Mannes G A, Maier A, Thieme C, Wiebecke B, Paumgartner G
N Engl J Med. 1986 Dec 25;315(26):1634-8. doi: 10.1056/NEJM198612253152602.
Several investigators have reported an association between low serum cholesterol levels and an increased frequency of colorectal cancer. Because low cholesterol levels may be a result of an established cancer, we have investigated the relation between serum cholesterol levels and the frequency of colorectal adenomas, which are thought to be precursors of colon cancer. We prospectively studied 1083 consecutive patients who underwent colonoscopy (241 of whom were excluded because of malignant disease, chronic inflammatory bowel disease, familial polyposis, or partial colectomy). In the remaining 842 patients, analysis of covariance was performed to evaluate the contribution of serum cholesterol to the risk of colorectal adenoma. Serum cholesterol levels were significantly and positively associated with the frequency of colorectal adenoma in subjects of both sexes. After adjustment for age and body-mass index, this positive association remained significant between the top quintile and the lowest quintile for serum cholesterol, with regard to the total study group (odds ratio, 2.0; 95 percent confidence limits, 1.1 and 3.6) and men only (odds ratio, 2.2; 95 percent confidence limits, 1.0 and 4.8). We conclude that there is not an inverse correlation between serum cholesterol levels and the risk of colorectal adenomas; on the contrary, there appears to be a small positive association.
几位研究者报告了低血清胆固醇水平与结直肠癌发病率增加之间的关联。由于低胆固醇水平可能是已患癌症的结果，我们研究了血清胆固醇水平与结直肠腺瘤发病率之间的关系，结直肠腺瘤被认为是结肠癌的前体。我们前瞻性地研究了1083例连续接受结肠镜检查的患者（其中241例因恶性疾病、慢性炎症性肠病、家族性息肉病或部分结肠切除术而被排除）。在其余842例患者中，进行协方差分析以评估血清胆固醇对结直肠腺瘤风险的影响。在男女受试者中，血清胆固醇水平与结直肠腺瘤发病率均呈显著正相关。在对年龄和体重指数进行校正后，对于整个研究组（优势比，2.0；95%置信区间，1.1和3.6）以及仅男性（优势比，2.2；95%置信区间，1.0和4.8）而言，血清胆固醇最高五分位数与最低五分位数之间的这种正相关仍然显著。我们得出结论，血清胆固醇水平与结直肠腺瘤风险之间不存在负相关；相反，似乎存在较小的正相关。
