撒丁岛胃癌死亡率与甲状腺肿的空间关联。

Spatial Association between Gastric Cancer Mortality and Goiter in Sardinia.

机构信息

Dipartimento di Scienze Mediche, Chirurgiche e Sperimentali, University of Sassari, Sassari 07100, Italy.

Baylor College of Medicine, 77030 Houston, Texas, USA.

出版信息

Asian Pac J Cancer Prev. 2021 Jan 1;22(1):105-110. doi: 10.31557/APJCP.2021.22.1.105.

DOI:10.31557/APJCP.2021.22.1.105

PMID:33507686

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC8184186/

Abstract

BACKGROUND

Gastric cancer (GC) is the third leading cause of cancer mortality worldwide. The incidence of GC varies between countries according to exposure to different risk factors. Hypothyroidism has been suggested as a potential GC risk factor. In Sardinia, Italy, the prevalence of endemic goiter is high and GC mortality is unevenly distributed. This ecological study aimed to investigate GC mortality and its relationship with hypothyroidism, adjusting for potential confounders.

METHODS

The spatial association between GC mortality and goiter (a proxy of hypothyroidism), diet, stature and pastoralism (a proxy of Helicobacter pylori infection), available at the aggregated level, was modelled in the island's 377 municipalities, separately by sex, using geographically weighted regression (GWR).

RESULTS

The GC standardized mortality ratio ranged from 0.0 to 10.4 across municipalities. A hotspot of GC mortality was detected in the central mountainous area of Sardinia among males, positively associated with goiter (GWR estimate 0.213 ± 0.122), and the practice of sheep‒rearing (GWR estimate 0.127 ± 0.080), whereas a negative association with the diet score (GWR estimate 0.032 ± 0.034), and null for stature were found. No significant associations were found in females.

CONCLUSION

Within the limitations of ecological studies goiter prevalence was an independent predictor of GC mortality in males.

摘要

背景

胃癌（GC）是全球导致死亡的第三大癌症原因。根据接触不同危险因素的情况，各国胃癌的发病率不同。甲状腺功能减退症已被认为是胃癌的一个潜在危险因素。在意大利撒丁岛，地方性甲状腺肿的患病率很高，胃癌死亡率分布不均。本生态研究旨在调查胃癌死亡率及其与甲状腺功能减退症的关系，并调整潜在的混杂因素。

方法

使用地理加权回归（GWR）分别按性别在该岛的 377 个市/镇分析了胃癌死亡率与甲状腺肿（甲状腺功能减退的一个替代指标）、饮食、身高和畜牧业（幽门螺杆菌感染的一个替代指标）在聚集水平上的空间关联。

结果

各市/镇的胃癌标准化死亡率从 0.0 到 10.4 不等。在撒丁岛中部山区的男性中发现了一个胃癌死亡率热点，与甲状腺肿呈正相关（GWR 估计值为 0.213 ± 0.122），与牧羊业呈正相关（GWR 估计值为 0.127 ± 0.080），与饮食评分呈负相关（GWR 估计值为 0.032 ± 0.034），而与身高无关。在女性中未发现显著关联。