Fukuoka City Medical Association, Fukuoka City Health Promotion Support Center, Maizuru 2-5-1, Chuou-ku, Fukuoka, 810-0073, Japan.
Faculty of Advanced Science and Technology, Kumamoto University, Kumamoto, Japan.
Sci Rep. 2021 Jun 24;11(1):13224. doi: 10.1038/s41598-021-92442-2.
Serum levels of bilirubin, a strong antioxidant, may influence cancer risk. We aimed to assess the association between serum bilirubin levels and cancer risk. Data were retrieved from 10-year electronic medical records at Kyushu University Hospital (Japan) for patients aged 20 to 69 years old. The associations of baseline bilirubin levels with cancer risk (lung, colon, breast, prostate, and cervical) were evaluated using a gradient boosting decision tree (GBDT) model, a machine learning algorithm, and Cox proportional hazard regression model, adjusted for age, smoking, body mass index, and diabetes. The number of study subjects was 29,080. Median follow-up time was 4.7 years. GBDT models illustrated that baseline bilirubin levels were negatively and non-linearly associated with the risk of lung (men), colon, and cervical cancer. In contrast, a U-shaped association was observed for breast and prostate cancer. Cox hazard regression analyses confirmed that baseline bilirubin levels (< 1.2 mg/dL) were negatively associated with lung cancer risk in men (HR = 0.474, 95% CI 0.271-0.828, P = 0.009) and cervical cancer risk (HR = 0.365, 95% CI 0.136-0.977, P = 0.045). Additionally, low bilirubin levels (< 0.6 mg/dL) were associated with total death (HR = 1.744, 95% CI 1.369-2.222, P < 0.001). Serum bilirubin may have a beneficial effect on the risk of some types of cancers.
血清胆红素水平是一种强大的抗氧化剂，可能会影响癌症风险。我们旨在评估血清胆红素水平与癌症风险之间的关系。我们从九州大学医院（日本）的 10 年电子病历中检索了数据，这些数据来自年龄在 20 至 69 岁的患者。使用梯度提升决策树（GBDT）模型、机器学习算法和 Cox 比例风险回归模型，调整年龄、吸烟、体重指数和糖尿病等因素，评估基线胆红素水平与癌症风险（肺癌、结肠癌、乳腺癌、前列腺癌和宫颈癌）之间的关系。研究对象的数量为 29080 人。中位随访时间为 4.7 年。GBDT 模型表明，基线胆红素水平与肺癌（男性）、结肠癌和宫颈癌的风险呈负相关且非线性相关。相比之下，乳腺癌和前列腺癌则呈 U 型关联。Cox 风险回归分析证实，基线胆红素水平（<1.2mg/dL）与男性肺癌风险（HR=0.474，95%CI 0.271-0.828，P=0.009）和宫颈癌风险（HR=0.365，95%CI 0.136-0.977，P=0.045）呈负相关。此外，低胆红素水平（<0.6mg/dL）与总死亡率（HR=1.744，95%CI 1.369-2.222，P<0.001）相关。血清胆红素可能对某些类型的癌症风险有有益的影响。
