PLOS MED:体检关注这一指标——脂蛋白A或会增加“癌王”前列腺癌风险

2022-02-07 MedSci原创 MedSci原创

遗传预测的脂蛋白(a)浓度与PCa风险的增加有关。

前列腺癌(PCa)是男性最常诊断的癌症之一,也因其高死亡率被称为“癌中之王”。2018年全球共报告了1276106例发病病例。PCa发病率差异很大,这体现在全球范围内年龄调整后的发病率有40倍的差异。

一些研究认为,这可能是由于在前列腺特异性抗原(PSA)筛查盛行的国家,诊断的数量增加。目前已确定的PCa的危险因素包括年龄较大、非洲裔和遗传等不可改变因素,而侵略性PCa的一些潜在危险因素包括吸烟、肥胖、维生素D较低和血脂水平较高。

为了明确遗传预测的血脂浓度与PCa之间的关系,来自英国伦敦帝国学院公共卫生学院流行病学和生物统计学系的专家开展了相关研究,结果发表在PLOS Medicine杂志上。

低密度脂蛋白(LDL)胆固醇、高密度脂蛋白(HDL)胆固醇、甘油三酯(TG)、载脂蛋白A(apoA)和B(apoB)、脂蛋白A(Lp(a))和PCa的数据分别来自英国生物库和PRACTICAL联盟的全基因组关联研究。使用了双样本汇总级孟德尔随机化(MR)方法,同时使用了单变量和多变量(MVMR)模型,并利用各种稳健方法和敏感性分析来评估违反MR假设的可能性。

总的来说,没有观察到HDL、TG、apoA和apoB的遗传预测浓度与PCa风险之间的关联。在单变量分析中,遗传预测的LDL浓度与总的PCa呈正相关,但HDL、TG和Lp(a)的没有看到明显的关联。

进一步在单变量(每标准差的OR加权中值(SD)=1.091;95%CI 1.028至1.157;P=0.004)和调整其他血脂特征后的MVMR分析中,遗传预测的Lp(a)浓度与较高的总PCa风险相关(每SD的ORIVW=1.068;95%CI 1.005-1.134;P=0.034)。遗传预测的Lp(a)也与晚期(OR per SD = 1.078; 95% CI 0.999-1.163; P = 0.055)和早年发病的PCa(OR per SD = 1.150; 95% CI 1.015-1.303; P = 0.028)有关。

由此可见,遗传预测的脂蛋白(a)浓度与PCa风险的增加有关。

 

参考文献:

The relationship between lipoprotein A and other lipids with prostate cancer risk: A multivariable Mendelian randomisation study. https://doi.org/10.1371/journal.pmed.1003859

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    2022-05-30 sjq027
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    2022-02-08 marongnuan
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    2022-02-08 zhouqu_8
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    2022-02-07 ms4000000835327611

    学习了

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