Shin Jong Won, Kim Namhee, Minh Nguyen Thien, Chapagain Durga Datta, Jee Sun Ha
Department of Laboratory Medicine, Asan Medical Center, University of Ulsan College of Medicine, Ulsan, Republic of Korea; Department of Epidemiology and Health Promotion, Institute for Health Promotion, School of Public Health, Yonsei University, Republic of Korea.
Wonju College of Nursing, Yonsei University, Wonju, Republic of Korea.
Cancer Epidemiol. 2025 Feb;94:102727. doi: 10.1016/j.canep.2024.102727. Epub 2024 Dec 15.
Bilirubin is a potent antioxidant that neutralizes reactive oxygen species (ROS). While previous studies have predominantly focused on the association between total bilirubin and cancer risk, this study evaluates the association of different bilirubin subgroups with cancer risk in men and women.
Data were derived from the Korean Cancer Prevention Study-II cohort, including 133,630 participants. Over a mean follow-up of 13.5 years, 9876 cancer cases were identified. Serum bilirubin levels (total, indirect, direct) were categorized into sex-specific quartiles and analyzed. Cox proportional hazard models were used to estimate hazard ratios (HR) and 95 % confidence intervals (CI), along with trend analyses.
In men, a 1 standard deviation (SD) increase in total bilirubin was inversely associated with lung cancer risk (HR: 0.82, 95 % CI: 0.74-0.91), and direct bilirubin showed an inverse association (HR: 0.83, 95 % CI: 0.74-0.93). In contrast, in women, a 1 SD increase in total bilirubin was positively associated with lung cancer risk (HR: 1.15, 95 % CI: 1.00-1.32). Among male smokers, a 1 SD increase in total bilirubin (≥30 cigarettes/day) was inversely associated with lung cancer risk (HR: 0.73, 95 % CI: 0.55-0.97), and a 1 SD increase in direct bilirubin (10-19 cigarettes/day) showed an inverse association (HR: 0.79, 95 % CI: 0.63-0.99).
In men, both total and direct bilirubin levels were inversely associated with lung cancer risk, whereas in women, total bilirubin was positively associated with lung cancer risk.
胆红素是一种有效的抗氧化剂，可中和活性氧（ROS）。虽然先前的研究主要集中在总胆红素与癌症风险之间的关联，但本研究评估了不同胆红素亚组与男性和女性癌症风险之间的关联。
数据来自韩国癌症预防研究-II队列，包括133630名参与者。在平均13.5年的随访期间，共确定了9876例癌症病例。血清胆红素水平（总胆红素、间接胆红素、直接胆红素）按性别特异性四分位数进行分类并分析。采用Cox比例风险模型估计风险比（HR）和95%置信区间（CI），并进行趋势分析。
在男性中，总胆红素增加1个标准差（SD）与肺癌风险呈负相关（HR：0.82，95%CI：0.74-0.91），直接胆红素也呈负相关（HR：0.83，95%CI：0.74-0.93）。相比之下，在女性中，总胆红素增加1个标准差与肺癌风险呈正相关（HR：1.15，95%CI：1.00-1.32）。在男性吸烟者中，总胆红素增加1个标准差（≥30支/天）与肺癌风险呈负相关（HR：0.73，95%CI：0.55-0.97），直接胆红素增加1个标准差（10-19支/天）也呈负相关（HR：0.79，95%CI：0.63-0.99）。
在男性中，总胆红素和直接胆红素水平均与肺癌风险呈负相关，而在女性中，总胆红素与肺癌风险呈正相关。
