AJG: 长期使用他汀类药物后患者总胆固醇水平和结直肠癌风险的变化

2021-11-27 MedSci原创 MedSci原创

长期使用他汀类药物与结肠癌风险之间的关系!

      几十年来,他汀类降脂药是一种用于治疗高胆固醇血症和降低心脏死亡率和特效药物。同时,他汀类药物作为一种潜在的化学预防剂,学界已经进行了深入的研究,特别是对结直肠癌 (CRC)的影响更是研究热点。然而,目前的流行病学和长期使用他汀类药物的临床证据并不能对CRC的一级预防有确定性的结论。时间是结直肠癌化学预防的关键问题,正常黏膜一般至少需要10年才能恶变成CRC,因此,本项研究旨在探究他汀类药物使用对总胆固醇水平和CRC发生率的影响。

 

      研究人员使用护士健康研究和卫生专业人员的研究队列进行了随访研究,将符合条件的参与者(100,300 名女性和 47,991 名男性)进行了长达 24 年的随访跟踪。并运用Cox比例风险模型估计风险比和 95% 置信区间。

 

      随访期间研究人员总共记录了2,924 例CRC病例的发生。在完全调整后的分析中,他汀类药物使用时间越长,结肠癌风险越高(与从不使用者相比,他汀类使用1-5年的风险比1.09、95%CI:0.95-1.25;6-10 年的风险比为 1.16、95%CI:0.99-1.36; 11-15 年的风险比为 1.08、95%CI:0.81-1.44;>15 年的风险比为 1.85、95%CI:1.30-2.61;P = 0.004)。风险升高是由近端结肠癌驱动的(1-5年为 1.16、0.98-1.38;6-10 年为 1.19、0.98-1.45;11-15 年为 1.25、0.89-1.74;>15年为 2.17、1.46-3.24;P= 0.001)。另外,总胆固醇水平与 CRC 风险无关。

该研究的研究结果不支持他汀类药物在 CRC 化学预防中的益处,也不支持总胆固醇水平与 CRC 风险之间的任何关联。相反,长期使用他汀类药物可能与结肠癌风险增加有关。

原始出处:

Zhang, Yin. Et al. Long-Term Statin Use, Total Cholesterol Level, and Risk of Colorectal Cancer: A Prospective Cohort Study. The American Journal of Gastroenterology.2021.

