Center for Big Data Research in Health and Medicine, The First Affiliated Hospital of Shandong First Medical University & Shandong Provincial Qianfoshan Hospital, Jinan, China.
Shandong Provincial Qianfoshan Hospital, Cheeloo College of Medicine, Shandong University, Jinan, China.
Lipids Health Dis. 2020 Nov 4;19(1):233. doi: 10.1186/s12944-020-01411-7.
Previous studies have shown that serum carcinoembryonic antigen (CEA) is independently associated with metabolic syndrome (MetS). However, these studies were mainly cross-sectional analyses, and cause was not clarified. In the present study, two bidirectional cohort studies were conducted to investigate the bidirectional associations between CEA and MetS using a Chinese male sample cohort.
The initial longitudinal cohort included 9629 Chinese males enrolled from January 2010 to December 2015. Two bidirectional cohorts were conducted in the study: subcohort A (from CEA to MetS, n = 6439) included participants without MetS at baseline to estimate the risk of developing incident MetS; subcohort B (from MetS to CEA, n = 8533) included participants without an elevated CEA level (Hyper-CEA) at baseline to examine the risk of developing incident Hyper-CEA. Hazard ratios (HRs) and 95% confidence intervals (CIs) were estimated using Cox proportional hazards models.
In subcohort A, the incidence densities of MetS among participants with and without Hyper-CEA were 84.56 and 99.28 per 1000 person-years, respectively. No significant effects of Hyper-CEA on incident MetS were observed in subcohort A (HR, 0.89; 95% CI, 0.71 to 1.12; P = 0.326). In subcohort B, a higher incidence density of Hyper-CEA was found among participants with MetS (33.42 and 29.13 per 1000 person-years for those with and without MetS, respectively). For nonsmoking participants aged > 65 years, MetS increased the risk of incident Hyper-CEA (HR, 1.87; 95% CI, 1.09 to 3.20; P = 0.022).
For the direction of CEA on incident MetS, no significant association was observed. For the direction of MetS on incident Hyper-CEA, MetS in nonsmoking elderly men could increase the risk of incident Hyper-CEA, while this association was not found in other stratified participants. The clinical implications of the association between CEA and MetS should be interpreted with caution.
先前的研究表明，血清癌胚抗原（CEA）与代谢综合征（MetS）独立相关。然而，这些研究主要是横断面分析，因果关系尚不清楚。本研究使用中国男性样本队列进行了两项双向队列研究，以调查 CEA 与 MetS 之间的双向关联。
初始纵向队列纳入了 2010 年 1 月至 2015 年 12 月期间招募的 9629 名中国男性。在该研究中进行了两项双向队列研究：亚队列 A（CEA 到 MetS，n=6439）包括基线时无 MetS 的参与者，以估计发生代谢综合征的风险；亚队列 B（MetS 到 CEA，n=8533）包括基线时无升高的 CEA 水平（高 CEA）的参与者，以检查发生高 CEA 的风险。使用 Cox 比例风险模型估计风险比（HR）和 95%置信区间（CI）。
在亚队列 A 中，基线时有高 CEA 和无高 CEA 的参与者的 MetS 发生率密度分别为 84.56 和 99.28/1000 人年。在亚队列 A 中，高 CEA 对代谢综合征的发生无显著影响（HR，0.89；95%CI，0.71 至 1.12；P=0.326）。在亚队列 B 中，在患有 MetS 的参与者中发现了更高的高 CEA 发生率密度（患有和不患有 MetS 的参与者分别为 33.42 和 29.13/1000 人年）。对于年龄>65 岁的不吸烟者，MetS 增加了发生高 CEA 的风险（HR，1.87；95%CI，1.09 至 3.20；P=0.022）。
CEA 对代谢综合征发生的方向没有显著关联。对于 MetS 对高 CEA 发生的方向，非吸烟老年男性的 MetS 可能会增加高 CEA 的发生风险，但在其他分层参与者中未发现这种关联。CEA 与 MetS 之间的关联的临床意义应谨慎解释。
