非高密度脂蛋白-胆固醇和TC/HDL-C比值与肿瘤发病风险的关联分析  

Association analysis of non-high-density lipoprotein-cholesterol and TC/HDL-C ratio with cancer risk

作　　者：谢旖婧 姜永根 吴毅凌 苏旭燕 朱栋良 王静茹 高培培[3] 袁黄波 赵琦[1] 徐珂琳 张铁军[1,4,5] 满秋红 陈兴栋 赵根明[1] 蒋艳峰 索晨[1,5,8] XIE Yijing;JIANG Yonggen;WU Yiling;SU Xuyan;ZHU Dongliang;WANG Jingru;GAO Peipei;YUAN Huangbo;ZHAO Qi;XU Kelin;ZHANG Tiejun;MAN Qiuhong;CHEN Xingdong;ZHAO Genming;JIANG Yanfeng;SUO Chen(School of Public Health,Fudan University,Shanghai 200032,China;Songjiang District Center for Disease Control and Prevention,Shanghai 201620,China;State Key Laboratory of Genetic Engineering,Human Phenome Institute,School of Life Sciences,Fudan University,Shanghai 200438,China;Yiwu Research Institute of Fudan University,Zhejiang Yiwu 322000,China;Fudan University Taizhou Institute of Health Sciences,Jiangsu Taizhou 225316,China;Shanghai Fourth Peoples Hospital,School of Medicine,Tongji University,Shanghai 200434,China;State Key Laboratory of Genetic Engineering,Human Phenome Institute,Zhangjiang Fudan International Innovation Center,and National Clinical Research Center for Aging and Medicine,Huashan Hospital,Fudan University,Shanghai 200438,China;Shanghai Institute of Infectious Disease and Biosecurity,Shanghai 200032,China.)

机构地区：[1]复旦大学公共卫生学院,上海200032 [2]上海市松江区疾病预防与控制中心,上海201620 [3]复旦大学遗传工程国家重点实验室-人类表型组研究院-生命科学学院,上海200438 [4]复旦大学义乌研究院,浙江义乌322000 [5]复旦大学泰州健康科学研究院,江苏泰州225316 [6]同济大学附属上海市第四人民医院,上海200434 [7]复旦大学遗传工程国家重点实验室-人类表型组研究院-张江复旦国际创新中心-华山医院国家老年疾病临床医学研究中心,上海200438 [8]上海市重大传染病与生物安全研究院,上海200032

出　　处：《现代肿瘤医学》2023年第17期3289-3295,共7页Journal of Modern Oncology

基　　金：国家重点研发计划项目(编号:2019YFC1315804,2022YFC3400700);国家重点研发计划“精准医学研究”重点专项(编号:2017YFC0907000);国家自然科学基金项目(编号:82073637);上海市自然科学基金(编号:20ZR1405600);江苏省泰州市科技支撑计划(编号:TS202224);上海市第四人民医院学科助推计划重点项目(编号:SY-XKZT-2020-1002)。

摘　　要：目的:探究非高密度脂蛋白-胆固醇(non-high-density lipoprotein-cholesterol,non-HDL-C)和总胆固醇/高密度脂蛋白胆固醇(TC/HDL-C)比值与恶性肿瘤发病风险的关联,以评估其在肿瘤预防中的价值。方法:数据来源于2016年04月至2017年11月在上海松江区部分社区开展的自然人群队列。研究人群为20~74岁常住居民,并完成了问卷调查、体格检查和血液和尿液生化检测。采用Cox等比例风险回归模型和限制性立方样条函数估计non-HDL-C和TC/HDL-C比值水平与恶性肿瘤的关联及剂量-反应关系。结果:研究共纳入33414名研究对象,中位随访时间为4.88年,新发肿瘤病例911例。non-HDL-C水平与肿瘤发病风险呈负相关,1-SD增量non-HDL-C水平降低9%肿瘤发病风险。TC/HDL-C比值为2.03~2.97者的肿瘤发病风险增加。在男性和既往无糖尿病病史人群中均显示non-HDL-C的Q4水平组肿瘤发病风险低于Q1组[HR(95%CI)=0.74(0.56,0.99),HR(95%CI)=0.79(0.64,0.98)]。结论:non-HDL-C水平与恶性肿瘤发病风险有关,是潜在的可改变的肿瘤危险因素。Objective:Exploring the association between levels of non-HDL-C and TC/HDL-C ratio and cancer risk to assess the values in cancer prevention.Methods:The study was conducted on the general population cohort between April 2016 and November 2017 in several communities of Songjiang District.Permanent residents aged 20~74 years were recruited and they completed the questionnaires,physical examinations,and laboratory tests(blood and urine).Cox proportional hazard models and multivariable restricted cubic spline models were both used to assess the association and dose-response relationship of non-HDL-C and TC/HDL-C with cancer risk.Results:A total of 33414 participants were involved,with a median follow-up year of 4.88,and 911 were newly diagnosed with cancer.There was an inverse association between non-HDL-C levels and cancer risk,and a 1-SD increment of non-HDL-C decreased cancer risk by 9%.Individuals with TC/HDL-C at 2.03~2.97 had an increased risk of cancer.Individuals with high non-HDL-C levels had a lower risk of developing cancer than those with low non-HDL-C levels was shown in males and the population without diabetes[HR(95%CI)=0.74(0.56,0.99),HR(95%CI)=0.79(0.64,0.98)].Conclusion:non-HDL-C levels were associated with cancer risk,and it may be a potential modifiable risk factor of cancer.

关 键 词：血脂衍生指标 NON-HDL-C TC/HDL-C 肿瘤风险 

分 类 号：R730.1[医药卫生—肿瘤]