胆红素代谢与甲状腺癌：基于ALBI和PALBI指数的见解

Bilirubin Metabolism and Thyroid Cancer: Insights from ALBI and PALBI Indices.

作者信息

Shin Jong Won, Sull Jae Woong, Minh Nguyen Thien, Jee Sun Ha

机构信息

Department of Laboratory Medicine, Asan Medical Center, University of Ulsan College of Medicine, Ulsan, Seoul 05505, Republic of Korea.

Department of Epidemiology and Health Promotion, Institute for Health Promotion, School of Public Health, Yonsei University, Seoul 03772, Republic of Korea.

出版信息

Biomolecules. 2025 Jul 18;15(7):1042. doi: 10.3390/biom15071042.

DOI:10.3390/biom15071042

PMID:40723913

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC12293926/

Abstract

BACKGROUND

This study evaluated the association between bilirubin subtypes (total, indirect, and direct bilirubin) and thyroid cancer risk, with a particular focus on stratified analyses using the ALBI (Albumin-Bilirubin) and PALBI (Platelet-Albumin-Bilirubin) indices by sex, smoking and drinking status, and age under 50 years.

METHODS

Data were obtained from 133,596 participants in the Korean Cancer Prevention Study-II (KCPS-II) cohort. During a mean follow-up period of 13.55 years, 2314 cases of thyroid cancer (ICD-10: C73) were identified. Serum bilirubin levels and ALBI and PALBI indices were analyzed using Cox proportional hazards regression models stratified by age, sex, smoking, and alcohol consumption status to estimate hazard ratios (HRs) and 95% confidence intervals (CIs).

RESULTS

In women, indirect bilirubin showed the strongest inverse association with thyroid cancer risk. ALBI and PALBI indices based on indirect bilirubin also demonstrated significant associations. A 1 standard deviation (SD) increase in indirect bilirubin was associated with a decreased risk of thyroid cancer (HR: 0.92, 95% CI: 0.84-0.99), and the ALBI index similarly showed an inverse association (HR: 0.92, 95% CI: 0.87-0.99). In contrast, the PALBI index was positively associated with thyroid cancer risk (HR: 1.11, 95% CI: 1.03-1.20). Among women who had never smoked, significant associations were observed for indirect bilirubin (HR: 0.91, 95% CI: 0.83-1.00), ALBI (HR: 0.93, 95% CI: 0.86-1.00), and PALBI (HR: 1.14, 95% CI: 1.05-1.23). In analyses stratified by alcohol consumption, the PALBI index was associated with increased thyroid cancer risk in non-drinkers, former drinkers, and ever drinkers, with respective risk increases of 15%, 18%, and 9%.

CONCLUSIONS

In women, indirect bilirubin was significantly and inversely associated with thyroid cancer risk, and the ALBI and PALBI indices incorporating indirect bilirubin showed consistent results. These findings suggest that indirect bilirubin may play a critical role in the metabolic pathways underlying thyroid cancer in women.

摘要

背景

本研究评估了胆红素亚型（总胆红素、间接胆红素和直接胆红素）与甲状腺癌风险之间的关联，特别关注按性别、吸烟和饮酒状况以及50岁以下年龄分层分析的白蛋白-胆红素（ALBI）和血小板-白蛋白-胆红素（PALBI）指数。

方法

数据来自韩国癌症预防研究-II（KCPS-II）队列中的133596名参与者。在平均13.55年的随访期内，确定了2314例甲状腺癌病例（国际疾病分类第十版：C73）。使用Cox比例风险回归模型对血清胆红素水平以及ALBI和PALBI指数按年龄、性别、吸烟和饮酒状况进行分层分析，以估计风险比（HRs）和95%置信区间（CIs）。

结果

在女性中，间接胆红素与甲状腺癌风险呈现最强的负相关。基于间接胆红素的ALBI和PALBI指数也显示出显著关联。间接胆红素增加1个标准差（SD）与甲状腺癌风险降低相关（HR：0.92，95%CI：0.84-0.99），ALBI指数同样显示出负相关（HR：0.92，95%CI：0.87-0.99）。相比之下，PALBI指数与甲状腺癌风险呈正相关（HR：1.11，95%CI：1.03-1.20）。在从不吸烟的女性中，间接胆红素（HR：0.91，95%CI：0.83-1.00）、ALBI（HR：0.93，95%CI：0.86-1.00）和PALBI（HR：1.14，95%CI：1.05-1.23）均观察到显著关联。在按饮酒状况分层的分析中，PALBI指数与不饮酒者、既往饮酒者和当前饮酒者的甲状腺癌风险增加相关，风险分别增加15%、18%和9%。