Lee Ji Eun, Han Kyungdo, Yoo Juhwan, Yeo Yohwan, Cho In Young, Cho Belong, Kwon Hyuktae, Shin Dong Wook, Cho Jong Ho, Park Yong-Moon
Department of Family Medicine, Seoul National University Hospital, Seoul 03080, Korea.
Department of Statistics and Actuarial Science, Soongsil University, Seoul 06978, Korea.
J Pers Med. 2022 Mar 1;12(3):375. doi: 10.3390/jpm12030375.
Certain metabolic parameters increase the risk of esophageal cancer. This study investigated the association between the variability in metabolic parameters and esophageal cancer incidence using large nationally representative data. Using the health checkup and claims data provided by the Korean National Health Insurance Service (NHIS), we included 8,376,233 subjects who underwent NHIS-provided health checkups between 2009 and 2010 (index year) and two or more health checkups within five years before the index year. Hazard ratios (HRs) and 95% confidence intervals (CIs) for esophageal cancer were obtained using Cox proportional hazards models according to the quartiles of variability of each metabolic parameter: fasting blood glucose (FBG), weight, systolic blood pressure (SBP), and total cholesterol (TC) as well as a cumulative number of high-variability parameters. A total of 6,455 cases of esophageal cancer occurred during a mean (±SD) follow-up of 8.8 (±1.1) years. The following metabolic parameters were used, with an adjusted HR and 95% CI: FBG (1.11, 1.03-1.18), weight (1.15, 1.07-1.23), SBP (1.08, 1.01-1.16), and TC (1.23, 1.15-1.32). The risk of esophageal cancer was higher in the highest quartile of variability than the lower quartiles. The risk of esophageal cancer gradually increased with a greater number of high-variability parameters: 1.08 (1.02-1.15), 1.22 (1.14-1.31), and 1.33 (1.21-1.46) for 1, 2, and 3-4 high-variability parameters (vs. none). A high variability of metabolic parameters was associated with an increased esophageal cancer risk. Further studies are needed to replicate our findings in other populations.
某些代谢参数会增加患食管癌的风险。本研究利用全国具有代表性的大型数据，调查了代谢参数变异性与食管癌发病率之间的关联。利用韩国国民健康保险服务（NHIS）提供的健康检查和理赔数据，我们纳入了8376233名在2009年至2010年（索引年份）期间接受NHIS提供的健康检查，且在索引年份前五年内进行过两次或更多次健康检查的受试者。根据每个代谢参数（空腹血糖（FBG）、体重、收缩压（SBP）和总胆固醇（TC））变异性的四分位数以及高变异性参数的累积数量，使用Cox比例风险模型获得食管癌的风险比（HRs）和95%置信区间（CIs）。在平均（±标准差）8.8（±1.1）年的随访期间，共发生了6455例食管癌病例。使用了以下代谢参数，并给出了调整后的HR和95%CI：FBG（1.11，1.03 - 1.18）、体重（1.15，1.07 - 1.23）、SBP（1.08，1.01 - 1.16）和TC（1.23，1.15 - 1.32）。变异性最高的四分位数患食管癌的风险高于较低四分位数。食管癌的风险随着高变异性参数数量的增加而逐渐增加：1个、2个和3 - 4个高变异性参数（与无高变异性参数相比）的风险分别为1.08（1.02 - 1.15）、1.22（1.14 - 1.31）和1.33（1.21 - 1.46）。代谢参数的高变异性与食管癌风险增加有关。需要进一步研究在其他人群中复制我们的研究结果。