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    2022-01-31 sjq027
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  5. [GetPortalCommentsPageByObjectIdResponse(id=1705386, encodeId=709c1e05386a5, content=<a href='/topic/show?id=7b9de87144b' target=_blank style='color:#2F92EE;'>#结直肠癌风险#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=44, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=78714, encryptionId=7b9de87144b, topicName=结直肠癌风险)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=c54a30977679, createdName=lfyang, createdTime=Tue May 24 00:59:17 CST 2022, time=2022-05-24, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=2062056, encodeId=776c2062056d8, content=<a href='/topic/show?id=e6e1e15509f' target=_blank style='color:#2F92EE;'>#癌风险#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=32, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=71550, encryptionId=e6e1e15509f, topicName=癌风险)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=d58a435, createdName=sjq027, createdTime=Mon Jan 31 15:59:17 CST 2022, time=2022-01-31, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1655292, encodeId=89b9165529272, content=<a href='/topic/show?id=966552e7237' target=_blank style='color:#2F92EE;'>#总胆固醇#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=42, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=52772, encryptionId=966552e7237, topicName=总胆固醇)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=741e24715588, createdName=ycmayy, createdTime=Thu Apr 21 00:59:17 CST 2022, time=2022-04-21, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=2010189, encodeId=43b92010189a6, content=<a href='/topic/show?id=3ea49698234' target=_blank style='color:#2F92EE;'>#长期使用#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=53, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=96982, encryptionId=3ea49698234, topicName=长期使用)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=365d170, createdName=chenwq08, createdTime=Tue Mar 15 18:59:17 CST 2022, time=2022-03-15, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=2057342, encodeId=a9a8205e34212, content=<a href='/topic/show?id=18982222db' target=_blank style='color:#2F92EE;'>#AJG#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=37, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=2222, encryptionId=18982222db, topicName=AJG)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=2978132, createdName=minzju5052, createdTime=Sat Apr 02 05:59:17 CST 2022, time=2022-04-02, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=2044627, encodeId=7ae5204462ee4, content=<a href='/topic/show?id=644725344b1' target=_blank style='color:#2F92EE;'>#他汀类药#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=23, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=25344, encryptionId=644725344b1, topicName=他汀类药)], attachment=null, authenticateStatus=null, createdAvatar=https://thirdwx.qlogo.cn/mmopen/vi_32/Q0j4TwGTfTIibticIBly5jCSic5ZElW4He3rO4DMpUHUFaFX57OicNMnzckWaicBNeStwugWHFCuOdicoakApM4HGmtw/132, createdBy=f8672500006, createdName=ms6390871039024434, createdTime=Tue Jul 26 09:59:17 CST 2022, time=2022-07-26, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1453621, encodeId=13e714536215b, content=<a href='/topic/show?id=098ee8679ad' target=_blank style='color:#2F92EE;'>#结直肠#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=27, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=78679, encryptionId=098ee8679ad, topicName=结直肠)], attachment=null, authenticateStatus=null, createdAvatar=/v1.0.0/img/user_icon.png, createdBy=9ace5575596, createdName=crystal0564, createdTime=Mon Nov 29 06:59:17 CST 2021, time=2021-11-29, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1074722, encodeId=9b1610e4722f1, content=不会吧, beContent=null, objectType=article, channel=null, level=null, likeNumber=54, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=96425723286, createdName=ms5000000353966274, createdTime=Sun Nov 28 10:02:21 CST 2021, time=2021-11-28, status=1, ipAttribution=)]
    2022-04-02 minzju5052
  6. [GetPortalCommentsPageByObjectIdResponse(id=1705386, encodeId=709c1e05386a5, content=<a href='/topic/show?id=7b9de87144b' target=_blank style='color:#2F92EE;'>#结直肠癌风险#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=44, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=78714, encryptionId=7b9de87144b, topicName=结直肠癌风险)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=c54a30977679, createdName=lfyang, createdTime=Tue May 24 00:59:17 CST 2022, time=2022-05-24, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=2062056, encodeId=776c2062056d8, content=<a href='/topic/show?id=e6e1e15509f' target=_blank style='color:#2F92EE;'>#癌风险#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=32, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=71550, encryptionId=e6e1e15509f, topicName=癌风险)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=d58a435, createdName=sjq027, createdTime=Mon Jan 31 15:59:17 CST 2022, time=2022-01-31, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1655292, encodeId=89b9165529272, content=<a href='/topic/show?id=966552e7237' target=_blank