School of Public Administration and Policy, Renmin University of China, Beijing, China.
Department of Epidemiology and Biostatistics, Huazhong University of Science and Technology Tongji Medical College, Wuhan, China.
BMJ Open. 2022 May 24;12(5):e059642. doi: 10.1136/bmjopen-2021-059642.
To explore the correlation between the ideal cardiovascular health metrics (ICVHMs) and the incidence of colorectal cancer (CRC) among people aged 50 years or older.
Prospective cohort study.
The UK Biobank, a prospective cohort of middle-aged participants recruited between 2006 and 2010.
The study included 342 226 participants from the UK Biobank aged 50 years or older without prevalent cancer.
The ICVHMs consist of four behavioural factors (abstinence from smoking, ideal body mass index (BMI), physical activity at goal and consumption of healthy diet) and three cardiometabolic factors (untreated total cholesterol <200 mg/dL, untreated blood pressure <120/80 mm Hg and untreated fasting plasma glucose <100 mg/dL).
The outcome was ascertained by linkage to cancer and death registries using the International Classification of Diseases, Tenth codes C18-C20.
During a median follow-up time of 8.72 years, 3060 CRC cases were identified. Compared with the reference (participants with ICVHMs ≤2), the multivariable-adjusted HRs for subgroups with 3, 4, 5 and ≥6 ICVHM factors were 0.98 (95% CI 0.85 to 1.12), 0.90 (95% CI 0.77 to 1.02), 0.85 (95% CI 0.71 to 0.98) and 0.69 (95% CI 0.48 to 0.90), respectively. Among the seven ICVHM factors, lower BMI, healthier diet and ideal fasting plasma glucose were significantly associated with lower risk of CRC (HR: 0.86, 95% CI 0.78 to 0.95; HR: 0.92, 95% CI 0.84 to 0.99; HR: 0.90, 95% CI 0.80 to 0.99).
Adherence to the ICVHMs was associated with a lower risk of CRC among people aged 50 years or older. Among the seven ICVHM factors, BMI, diet and fasting plasma glucose played a more critical role in the prevention of CRC. These findings imply that adherence to ICVHMs should be encouraged to reduce the burden of cardiovascular disease as well as CRC.
探讨理想心血管健康指标（ICVHMs）与 50 岁及以上人群结直肠癌（CRC）发病风险的相关性。
前瞻性队列研究。
英国生物库，是一项 2006 年至 2010 年间招募的中年参与者的前瞻性队列研究。
该研究纳入了来自英国生物库的 342226 名年龄在 50 岁及以上、无癌症既往史的参与者。
ICVHMs 由四个行为因素（不吸烟、理想体重指数（BMI）、达到目标的身体活动和健康饮食）和三个心血管代谢因素（未经治疗的总胆固醇<200mg/dL、未经治疗的血压<120/80mmHg 和未经治疗的空腹血糖<100mg/dL）组成。
通过国际疾病分类第十版（C18-C20）代码，将癌症和死亡登记与国际分类进行链接，以确定结局。
在中位随访时间 8.72 年内，共确定了 3060 例 CRC 病例。与参考组（ICVHMs≤2 的参与者）相比，ICVHMs 因素为 3、4、5 和≥6 的亚组多变量校正 HR 分别为 0.98（95%CI 0.85 至 1.12）、0.90（95%CI 0.77 至 1.02）、0.85（95%CI 0.71 至 0.98）和 0.69（95%CI 0.48 至 0.90）。在七个 ICVHMs 因素中，较低的 BMI、更健康的饮食和理想的空腹血糖与 CRC 风险降低显著相关（HR：0.86，95%CI 0.78 至 0.95；HR：0.92，95%CI 0.84 至 0.99；HR：0.90，95%CI 0.80 至 0.99）。
50 岁及以上人群遵循 ICVHMs 与 CRC 发病风险降低相关。在七个 ICVHMs 因素中，BMI、饮食和空腹血糖在 CRC 的预防中起着更为关键的作用。这些发现表明，应鼓励人们遵循 ICVHMs，以降低心血管疾病和 CRC 的负担。
