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非酒精性脂肪性肝病和代谢综合征对中国女性结直肠癌死亡率的综合影响:一项回顾性研究。

The combined effect of non-alcoholic fatty liver disease and metabolic syndrome on colorectal carcinoma mortality: a retrospective in Chinese females.

机构信息

Department of Gastroenterology, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, 325000, Zhejiang, People's Republic of China.

出版信息

World J Surg Oncol. 2018 Aug 10;16(1):163. doi: 10.1186/s12957-018-1461-z.

Abstract

BACKGROUND

This research aimed to investigate whether metabolic syndrome (MetS) and non-alcoholic fatty liver disease (NAFLD) had both individual and synergistic effects on the prognosis for female colorectal carcinoma (CRC) patients.

METHODS

The relationship between CRC prognosis and NAFLD as well as MetS was evaluated in 764 female participants. Based on the NAFLD level, patients were divided into significant NAFLD (SNAFLD), "moderate" and "severe" level, and non-SNAFLD, "non" and "mild" level. All the patients were categorized into four subgroups according to the status of SNAFLD and MetS and then a comparison of CRC prognosis among those four groups was performed.

RESULTS

NAFLD, SNAFLD, and MetS were independent factors for CRC-specific mortality with the adjustment of age and other confounders. The hazard ratio (HR) of CRC-specific mortality in MetS (+) SNAFLD (+) group was significantly higher than that in other three groups. Relative excess risk of interaction (RERI) was 2.203 with 95% CI ranged from 0.197 to 4.210, attributable proportion (AP) was 0.444 with range from 0.222 to 0.667, and synergy index (SI) of 2.256 with 95% CI from 1.252 to 4.065, indicating SNAFLD and MetS had a significant synergic effect on CRC-specific mortality.

CONCLUSIONS

SNAFLD and MetS are independent risk factors for CRC-specific mortality in females. Moreover, those two diseases have a synergistic effect on promoting CRC-specific mortality.

摘要

背景

本研究旨在探讨代谢综合征(MetS)和非酒精性脂肪性肝病(NAFLD)是否对女性结直肠癌(CRC)患者的预后有单独和协同作用。

方法

本研究共纳入 764 名女性参与者,评估了 CRC 预后与 NAFLD 和 MetS 的关系。根据 NAFLD 水平,将患者分为显著 NAFLD(SNAFLD)、“中度”和“重度”水平,以及非 SNAFLD、“非”和“轻度”水平。所有患者根据 SNAFLD 和 MetS 的状况分为四组,然后比较这四组之间的 CRC 预后。

结果

NAFLD、SNAFLD 和 MetS 是 CRC 特异性死亡率的独立因素,可调整年龄和其他混杂因素。MetS(+)SNAFLD(+)组的 CRC 特异性死亡率的危险比(HR)明显高于其他三组。交互超额相对危险度(RERI)为 2.203,95%CI 范围为 0.197 至 4.210,归因比例(AP)为 0.444,范围为 0.222 至 0.667,协同指数(SI)为 2.256,95%CI 为 1.252 至 4.065,表明 SNAFLD 和 MetS 对 CRC 特异性死亡率有显著协同作用。

结论

SNAFLD 和 MetS 是女性 CRC 特异性死亡率的独立危险因素。此外,这两种疾病对促进 CRC 特异性死亡率有协同作用。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d6b7/6086998/e40a08a63d3f/12957_2018_1461_Fig1_HTML.jpg

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