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Influence of ideal cardiovascular health behaviors and factors on the onset of primary liver cancer
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摘要:
目的探究理想心血管健康行为和因素对中国北方地区原发性肝癌的发病有无影响。方法采用前瞻性队列的研究方法,收集2006年7月-2007年6月95 055例参加健康查体的开滦集团在职及离退休职工的体检资料,并对原发性肝癌的发病情况进行随访。根据心血管健康评分（CHS）对研究对象进行分组,其中第一分位组（CHS≤7分） 27 143例,第二分位组（7分<CHS≤9分） 35 488例,第三分位组（9分<CHS≤14分） 32 424例,计算各组的肝癌人年发病率。正态分布的计量资料多组间比较采用单因素方差分析;偏态分布的计量资料多组间比较采用Kruskal-Wallis H检验。计数资料组间比较采用χ2检验。用寿命表法计算各分组原发性肝癌的累积发病率,并用log-rank检验比较组间累积发病率的差异;采用Cox比例风险模型分析理想心血管健康行为和因素对原发性肝癌发病的影响。结果 3组年龄、男性比例、BMI、总胆固醇、空腹血糖、ALT、超敏C反应蛋白水平及饮酒、家庭收入、受教育程度、脂肪肝、癌症家族史、理想吸烟、理想体育锻炼、理想BMI、理想血压、理想总胆固醇、理想血糖、理想饮食比例组...
Abstract:Objective To investigate the influence of ideal cardiovascular health behaviors and factors on the onset of primary liver cancer in northern China. Methods A prospective cohort study was conducted for 95 055 on-the-job or retired employees of Kailuan Group who underwent physical examination from July 2006 to June 2007,and related data were collected. They were followed up to observe the onset of primary liver cancer. According to the cardiovascular health score( CHS),the subjects were divided into first quartile group with 27 143 subjects( CHS≤7),second quartile group with 35 488 subjects( 7 < CHS≤9),and third quartile group with 32 424 subjects( 9 < CHS≤14),and the person-year incidence rate was calculated. A one-way analysis of variance was used for comparison of normally distributed continuous data between multiple groups,and the Kruskal-Wallis H test was used for comparison of continuous data with skewed distribution between multiple groups. The chi-square test was used for comparison of categorical data between groups. The life-table method was used to calculate the cumulative incidence rate of primary liver cancer,and the log-rank test was used for comparison of cumulative incidence rate between groups. The Cox proportional hazards model was used to analyze the influence of ideal cardiovascular health behaviors and factors on the onset of primary liver cancer. Results There were significant differences between the three groups in age,male/female ratio,body mass index,total cholesterol,fasting blood glucose,alanine aminotransferase,hypersensitive C-reactive protein,drinking,family income,educational level,fatty liver disease,family history of cancer,and proportion of subjects with ideal smoking,ideal physical exercise,ideal body mass index,ideal blood pressure,ideal total cholesterol,ideal blood glucose,and ideal diet ratio( all P < 0. 05). The mean follow-up time was 11. 49 ± 1. 86 years,and a total of 387 cases of primary liver cancer were observed,among whom there were 360 male and 27 female patients. The person-year incidence rates of the three groups were 4. 11/10 000 person-years,3. 78/10 000 person-years,and 2. 84/10 000 person-years,respectively. The 10-year cumulative incidence rates of the three groups were 4. 43‰,3. 61‰,and 2. 84‰,respectively,and there was a significant difference in the cumulative incidence rate between the three groups( χ2= 8. 29,P =0. 016). The Cox proportional hazards model showed that after adjustment for confounding factors( age,sex,alanine aminotransferase,hypersensitive C-reactive protein,drinking,family income,educational level,positive HBs Ag,liver cirrhosis,fatty liver disease,and family history of cancer),compared with the first quartile group,the second quartile group had a hazard ratio( HR) of 0. 87( 95% confidence interval [CI]: 0. 67-1. 13) and the third quartile group had an HR of 0. 74( 95% CI: 0. 56-0. 98)( P for trend < 0. 05). Conclusion The higher scores of ideal cardiovascular health behaviors and factors play a protective role in the onset of primary liver cancer,and the risk of primary liver cancer decreases with the increase in cardiovascular score.
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Key words:
- liver neoplasms /
- healthy lifestyle /
- cohort studies
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