急性心肌梗死与结肠癌风险之间关联的性别差异。

Sex disparities in the association between acute myocardial infarction and colon cancer risk.

机构信息

Division of Cardiology, Linko Branch, Chang Gung Memorial Hospital, Taoyuan, Taiwan.

Graduate Institute of Clinical Medical Sciences, College of Medicine, Chang Gung University, Taoyuan, Taiwan.

出版信息

Cancer Med. 2023 Feb;12(3):2958-2969. doi: 10.1002/cam4.5205. Epub 2022 Sep 7.

DOI:10.1002/cam4.5205

PMID:36069126

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC9939112/

Abstract

BACKGROUND

Acute myocardial infarction (AMI) and colon cancer share similar risk factors. Studies have suggested an association between AMI and colon cancer; however, evidence is conflicting. Whether sex disparities exist in this association in the real world remains unknown.

METHODS

In this population-based retrospective cohort study, 94,780 and 97,987 male patients and 38,697 and 72,007 female patients with and without new-onset AMI, respectively, from January 1, 2001, to December 31, 2012, were enrolled from Taiwan's National Health Insurance Research Database. Inverse probability of treatment weighting (IPTW) was used to balance covariates across study groups. The primary outcome was a new diagnosis of colon cancer.

RESULTS

The incidence rate of colon cancer was 1.54 (95% confidence interval [CI] = 1.46-1.62) and 1.40 (95% CI = 1.32-1.48) per 1000 person-years in the male patients and 1.62 (95% CI = 1.50-1.74) and 1.22 (95% CI = 1.13-1.32) in the female patients, in the AMI and non-AMI groups, respectively. AMI was associated with a significantly higher risk of colon cancer in the female patients (hazard ratio [HR] = 1.31, 95% CI = 1.06-1.61) but not in the male patients (HR = 1.09, 95% CI = 0.95-1.26). In the subgroup analysis, the association between AMI and colon cancer in the female patients was stronger in those aged ≥65 years (HR = 1.28, 95% CI = 1.13-1.44).

CONCLUSIONS

An increased risk of colon cancer was observed only in the female patients with AMI. The association between AMI and colon cancer in the female patients was the most evident in those aged ≥65 years.

摘要

背景

急性心肌梗死（AMI）和结肠癌具有相似的危险因素。有研究提示 AMI 与结肠癌之间存在关联，但证据相互矛盾。在真实世界中，这种关联是否存在性别差异尚不清楚。

方法

本基于人群的回顾性队列研究纳入了 2001 年 1 月 1 日至 2012 年 12 月 31 日期间分别来自台湾全民健康保险研究数据库的新发 AMI 男性患者 94780 例和女性患者 38697 例（AMI 组）以及无新发 AMI 的男性患者 97987 例和女性患者 72007 例（非 AMI 组）。采用逆概率治疗加权（IPTW）法平衡研究组间的协变量。主要结局为结肠癌的新诊断。

结果

在男性患者中，AMI 组和非 AMI 组的结肠癌发病率分别为 1.54（95%置信区间[CI] 1.46-1.62）和 1.40（95% CI 1.32-1.48）/1000 人年，在女性患者中，AMI 组和非 AMI 组的发病率分别为 1.62（95% CI 1.50-1.74）和 1.22（95% CI 1.13-1.32）/1000 人年。与男性患者相比，AMI 与女性患者结肠癌发病风险显著升高相关（风险比[HR] 1.31，95% CI 1.06-1.61），但与男性患者无关（HR 1.09，95% CI 0.95-1.26）。在亚组分析中，在年龄≥65 岁的女性患者中，AMI 与结肠癌之间的关联更强（HR 1.28，95% CI 1.13-1.44）。