United States. Distance from time zone meridian was estimated using the location of each SEER county's Center of Population in a geographic information system. Poisson regression with robust variance estimation was used to calculate incidence rate ratios (IRRs) and 95% confidence intervals (CIs) for the association between distance from time zone meridian and HCC risk adjusting for individual-level age at diagnosis, sex, race/ethnicity, year of diagnosis, SEER registry, and county-level prevalence of health conditions, lifestyle factors, shift work occupation, socioeconomic status, and demographic and environmental factors. A 5-degree increase in longitude moving east to west within a time zone was associated with a statistically significant increased risk for HCC (IRR, 1.07; 95% CI, 1.01-1.14, = 0.03). A statistically significant positive association was observed among those <65 years old, while no association was observed among individuals ≥65 years old ( < 0.01). Circadian misalignment from residing in the western region of a time zone may impact hepatocarcinogenesis. Circadian misalignment may be an independent risk factor for HCC. .
昼夜节律紊乱可能会增加罹患肝细胞癌（HCC）的风险。本研究旨在探讨美国昼夜节律紊乱的时间带子午线距离（昼夜节律紊乱的替代指标）与 HCC 风险之间的关联，并在调整已知 HCC 风险因素后进行分析。美国的监测、流行病学和最终结果（SEER）数据库提供了 1965 年至 2014 年期间，来自美国 16 个基于人群的癌症登记处的 56347 例 HCC 病例的信息。使用地理信息系统中每个 SEER 县人口中心的位置来估算时间带子午线的距离。泊松回归分析和稳健方差估计用于计算距离时间带子午线的距离与 HCC 风险之间的关联的发病率比（IRR）和 95%置信区间（CI），并在个体水平上调整诊断时的年龄、性别、种族/族裔、诊断年份、SEER 登记处以及县一级的健康状况、生活方式因素、轮班工作职业、社会经济地位以及人口和环境因素。在一个时区范围内，经度每向东或向西移动 5 度，与 HCC 的风险增加具有统计学显著相关性（IRR，1.07；95%CI，1.01-1.14，=0.03）。在年龄<65 岁的人群中观察到统计学显著的正相关，而在年龄≥65 岁的人群中则未观察到相关性（<0.01）。居住在时区的西部可能会导致昼夜节律紊乱，从而影响肝癌的发生。昼夜节律紊乱可能是 HCC 的一个独立危险因素。
