Wen Y, Wang G, Chen H D, Li X, Lyu Z Y, Feng X S, Wei L P, Chen Y H, Chen S H, Ren J S, Shi J F, Cui H, Wu S L, Dai M, Li N
Office of Cancer Screening, National Cancer Center/ National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100021, China.
Department of Oncology, Kailuan General Hospital, Tangshan 063000, China.
Zhonghua Yu Fang Yi Xue Za Zhi. 2020 Jul 6;54(7):753-759. doi: 10.3760/cma.j.cn112150-20190809-00646.
To investigate the association between total cholesterol (TC) and primary liver cancer in Chinese males. Since May 2006, all the male workers, including the employees and the retirees in Kailuan Group were recruited in the Kailuan male dynamic cohort study. Information about demographics, medical history and TC levels was collected at the baseline interview, as well as information on newly-diagnosed primary liver cancer cases during the follow-up period. A total of 110 612 males were recruited in the cohort by 31 December 2015. TC levels were divided into four categories by quartile (<4.27, 4.27-4.90, 4.90-5.56 and ≥5.56 mmol/L), with the first quartile group serving as the referent category. Cox proportional hazards regression model was used to evaluate the association between TC levels and primary liver cancer risk. By December 31, 2015, a follow-up of 861 711.45 person-years was made with a median follow-up period of 8.83 years. During the follow-up, 355 primary liver cancer cases were identified. Compared with the first quartile, the of incident primary liver cancer among participants with the second, third and highest quartile TC levels were 0.76 (95%: 0.58-1.01), 0.59 (95%: 0.43-0.79), and 0.36 (95%: 0.25-0.52), respectively after adjusting for age, educational level, income level, smoking status, drinking status, body mass index, and HBsAg status (<0.001). Subgroup analyses found that the association between TC levels and primary liver cancer was robust (all <0.05). The results didn't change significantly after exclusion of newly-diagnosed cases within the first 2 years, males with history of cirrhosis or subjects who took antihyperlipidemic drugs, participants with higher TC levels had a lower risk of primary liver cancer (all <0.05) and (95%) of incident primary liver cancer among participants with the highest quartile TC levels were 0.41 (0.28-0.61), 0.36 (0.25-0.53) and 0.38 (0.26-0.54), respectively. In this large prospective study, we found that baseline TC levels were inversely associated with primary liver cancer risk, and low TC level might increase the risk of primary liver cancer.
探讨中国男性总胆固醇（TC）与原发性肝癌之间的关联。自2006年5月起，开滦集团的所有男性职工，包括在职员工和退休人员，均被纳入开滦男性动态队列研究。在基线访谈时收集了人口统计学、病史和TC水平等信息，以及随访期间新诊断的原发性肝癌病例信息。截至2015年12月31日，该队列共纳入110612名男性。TC水平按四分位数分为四类（<4.27、4.27 - 4.90、4.90 - 5.56和≥5.56 mmol/L），第一四分位数组作为参照组。采用Cox比例风险回归模型评估TC水平与原发性肝癌风险之间的关联。截至2015年12月31日，随访861711.45人年，中位随访期为8.83年。随访期间，共确诊355例原发性肝癌病例。在调整年龄、教育水平、收入水平、吸烟状况、饮酒状况、体重指数和乙肝表面抗原（HBsAg）状态后，与第一四分位数相比，第二四分位数、第三四分位数和最高四分位数TC水平参与者的原发性肝癌发病风险比分别为0.76（95%置信区间：0.58 - 1.01）、0.59（95%置信区间：0.43 - 0.79）和0.36（95%置信区间：0.25 - 0.52）（P<0.001）。亚组分析发现，TC水平与原发性肝癌之间的关联具有稳健性（均P<0.05）。在排除前2年内新诊断的病例、有肝硬化病史的男性或服用降脂药物的受试者后，结果无显著变化，TC水平较高的参与者原发性肝癌风险较低（均P<0.05），最高四分位数TC水平参与者的原发性肝癌发病风险比（95%置信区间）分别为0.41（0.28 - 0.61）、0.36（0.25 - 0.53）和0.38（0.26 - 0.54）。在这项大型前瞻性研究中，我们发现基线TC水平与原发性肝癌风险呈负相关，低TC水平可能增加原发性肝癌风险。