style='color:#2F92EE;'>#总胆固醇#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=42, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=52772, encryptionId=966552e7237, topicName=总胆固醇)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=741e24715588, createdName=ycmayy, createdTime=Thu Apr 21 00:59:17 CST 2022, time=2022-04-21, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=2010189, encodeId=43b92010189a6, content=<a href='/topic/show?id=3ea49698234' target=_blank style='color:#2F92EE;'>#长期使用#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=53, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=96982, encryptionId=3ea49698234, topicName=长期使用)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=365d170, createdName=chenwq08, createdTime=Tue Mar 15 18:59:17 CST 2022, time=2022-03-15, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=2057342, encodeId=a9a8205e34212, content=<a href='/topic/show?id=18982222db' target=_blank style='color:#2F92EE;'>#AJG#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=37, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=2222, encryptionId=18982222db, topicName=AJG)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=2978132, createdName=minzju5052, createdTime=Sat Apr 02 05:59:17 CST 2022, time=2022-04-02, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=2044627, encodeId=7ae5204462ee4, content=<a href='/topic/show?id=644725344b1' target=_blank style='color:#2F92EE;'>#他汀类药#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=23, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=25344, encryptionId=644725344b1, topicName=他汀类药)], attachment=null, authenticateStatus=null, createdAvatar=https://thirdwx.qlogo.cn/mmopen/vi_32/Q0j4TwGTfTIibticIBly5jCSic5ZElW4He3rO4DMpUHUFaFX57OicNMnzckWaicBNeStwugWHFCuOdicoakApM4HGmtw/132, createdBy=f8672500006, createdName=ms6390871039024434, createdTime=Tue Jul 26 09:59:17 CST 2022, time=2022-07-26, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1453621, encodeId=13e714536215b, content=<a href='/topic/show?id=098ee8679ad' target=_blank style='color:#2F92EE;'>#结直肠#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=27, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=78679, encryptionId=098ee8679ad, topicName=结直肠)], attachment=null, authenticateStatus=null, createdAvatar=/v1.0.0/img/user_icon.png, createdBy=9ace5575596, createdName=crystal0564, createdTime=Mon Nov 29 06:59:17 CST 2021, time=2021-11-29, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1074722, encodeId=9b1610e4722f1, content=不会吧, beContent=null, objectType=article, channel=null, level=null, likeNumber=54, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=96425723286, createdName=ms5000000353966274, createdTime=Sun Nov 28 10:02:21 CST 2021, time=2021-11-28, status=1, ipAttribution=)]
  7. [GetPortalCommentsPageByObjectIdResponse(id=1705386, encodeId=709c1e05386a5, content=<a href='/topic/show?id=7b9de87144b' target=_blank style='color:#2F92EE;'>#结直肠癌风险#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=44, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=78714, encryptionId=7b9de87144b, topicName=结直肠癌风险)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=c54a30977679, createdName=lfyang, createdTime=Tue May 24 00:59:17 CST 2022, time=2022-05-24, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=2062056, encodeId=776c2062056d8, content=<a href='/topic/show?id=e6e1e15509f' target=_blank style='color:#2F92EE;'>#癌风险#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=32, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=71550, encryptionId=e6e1e15509f, topicName=癌风险)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=d58a435, createdName=sjq027, createdTime=Mon Jan 31 15:59:17 CST 2022, time=2022-01-31, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1655292, encodeId=89b9165529272, content=<a href='/topic/show?id=966552e7237' target=_blank style='color:#2F92EE;'>#总胆固醇#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=42, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=52772, encryptionId=966552e7237, topicName=总胆固醇)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=741e24715588, createdName=ycmayy, createdTime=Thu Apr 21 00:59:17 CST 2022, time=2022-04-21, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=2010189, encodeId=43b92010189a6, content=<a href='/topic/show?id=3ea49698234' target=_blank style='color:#2F92EE;'>#长期使用#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=53, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=96982, encryptionId=3ea49698234, topicName=长期使用)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=365d170, createdName=chenwq08, createdTime=Tue Mar 15 18:59:17 CST 2022, time=2022-03-15, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=2057342, encodeId=a9a8205e34212, content=<a href='/topic/show?id=18982222db' target=_blank style='color:#2F92EE;'>#AJG#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=37, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=2222, encryptionId=18982222db, topicName=AJG)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=2978132, createdName=minzju5052, createdTime=Sat Apr 02 05:59:17 CST 2022, time=2022-04-02, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=2044627, encodeId=7ae5204462ee4, content=<a href='/topic/show?id=644725344b1' target=_blank