诊断前循环胆汁酸浓度与肝癌风险:12个队列的巢式病例对照分析

IF 4.1 Q2 ONCOLOGY
Cody Z Watling, Jessica L Petrick, Barry I Graubard, Xuehong Zhang, Matthew J Barnett, Julie E Buring, Yu Chen, A Heather Eliassen, J Michael Gaziano, Jonathan N Hofmann, Wen-Yi Huang, Jae H Kang, Jill Koshiol, Erikka Loftfield, I-Min Lee, Steven C Moore, Lorelei A Mucci, Marian L Neuhouser, Christina C Newton, Julie R Palmer, Mark P Purdue, Lynn Rosenberg, Howard D Sesso, Martha Shrubsole, Lesley Tinker, Matthew Triplette, Caroline Y Um, Kala Visvanathan, Eleanor L Watts, Jean Wactawski-Wende, Walter Willett, Fen Wu, Wei Zheng, Peter T Campbell, Dinesh Barupal, Katherine A McGlynn
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引用次数: 0

摘要

背景:胆汁酸在肝脏中产生,对脂质消化很重要。然而,较高的循环胆汁酸水平与代谢紊乱、炎症和肠道菌群失调有关,这与肝癌的发生有关。迄今为止,很少有流行病学研究探讨循环胆汁酸与肝癌风险之间的关系。方法:我们在美国的12项前瞻性队列研究中进行了巢式病例对照研究。研究人员从872名肝癌患者和872名对照者的血液样本中测量了15种诊断前循环胆汁酸。比值比(OR)和95%置信区间(CI)使用循环胆汁酸水平和肝癌风险的多变量调整条件logistic回归分析进行估计。结果:原发性共轭胆汁酸浓度与肝癌的高风险呈正相关(糖胆酸浓度每增加一倍的OR [log2], 95% CI: 1.32, 1.24-1.40;糖胆酸:1.33,1.24-1.43;牛磺胆酸:1.28,1.22-1.35;牛磺酸去氧胆酸:1.32,1.24-1.39)。次级共轭胆汁酸也与肝癌风险呈正相关(浓度的两倍OR范围为1.11至1.22)。除石胆酸外,未结合胆汁酸浓度通常与肝癌风险无关(OR: 1.27, 1.16-1.39)。当分析结果被分为肝癌的两种主要亚型,肝细胞癌(HCC, 438例/438例对照)和肝内胆管癌(ICC, 111例/111例对照)时,发现原发性共轭胆汁酸浓度存在显著的异质性(所有p值)。结论:这些结果表明胆汁酸可能是HCC风险的重要标志物,并有助于肝癌的发生;然而,需要进一步使用系列测量进行研究。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Pre-diagnostic circulating bile acid concentrations and liver cancer risk: a nested case-control analysis of 12 cohorts.

Background: Bile acids are produced in the liver and are important for lipid digestion. Higher-circulating bile acid levels, however, have been linked to metabolic disorders, inflammation, and gut microbiota dysbiosis, which have been implicated in liver carcinogenesis. To date, few epidemiological studies have explored the association between circulating bile acids and liver cancer risk.

Methods: We conducted a nested case-control study among 12 prospective cohort studies located in the United States. Fifteen prediagnostic circulating bile acids were measured from blood samples among 872 individuals who developed liver cancer and 872 matched control participants. Odds ratios (ORs) and 95% confidence intervals (CIs) were estimated using multivariable-adjusted conditional logistic regression analysis of circulating bile acid levels and liver cancer risk.

Results: Primary conjugated bile acid concentrations were positively associated with higher risk of liver cancer (OR per doubling in concentrations [log2] and 95% CI of glycocholic acid: 1.32, 1.24 to 1.40; glycochenodeoxycholic acid: 1.33, 1.24 to 1.43; taurocholic acid: 1.28, 1.22 to 1.35; and taurchenodeoxycholic acid: 1.32, 1.24 to 1.39). Secondary conjugated bile acids were also positively associated with liver cancer risk (doubling of concentrations OR ranged from 1.11 to 1.22). Unconjugated bile acid concentrations were generally not associated with liver cancer risk, except lithocholic acid (OR per doubling: 1.27, 1.16 to 1.39). When analyses were separated into the 2 main subtypes of liver cancer, hepatocellular carcinoma (HCC; 438 cases/438 controls) and intrahepatic cholangiocarcinoma (ICC; 111 cases/111 controls), significant heterogeneity was observed for primary conjugated bile acid concentrations (all P < .001) that showed positive significant associations with HCC but not ICC.

Conclusions: These results suggest that bile acids may be important markers of HCC risk and contribute to hepatocarcinogenesis; however, further research using serial measurements is needed.

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来源期刊
JNCI Cancer Spectrum
JNCI Cancer Spectrum Medicine-Oncology
CiteScore
7.70
自引率
0.00%
发文量
80
审稿时长
18 weeks
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