Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, USA.
Department of Medical Oncology, Sun Yat-sen University Cancer Center, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Guangzhou, Guangdong, China.
Br J Cancer. 2021 Feb;124(3):663-670. doi: 10.1038/s41416-020-01143-6. Epub 2020 Nov 3.
It remains unclear whether serum lipids influence colorectal cancer (CRC) risk.
We conducted a prospective cohort study of 380,087 adults aged 40-69 years in the UK Biobank. Serum high-density cholesterol, low-density cholesterol, total cholesterol, triglycerides, and apolipoprotein A and B were measured. We used Cox proportional hazard models to estimate the multivariable hazard ratios (HRs) of CRC according to one standard deviation (SD) increment in serum lipids. We conducted subgroup analysis by tumour anatomical subsites.
During a median of 10.3 years of follow-up, we documented 2667 incident CRC cases. None of the lipid biomarkers was associated with the risk of CRC after adjusting for potential confounding factors, including body mass index and waist circumference. When assessed by cancer subsites, serum triglycerides was associated with an increased risk of cancer in the caecum and transverse colon, with the HR of 1.12 (95% CI, 1.00-1.25) and 1.29 (95% CI, 1.09-1.53), respectively; and apolipoprotein A was associated with a lower risk of hepatic flexure cancer (HR, 0.73, 95% CI, 0.56-0.96).
Serum lipid profiles were not associated with colorectal cancer risk after adjusting for obesity indicators. The potential subsite-specific effects of triglycerides and apolipoprotein A require further confirmation.
血清脂质是否会影响结直肠癌（CRC）风险尚不清楚。
我们对英国生物库中 380087 名年龄在 40-69 岁的成年人进行了一项前瞻性队列研究。测量了血清高密度胆固醇、低密度胆固醇、总胆固醇、甘油三酯、载脂蛋白 A 和 B。我们使用 Cox 比例风险模型根据血清脂质的一个标准差（SD）增量来估计 CRC 的多变量风险比（HR）。我们按肿瘤解剖部位进行了亚组分析。
在中位数为 10.3 年的随访期间，我们记录了 2667 例 CRC 病例。在调整了潜在混杂因素（包括体重指数和腰围）后，没有一种脂质生物标志物与 CRC 风险相关。当按癌症部位评估时，血清甘油三酯与盲肠和横结肠癌的风险增加相关，HR 分别为 1.12（95%CI，1.00-1.25）和 1.29（95%CI，1.09-1.53）；载脂蛋白 A 与肝曲癌的风险降低相关（HR，0.73，95%CI，0.56-0.96）。
在调整肥胖指标后，血清脂质谱与结直肠癌风险无关。甘油三酯和载脂蛋白 A 的潜在亚部位特异性作用需要进一步证实。