style='color:#2F92EE;'>#他汀类药#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=23, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=25344, encryptionId=644725344b1, topicName=他汀类药)], attachment=null, authenticateStatus=null, createdAvatar=https://thirdwx.qlogo.cn/mmopen/vi_32/Q0j4TwGTfTIibticIBly5jCSic5ZElW4He3rO4DMpUHUFaFX57OicNMnzckWaicBNeStwugWHFCuOdicoakApM4HGmtw/132, createdBy=f8672500006, createdName=ms6390871039024434, createdTime=Tue Jul 26 09:59:17 CST 2022, time=2022-07-26, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1453621, encodeId=13e714536215b, content=<a href='/topic/show?id=098ee8679ad' target=_blank style='color:#2F92EE;'>#结直肠#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=27, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=78679, encryptionId=098ee8679ad, topicName=结直肠)], attachment=null, authenticateStatus=null, createdAvatar=/v1.0.0/img/user_icon.png, createdBy=9ace5575596, createdName=crystal0564, createdTime=Mon Nov 29 06:59:17 CST 2021, time=2021-11-29, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1074722, encodeId=9b1610e4722f1, content=不会吧, beContent=null, objectType=article, channel=null, level=null, likeNumber=54, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=96425723286, createdName=ms5000000353966274, createdTime=Sun Nov 28 10:02:21 CST 2021, time=2021-11-28, status=1, ipAttribution=)]
  8. [GetPortalCommentsPageByObjectIdResponse(id=1705386, encodeId=709c1e05386a5, content=<a href='/topic/show?id=7b9de87144b' target=_blank style='color:#2F92EE;'>#结直肠癌风险#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=44, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=78714, encryptionId=7b9de87144b, topicName=结直肠癌风险)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=c54a30977679, createdName=lfyang, createdTime=Tue May 24 00:59:17 CST 2022, time=2022-05-24, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=2062056, encodeId=776c2062056d8, content=<a href='/topic/show?id=e6e1e15509f' target=_blank style='color:#2F92EE;'>#癌风险#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=32, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=71550, encryptionId=e6e1e15509f, topicName=癌风险)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=d58a435, createdName=sjq027, createdTime=Mon Jan 31 15:59:17 CST 2022, time=2022-01-31, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1655292, encodeId=89b9165529272, content=<a href='/topic/show?id=966552e7237' target=_blank style='color:#2F92EE;'>#总胆固醇#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=42, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=52772, encryptionId=966552e7237, topicName=总胆固醇)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=741e24715588, createdName=ycmayy, createdTime=Thu Apr 21 00:59:17 CST 2022, time=2022-04-21, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=2010189, encodeId=43b92010189a6, content=<a href='/topic/show?id=3ea49698234' target=_blank style='color:#2F92EE;'>#长期使用#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=53, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=96982, encryptionId=3ea49698234, topicName=长期使用)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=365d170, createdName=chenwq08, createdTime=Tue Mar 15 18:59:17 CST 2022, time=2022-03-15, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=2057342, encodeId=a9a8205e34212, content=<a href='/topic/show?id=18982222db' target=_blank style='color:#2F92EE;'>#AJG#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=37, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=2222, encryptionId=18982222db, topicName=AJG)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=2978132, createdName=minzju5052, createdTime=Sat Apr 02 05:59:17 CST 2022, time=2022-04-02, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=2044627, encodeId=7ae5204462ee4, content=<a href='/topic/show?id=644725344b1' target=_blank style='color:#2F92EE;'>#他汀类药#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=23, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=25344, encryptionId=644725344b1, topicName=他汀类药)], attachment=null, authenticateStatus=null, createdAvatar=https://thirdwx.qlogo.cn/mmopen/vi_32/Q0j4TwGTfTIibticIBly5jCSic5ZElW4He3rO4DMpUHUFaFX57OicNMnzckWaicBNeStwugWHFCuOdicoakApM4HGmtw/132, createdBy=f8672500006, createdName=ms6390871039024434, createdTime=Tue Jul 26 09:59:17 CST 2022, time=2022-07-26, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1453621, encodeId=13e714536215b, content=<a href='/topic/show?id=098ee8679ad' target=_blank style='color:#2F92EE;'>#结直肠#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=27, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=78679, encryptionId=098ee8679ad, topicName=结直肠)], attachment=null, authenticateStatus=null, createdAvatar=/v1.0.0/img/user_icon.png, createdBy=9ace5575596, createdName=crystal0564, createdTime=Mon Nov 29 06:59:17 CST 2021, time=2021-11-29, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1074722, encodeId=9b1610e4722f1, content=不会吧, beContent=null, objectType=article, channel=null, level=null, likeNumber=54, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=96425723286, createdName=ms5000000353966274, createdTime=Sun Nov 28 10:02:21 CST 2021, time=2021-11-28, status=1, ipAttribution=)]
    2021-11-28 ms5000000353966274

    不会吧

    0

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