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

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.