Shao Yelin, Li Wenyuan, Wen Chi Pang, Yang Min, Ning Xian, Hu Kejia, Wu Xifeng
Center of Clinical Big Data and Analytics of the Second Affiliated Hospital, School of Public Health, Zhejiang University School of Medicine, 866 Yuhangtang Road, Hangzhou, Zhejiang, 310058, China.
Institute of Population Health Sciences, National Health Research Institutes, Zhunan, Taiwan.
Eur J Epidemiol. 2024 Dec;39(12):1363-1371. doi: 10.1007/s10654-024-01175-9. Epub 2024 Dec 11.
To investigate the associations of changes in lipidemic profile with the risk of lung cancer incidence, and to elucidate how modifiable risk factors contribute to the associations.
The prospective study enrolled a cohort of 137,075 individuals with lipidemic profiles spanning from January 1, 1996 to December 31, 2006 in the Taiwan MJ Cohort. Follow-up was extended from the second clinical visit until December 31, 2007, with an average duration of 6.3 years. Participants was divided into four groups based on alterations in their lipidemic profile within a 1-3 year interval subsequent to initial enrollment. The associations of changes in lipidemic profiles with the incidence of lung cancer were assessed with Cox proportional hazard models. Associations between modifiable risk factors and lipidemic profile changes were evaluated using multivariable logistic regression models.
Of 137,075 participants with lipidemic profile, progression to dyslipidemia within a 3-year period was associated with elevated risks of lung cancer incidence (hazard ratio [HR] = 1.46; 95% CI: 1.01, 2.10) in comparison to persistent normolipidemic. However, reversion to normolipidemic did not contribute to a decreased lung cancer incidence risk (HR = 1.10; 95% CI: 0.74, 1.63), in comparison to persistent dyslipidemia. Body mass index and smoking as risk factors, along with physical activity as a protective factor, were associated with changes in lipidemic profile.
Within this large-scale cohort, progression to dyslipidemia emerged as a risk factor for lung cancer incidence, highlighting the significance of lipid control. The modifiable risk factors associated with dyslipidemia progression encompassed body mass index, physical activity, and smoking status, suggesting potential interventions targets.
研究血脂谱变化与肺癌发病风险的关联，并阐明可改变的风险因素如何促成这种关联。
这项前瞻性研究纳入了1996年1月1日至2006年12月31日期间台湾MJ队列中137,075名有血脂谱数据的个体。随访从第二次临床就诊开始，直至2007年12月31日，平均时长为6.3年。参与者在首次入组后的1至3年间隔内根据血脂谱变化分为四组。使用Cox比例风险模型评估血脂谱变化与肺癌发病率的关联。使用多变量逻辑回归模型评估可改变风险因素与血脂谱变化之间的关联。
在137,075名有血脂谱数据的参与者中，与持续正常血脂者相比，3年内进展为血脂异常与肺癌发病风险升高相关（风险比[HR]=1.46；95%置信区间：1.01, 2.10）。然而，与持续血脂异常相比，恢复至正常血脂并未降低肺癌发病风险（HR=1.10；95%置信区间：0.74, 1.63）。体重指数和吸烟作为风险因素，以及身体活动作为保护因素，与血脂谱变化相关。
在这个大规模队列中，进展为血脂异常成为肺癌发病的一个风险因素，突出了血脂控制的重要性。与血脂异常进展相关的可改变风险因素包括体重指数、身体活动和吸烟状况，提示了潜在的干预靶点。
